Effect of early hyperoxemia on the outcome in servere blunt chest trauma: A propensity score-based analysis of a single-center retrospective cohort

Gary Duclos (1) , Adrien Rivory (1) , Noémie Rességuier (2, 3) , Emmanuelle Hammad (1) , Coralie Vigne (1) , Zoé Meresse (1) , Bruno Pastène (1) , Xavier-Benoit d'Journo (1) , Samir Jaber (4, 5) , Laurent Zieleskiewicz (1, 6) , Marc Leone (1, 7) , Baptiste Maille , Marie Wilkin , Matthieu Million , Frédéric Franceschi , Linda Koutbi-Franceschi , Jérôme Hourdain , Elisa Martinez , Maxime Zabern , Christophe Gardella , Hervé Tissot-Dupont , Jagmeet Singh , Jean-Claude Deharo , Laurent Fiorina

1 APHM - Assistance Publique - Hôpitaux de Marseille
2 Support Unit for Clinical Research and Economic Evaluation, Assistance Publique-Hôpitaux de Marseille, Marseille 13385
3 CEReSS - Centre d'études et de recherche sur les services de santé et la qualité de vie
4 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
5 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
6 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
7 MEPHI - Microbes évolution phylogénie et infections

Purpose Our study aimed to explore the association between early hyperoxemia of the first 24 h on outcomes in patients with severe blunt chest trauma. Materials and methods In a level I trauma center, we conducted a retrospective study of 426 consecutive patients. Hyperoxemic groups were classified in severe (average PaO2 ≥ 200 mmHg), moderate (≥150 and < 200 mmHg) or mild (≥ 100 and < 200 mmHg) and compared to control group (≥60 and < 100 mmHg) using a propensity score based analysis. The first endpoint was the incidence of a composite outcome including death and hospital-acquired pneumonia occurring from admission to day 28. The secondary endpoints were the incidence of death, the number of hospital-acquired pneumonia, mechanical ventilation-free days and intensive care unit-free day at day 28. Results The incidence of the composite endpoint was lower in the severe hyperoxemia group(OR, 0.25; 95%CI, 0.09–0.73; P < 0.001) compared with control. The 28-day mortality incidence was lower in severe (OR, 0.23; 95%CI, 0.08–0.68; P < 0.001) hyperoxemia group (OR, 0.41; 95%CI, 0.17–0.97; P = 0.04). Significant association was found between hyperoxemia and secondary outcomes. Conclusion In our cohort early hyperoxemia during the first 24 h of admission after severe blunt chest trauma was not associated with worse outcome.

Mots clés: Blunt chest trauma; Hyperoxia; ARDS; Pneumonia; Critical care; Mechanical ventilation

Domaines: Sciences du Vivant [q-bio]

Gary Duclos, Adrien Rivory, Noémie Rességuier, Emmanuelle Hammad, Coralie Vigne, et al.. Effect of early hyperoxemia on the outcome in servere blunt chest trauma: A propensity score-based analysis of a single-center retrospective cohort. Journal of Critical Care, 2021, 63, pp.179-186. ⟨10.1016/j.jcrc.2020.09.008⟩. ⟨hal-02941991⟩