JAMA

Restrictive vs. liberal oxygen therapy in trauma patients

December 19, 2024

Study design: The TRAUMOX2 randomized trial investigated whether an early 8-hour restrictive oxygen strategy, compared with a liberal oxygen strategy, would reduce death and/or major respiratory complications in adult trauma patients. The study enrolled 1,508 patients from 15 prehospital bases and 5 major trauma centers in Denmark, the Netherlands, and Switzerland. Participants were randomized to receive either restrictive or liberal oxygen therapy upon trauma center admission or in the prehospital setting.

Results: The trial found no significant difference in the primary outcome of death and/or major respiratory complications within 30 days between the restrictive and liberal oxygen groups (16.1% vs. 16.7%, respectively). Both strategies resulted in similar outcomes, indicating that a restrictive oxygen approach didn't confer additional benefits over a liberal strategy in this patient population.

Impact on clinical practice: These findings suggest that early restrictive oxygen therapy doesn't reduce mortality or major respiratory complications compared with liberal oxygen therapy in severely injured trauma patients. This may influence guidelines and clinical practice regarding oxygen administration in trauma care, emphasizing the need for individualized patient management.

Source:

Arleth T, et al. (2024, December 10). JAMA. Early Restrictive vs Liberal Oxygen for Trauma Patients: The TRAUMOX2 Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/39657224/