{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:57:36Z","timestamp":1790744256462,"version":"4.1.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In COVID-19 patients requiring mechanical ventilation, the administration of high oxygen (O<jats:sub>2<\/jats:sub>) doses for prolonged time periods may be necessary. Although life-saving in most cases, O<jats:sub>2<\/jats:sub> may exert deleterious effects if administered in excessive concentrations. We aimed to describe the prevalence of hyperoxemia and excessive O<jats:sub>2<\/jats:sub> administration in mechanically ventilated patients with SARS-CoV-2 pneumonia and determine whether hyperoxemia is associated with mortality in the Intensive Care Unit (ICU) or the onset of ventilator-associated pneumonia (VAP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Retrospective single-center study on adult patients with SARS-CoV-2 pneumonia requiring invasive mechanical ventilation for \u226548 h. Patients undergoing extracorporeal respiratory support were excluded. We calculated the excess O<jats:sub>2<\/jats:sub> administered based on the ideal arterial O<jats:sub>2<\/jats:sub> tension (PaO<jats:sub>2<\/jats:sub>) target of 55\u201380 mmHg. We defined hyperoxemia as PaO<jats:sub>2<\/jats:sub> &amp;gt; 100 mmHg and hyperoxia + hyperoxemia as an inspired O<jats:sub>2<\/jats:sub> fraction (FiO<jats:sub>2<\/jats:sub>) &amp;gt; 60% + PaO<jats:sub>2<\/jats:sub> &amp;gt; 100 mmHg. Risk factors for ICU-mortality and VAP were assessed through multivariate analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred thirty-four patients were included. For each day of mechanical ventilation, each patient received a median excess O<jats:sub>2<\/jats:sub> of 1,121 [829\u20131,449] L. Hyperoxemia was found in 38 [27\u201355]% of arterial blood gases, hyperoxia + hyperoxemia in 11 [5\u201318]% of cases. The FiO<jats:sub>2<\/jats:sub> was not reduced in 69 [62\u201376]% of cases of hyperoxemia. Adjustments were made more frequently with higher PaO<jats:sub>2<\/jats:sub> or initial FiO<jats:sub>2<\/jats:sub> levels. ICU-mortality was 32%. VAP was diagnosed in 48.5% of patients. Hyperoxemia (OR 1.300 95% CI [1.097\u20131.542]), time of exposure to hyperoxemia (OR 2.758 [1.406\u20135.411]), hyperoxia + hyperoxemia (OR 1.144 [1.008\u20131.298]), and daily excess O<jats:sub>2<\/jats:sub> (OR 1.003 [1.001\u20131.005]) were associated with higher risk for ICU-mortality, independently of age, Sequential Organ failure Assessment score at ICU-admission and mean PaO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub>. Hyperoxemia (OR 1.033 [1.006\u20131.061]), time of exposure to hyperoxemia (OR 1.108 [1.018\u20131.206]), hyperoxia + hyperoxemia (OR 1.038 [1.003\u20131.075]), and daily excess O<jats:sub>2<\/jats:sub> (OR 1.001 [1.000\u20131.001]) were identified as risk factors for VAP, independently of body mass index, blood transfusions, days of neuromuscular blocking agents (before VAP), prolonged prone positioning and mean PaO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub> before VAP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Excess O<jats:sub>2<\/jats:sub> administration and hyperoxemia were common in mechanically ventilated patients with SARS-CoV-2 pneumonia. The exposure to hyperoxemia may be associated with ICU-mortality and greater risk for VAP.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.957773","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T05:14:07Z","timestamp":1658985247000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Too much tolerance for hyperoxemia in mechanically ventilated patients with SARS-CoV-2 pneumonia? 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