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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Medical research and clinical decision-making are based on the constant evolution of scientific evidence&#46; In this context&#44; the publication of meta-analyses and systematic reviews is essential to provide guidance to health care professionals&#46; The recently published study&#44; &#8220;Conservative versus liberal oxygen therapy in relation to all-cause mortality among patients in the intensive care unit&#58; a systematic review of randomized controlled trials with meta-analysis and trial sequential analysis&#8221;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> provides a valuable analysis of the medical literature current available up to the date of its analysis&#44; and sheds light on the implications of oxygen therapy in patients at the ICU setting&#46; However&#44; the ever-evolving nature of medical research has given us a new opportunity to expand and enrich its conclusions&#46; The aim of this article is to present a brief updated analysis&#8212;including additional studies recently published&#8212;to provide a more comprehensive and up-to-date view of short-term mortality in conservative oxygen vs liberal oxygen therapy in patients at the ICU setting&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">To identify the new relevant studies that should be added to this updated analysis&#44; a search was conducted in the Cochrane Plus database&#46; The search was conducted using its advanced search panel&#44; and specific criteria were applied to guarantee the inclusion of relevant articles&#46; The following English search terms were used&#58; &#8220;liberal oxygen therapy&#8221; and &#8220;conservative oxygen therapy&#46;&#8221; A temporal filter was applied to include only studies published over the past 3 years to ensure the inclusion of the most recent evidence available&#46; Also&#44; the search was limited to clinical trials to guarantee the quality and relevance of the studies selected for this updated analysis&#46; The search strategy was conducted systematically&#44; following Cochrane Plus guidelines and adhered to best practices available in medical literature review&#46; The studies identified through this process underwent a selection and evaluation process&#44; and those that met the inclusion criteria were considered for further analysis in this article&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Short-term mortality was defined as a clinical outcome&#58; studies reporting on 28-day mortality rates were included by default&#44; as this timeframe is a commonly accepted indicator of early clinical outcomes in critically ill patients&#46; However&#44; aware of the fact that some studies may have included 30-day mortality rate assessments&#44; we decided to include this data too&#44; considering that the 30-day timeframe is consistent with a short-term outcome in the context of critically ill patients at the ICU setting&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">A total of 9 randomized clinical trials were analyzed including 6 studies analyzed in Li et al&#46;&#8217;s work<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and 3 new trials&#58; Nafae et al&#46;&#8217;s study&#44;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and the post hoc analysis data of patients with sepsis from the ICU-ROX trial&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> and the ICONIC trial&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> These 9 trials included a total of 5216 patients admitted to the ICU&#46; The results did not show a significantly lower all-cause mortality rate in the short-term with the use of conservative oxygen therapy &#40;OR&#44; 0&#46;97&#59; 95&#37;CI&#44; 0&#46;86&#8211;1&#46;09 in the common effects model&#59; OR&#44; 0&#46;88&#59; 95&#37;CI&#44; 0&#46;71&#8211;1&#46;09 in the random effects model&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The results indicate moderate variability &#40;I&#178; of 44&#46;81&#37;&#41; that cannot be attributed to simple sampling error&#46; This heterogeneity&#44; referring to differences among studies in terms of population&#44; design&#44; or outcome measurement&#44; requires careful consideration when interpreting the results&#46; We did not find any statistically significant evidence either to support the lack of heterogeneity &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#62;&#8239;0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> shows the funnel plot of effect size against precision in a scatterplot&#46; The funnel plot exhibits a tilt toward the left&#44; which could be indicative of potential publication bias where studies with negative results are not disclosed&#46; Girardis et al&#46;&#8217;s work<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> deviates from the general shape of the funnel &#40;outlier&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">These results just do not clarify the debate of whether patients ventilated in the ICU setting with liberal oxygen therapy are genuinely at risk of developing hyperoxia and lung damage&#46; It is hypothesized that oxidative stress following the production of reactive agents with oxidant properties could be an important mechanism in the development of lung damage&#44; inducing phenomena such as apoptosis of the alveolar epithelium and changes to cellular functions&#44; especially at mitochondrial level&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;7</span></a> Although the prolonged use of a high fraction of inspired oxygen has historically been associated with potential detrimental effects on the lungs&#8212;mainly mild injuries such as atelectasis and hyperoxic bronchitis&#8212;a characteristic diffuse alveolar damage has not been found yet&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The question of whether hyperoxia and lung damage are legitimate concerns in patients on liberal oxygen therapy at the ICU setting remains a matter of discussion and requires a more detailed evaluation and understanding&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Despite the moderate variability seen&#44; our analyses support the need for a cautious approach when extrapolating the conclusions of individual studies to a broader context&#44; thus recognizing that differences seen among studies can have an impact on the results and should be considered in future research and clinical practices&#46;</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Funding</span><p id="par0050" class="elsevierStylePara elsevierViewall">This manuscript received no funding&#46;</p></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">None of the authors declared any conflicts of interest at the completion of this study&#46;</p></span></span>"
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                        "link" => array:1 [
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                        "link" => array:1 [
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                            "web" => "Medline"
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                        "paginaFinal" => "757"
                        "link" => array:1 [
                          0 => array:2 [
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                            "web" => "Medline"
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Letter to the Editor
Expanding the evidence: A brief updated analysis of short-term mortality in conservative oxygen therapy versus liberal oxygen therapy in intensive care unit patients
Ampliando la evidencia: breve análisis actualizado de la mortalidad a corto plazo en la oxigenoterapia conservadora frente a la oxigenoterapia liberal en pacientes de unidades de cuidados intensivos
Alejandro González-Castroa,
Corresponding author
e409@humv.es

Corresponding author.
, Yhivian Peñascoa, Claudia Silva-Garciaa, Carmen Huertas Martina, Camilo Gonzaleza, Raquel Ferrero-Francob
a Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
b Diplomado Universitario de Enfermería (DUE), Servicio Cántabro de Salud, Santander, Cantabria, Spain
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        "titulo" => "Ampliando la evidencia&#58; breve an&#225;lisis actualizado de la mortalidad a corto plazo en la oxigenoterapia conservadora frente a la oxigenoterapia liberal en pacientes de unidades de cuidados intensivos"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Medical research and clinical decision-making are based on the constant evolution of scientific evidence&#46; In this context&#44; the publication of meta-analyses and systematic reviews is essential to provide guidance to health care professionals&#46; The recently published study&#44; &#8220;Conservative versus liberal oxygen therapy in relation to all-cause mortality among patients in the intensive care unit&#58; a systematic review of randomized controlled trials with meta-analysis and trial sequential analysis&#8221;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> provides a valuable analysis of the medical literature current available up to the date of its analysis&#44; and sheds light on the implications of oxygen therapy in patients at the ICU setting&#46; However&#44; the ever-evolving nature of medical research has given us a new opportunity to expand and enrich its conclusions&#46; The aim of this article is to present a brief updated analysis&#8212;including additional studies recently published&#8212;to provide a more comprehensive and up-to-date view of short-term mortality in conservative oxygen vs liberal oxygen therapy in patients at the ICU setting&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">To identify the new relevant studies that should be added to this updated analysis&#44; a search was conducted in the Cochrane Plus database&#46; The search was conducted using its advanced search panel&#44; and specific criteria were applied to guarantee the inclusion of relevant articles&#46; The following English search terms were used&#58; &#8220;liberal oxygen therapy&#8221; and &#8220;conservative oxygen therapy&#46;&#8221; A temporal filter was applied to include only studies published over the past 3 years to ensure the inclusion of the most recent evidence available&#46; Also&#44; the search was limited to clinical trials to guarantee the quality and relevance of the studies selected for this updated analysis&#46; The search strategy was conducted systematically&#44; following Cochrane Plus guidelines and adhered to best practices available in medical literature review&#46; The studies identified through this process underwent a selection and evaluation process&#44; and those that met the inclusion criteria were considered for further analysis in this article&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Short-term mortality was defined as a clinical outcome&#58; studies reporting on 28-day mortality rates were included by default&#44; as this timeframe is a commonly accepted indicator of early clinical outcomes in critically ill patients&#46; However&#44; aware of the fact that some studies may have included 30-day mortality rate assessments&#44; we decided to include this data too&#44; considering that the 30-day timeframe is consistent with a short-term outcome in the context of critically ill patients at the ICU setting&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">A total of 9 randomized clinical trials were analyzed including 6 studies analyzed in Li et al&#46;&#8217;s work<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and 3 new trials&#58; Nafae et al&#46;&#8217;s study&#44;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and the post hoc analysis data of patients with sepsis from the ICU-ROX trial&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> and the ICONIC trial&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> These 9 trials included a total of 5216 patients admitted to the ICU&#46; The results did not show a significantly lower all-cause mortality rate in the short-term with the use of conservative oxygen therapy &#40;OR&#44; 0&#46;97&#59; 95&#37;CI&#44; 0&#46;86&#8211;1&#46;09 in the common effects model&#59; OR&#44; 0&#46;88&#59; 95&#37;CI&#44; 0&#46;71&#8211;1&#46;09 in the random effects model&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The results indicate moderate variability &#40;I&#178; of 44&#46;81&#37;&#41; that cannot be attributed to simple sampling error&#46; This heterogeneity&#44; referring to differences among studies in terms of population&#44; design&#44; or outcome measurement&#44; requires careful consideration when interpreting the results&#46; We did not find any statistically significant evidence either to support the lack of heterogeneity &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#62;&#8239;0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> shows the funnel plot of effect size against precision in a scatterplot&#46; The funnel plot exhibits a tilt toward the left&#44; which could be indicative of potential publication bias where studies with negative results are not disclosed&#46; Girardis et al&#46;&#8217;s work<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> deviates from the general shape of the funnel &#40;outlier&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">These results just do not clarify the debate of whether patients ventilated in the ICU setting with liberal oxygen therapy are genuinely at risk of developing hyperoxia and lung damage&#46; It is hypothesized that oxidative stress following the production of reactive agents with oxidant properties could be an important mechanism in the development of lung damage&#44; inducing phenomena such as apoptosis of the alveolar epithelium and changes to cellular functions&#44; especially at mitochondrial level&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;7</span></a> Although the prolonged use of a high fraction of inspired oxygen has historically been associated with potential detrimental effects on the lungs&#8212;mainly mild injuries such as atelectasis and hyperoxic bronchitis&#8212;a characteristic diffuse alveolar damage has not been found yet&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The question of whether hyperoxia and lung damage are legitimate concerns in patients on liberal oxygen therapy at the ICU setting remains a matter of discussion and requires a more detailed evaluation and understanding&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Despite the moderate variability seen&#44; our analyses support the need for a cautious approach when extrapolating the conclusions of individual studies to a broader context&#44; thus recognizing that differences seen among studies can have an impact on the results and should be considered in future research and clinical practices&#46;</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Funding</span><p id="par0050" class="elsevierStylePara elsevierViewall">This manuscript received no funding&#46;</p></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">None of the authors declared any conflicts of interest at the completion of this study&#46;</p></span></span>"
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                        "paginaFinal" => "779"
                        "link" => array:1 [
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                        "tituloSerie" => "Eur Respir J"
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                        "paginaInicial" => "745"
                        "paginaFinal" => "757"
                        "link" => array:1 [
                          0 => array:2 [
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                            "web" => "Medline"
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                      ]
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                        "paginaFinal" => "26"
                        "link" => array:1 [
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                        "paginaInicial" => "239"
                        "paginaFinal" => "254"
                        "link" => array:1 [
                          0 => array:2 [
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Article information
ISSN: 21735727
Original language: English
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