In Reply: Early Moderate Hyperoxemia does not Predict Outcome After Aneurysmal Subarachnoid Hemorrhage

In Reply: Early Moderate Hyperoxemia does not Predict Outcome After Aneurysmal Subarachnoid... CORRESPONDENCE PaO2-load, to describe the exposure to hyperoxia. We consider In Reply: Early Moderate Hyperoxemia does this idea as truly interesting. We encourage Drs Shen and Du to not Predict Outcome After Aneurysmal investigate the usefulness of the PaO2-load. Subarachnoid Hemorrhage To the Editor: Disclosure We thank Drs Shen and Du for their valuable comments The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article. about our article “Early Moderate Hyperoxemia Does Not Predict Outcome After Aneurysmal Subarachnoid Hemorrhage.” ∗ ‡ Targeting hyperoxemia in a neurocritical care setting is Maarit Lång, MD common practice, but the safety of hyperoxemia has been Rahul Raj, MD, PhD questioned. In previous studies the definition, the cutoff value, Markus Benedikt Skrifvars, MD, PhD and time of assessment of hyperoxemia vary by study. Bellomo Matti Reinikainen, MD, PhD et al have shown that the worst PaO2 is more representative of Stepani Bendel, MD, PhD mean PaO2 than the first PaO2. Hyperoxia in the early phase of Department of Intensive Care Medicine, critical illness may be associated with worse outcome. However, Kuopio University Hospital, KYS, in most studies hyperoxia exposure is based on a single value of Kuopio, Finland PaO2. We wanted to study the mean exposure to oxygen and we Department of Intensive Care Medicine, chose TWA-O2 as an indicator for that. It has been previously Helsinki University Central Hospital, HUS, shown that there is a significant correlation between TWA-O2 Helsinki, Finland and nPaO2 and similar findings were discovered in our study as Department of Intensive Care Medicine, presented in Figure. Drs Shen and Du suggest a new index, the North Karelia Central Hospital, Joensuu, Finland Correspondence: Department of Intensive Care Medicine, Kuopio University Hospital, PO Box 100, 70029 Kys, Kuopio, Finland. E-mail: maarit.lang@kuh.fi REFERENCES 1. Du K, Shen Y. Letter: Early moderate hyperoxemia does not predict outcome after aneurysmal subarachnoid hemorrhage. Neurosurgery. 2017;80(5):E252. 2. Lång M, Raj R, Skrifvars MB, et al. Early moderate hyperoxemia does not predict outcome after aneurysmal subarachnoid hemorrhage. Neurosurgery. 2016;78(4):540-545. 3. Bellomo R, Bailey M, Eastwood GM, et al. Arterial hyperoxia and in-hospital mortality after resuscitation from cardiac arrest. Crit Care. 2011;15(2):R90. 4. Damiani E, Adrario E, Girardis M, et al. Arterial hyperoxia and mortality in criti- cally ill patients: a systematic review and meta-analysis. Crit Care. 2014;18(6):711. 5. Raj R, Bendel S, Reinikainen M, et al. Hyperoxemia and long-term outcome after traumatic brain injury. Crit Care. 2013;17(4):R177. 6. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13(10):818-829. FIGURE. The correlation between time-weighted average PaO2 and Apache II PaO2; PaO2: partial pressure of oxygen. 10.1093/neuros/nyx034 NEUROSURGERY VOLUME 80 | NUMBER 5 | MAY 2017 | E253 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

In Reply: Early Moderate Hyperoxemia does not Predict Outcome After Aneurysmal Subarachnoid Hemorrhage

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Publisher
Congress of Neurological Surgeons
Copyright
Copyright © 2017 by the Congress of Neurological Surgeons
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1093/neuros/nyx034
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Abstract

CORRESPONDENCE PaO2-load, to describe the exposure to hyperoxia. We consider In Reply: Early Moderate Hyperoxemia does this idea as truly interesting. We encourage Drs Shen and Du to not Predict Outcome After Aneurysmal investigate the usefulness of the PaO2-load. Subarachnoid Hemorrhage To the Editor: Disclosure We thank Drs Shen and Du for their valuable comments The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article. about our article “Early Moderate Hyperoxemia Does Not Predict Outcome After Aneurysmal Subarachnoid Hemorrhage.” ∗ ‡ Targeting hyperoxemia in a neurocritical care setting is Maarit Lång, MD common practice, but the safety of hyperoxemia has been Rahul Raj, MD, PhD questioned. In previous studies the definition, the cutoff value, Markus Benedikt Skrifvars, MD, PhD and time of assessment of hyperoxemia vary by study. Bellomo Matti Reinikainen, MD, PhD et al have shown that the worst PaO2 is more representative of Stepani Bendel, MD, PhD mean PaO2 than the first PaO2. Hyperoxia in the early phase of Department of Intensive Care Medicine, critical illness may be associated with worse outcome. However, Kuopio University Hospital, KYS, in most studies hyperoxia exposure is based on a single value of Kuopio, Finland PaO2. We wanted to study the mean exposure to oxygen and we Department of Intensive Care Medicine, chose TWA-O2 as an indicator for that. It has been previously Helsinki University Central Hospital, HUS, shown that there is a significant correlation between TWA-O2 Helsinki, Finland and nPaO2 and similar findings were discovered in our study as Department of Intensive Care Medicine, presented in Figure. Drs Shen and Du suggest a new index, the North Karelia Central Hospital, Joensuu, Finland Correspondence: Department of Intensive Care Medicine, Kuopio University Hospital, PO Box 100, 70029 Kys, Kuopio, Finland. E-mail: maarit.lang@kuh.fi REFERENCES 1. Du K, Shen Y. Letter: Early moderate hyperoxemia does not predict outcome after aneurysmal subarachnoid hemorrhage. Neurosurgery. 2017;80(5):E252. 2. Lång M, Raj R, Skrifvars MB, et al. Early moderate hyperoxemia does not predict outcome after aneurysmal subarachnoid hemorrhage. Neurosurgery. 2016;78(4):540-545. 3. Bellomo R, Bailey M, Eastwood GM, et al. Arterial hyperoxia and in-hospital mortality after resuscitation from cardiac arrest. Crit Care. 2011;15(2):R90. 4. Damiani E, Adrario E, Girardis M, et al. Arterial hyperoxia and mortality in criti- cally ill patients: a systematic review and meta-analysis. Crit Care. 2014;18(6):711. 5. Raj R, Bendel S, Reinikainen M, et al. Hyperoxemia and long-term outcome after traumatic brain injury. Crit Care. 2013;17(4):R177. 6. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13(10):818-829. FIGURE. The correlation between time-weighted average PaO2 and Apache II PaO2; PaO2: partial pressure of oxygen. 10.1093/neuros/nyx034 NEUROSURGERY VOLUME 80 | NUMBER 5 | MAY 2017 | E253

Journal

NeurosurgeryOxford University Press

Published: May 1, 2017

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