Lower or Higher Oxygenation Targets for Acute Hypoxemic Respiratory Failure

Research output: Contribution to journalJournal articleResearchpeer-review


  • Olav L. Schjorring
  • Thomas L. Klitgaard
  • Perner, Anders
  • Jorn Wetterslev
  • Lange, Theis
  • Martin Siegemund
  • Minna Backlund
  • Frederik Keus
  • Jon H. Laake
  • Matthew Morgan
  • Katrin M. Thormar
  • Soren A. Rosborg
  • Jannie Bisgaard
  • Annette E. S. Erntgaard
  • Anne-Sofie H. Lynnerup
  • Rasmus L. Pedersen
  • Elena Crescioli
  • Theis C. Gielstrup
  • Meike T. Behzadi
  • Lone M. Poulsen
  • Stine Estrup
  • Jens P. Laigaard
  • Cheme Andersen
  • Camilla B. Mortensen
  • Bjorn A. Brand
  • Jonathan White
  • Inge-Lise Jarnvig
  • Møller, Morten Hylander
  • Lars Quist
  • Bestle, Morten Heiberg
  • Martin Schonemann-Lund
  • Maj K. Kamper
  • Mathias Hindborg
  • Alexa Hollinger
  • Caroline E. Gebhard
  • Nuria Zellweger
  • Meyhoff, Christian Sylvest
  • Mathias Hjort
  • Laura K. Bech
  • Thorbjorn Grofte
  • Helle Bundgaard
  • Lars H. M. Ostergaard
  • Maria A. Thyo
  • Thomas Hildebrandt
  • Bulent Uslu
  • Christoffer G. Solling
  • Ulf G. Pedersen
  • Andreasen, Anne Sofie
  • Maj-Brit N. Kjaer
  • Bodil S. Rasmussen
  • HOT-ICU Investigators


Patients with acute hypoxemic respiratory failure in the intensive care unit (ICU) are treated with supplemental oxygen, but the benefits and harms of different oxygenation targets are unclear. We hypothesized that using a lower target for partial pressure of arterial oxygen (Pao(2)) would result in lower mortality than using a higher target.


In this multicenter trial, we randomly assigned 2928 adult patients who had recently been admitted to the ICU (


At 90 days, 618 of 1441 patients (42.9%) in the lower-oxygenation group and 613 of 1447 patients (42.4%) in the higher-oxygenation group had died (adjusted risk ratio, 1.02; 95% confidence interval, 0.94 to 1.11; P=0.64). At 90 days, there was no significant between-group difference in the percentage of days that patients were alive without life support or in the percentage of days they were alive after hospital discharge. The percentages of patients who had new episodes of shock, myocardial ischemia, ischemic stroke, or intestinal ischemia were similar in the two groups (P=0.24).


Among adult patients with acute hypoxemic respiratory failure in the ICU, a lower oxygenation target did not result in lower mortality than a higher target at 90 days.

Original languageEnglish
JournalNew England Journal of Medicine
Issue number14
Pages (from-to)1301-1311
Number of pages11
Publication statusPublished - 2021

Number of downloads are based on statistics from Google Scholar and www.ku.dk

No data available

ID: 260089585