Somerset patients

Somerset patients lead the way in ground-breaking oxygen trial

PATIENTS being cared for at Musgrove Park Hospital’s critical care unit are taking part in a ground-breaking clinical trial.

The study, called UK-ROX, is being run by the Intensive Care National Audit and Research Centre (ICNARC) and funded by the National Institute for Health Research.

It aims to find out what level of oxygen best aids a person’s recovery.

The research is particularly relevent given the question marks over treatment in hospitals during the Covid pandemic.

It’s being run at over 100 NHS trusts in the country – and the first four UK patients signed up to the trial were cared for by Musgrove.

Each year, around 184,000 patients are admitted to NHS critical care units, and about one in three need help with their breathing using a ventilator.

Giving oxygen through the ventilator is an essential part of treatment, but it’s not currently known how much oxygen should be given to patients to optimise their recovery. Both too much and too little oxygen may cause harm.

The concentration of oxygen given through the ventilator is adjusted according to how much oxygen can be detected in a patient’s blood. This is known as oxygen saturation. Some studies have shown that having a lower, rather than higher, oxygen saturation may be beneficial for patients unwell in hospital.

The UK-ROX study aims to find out whether using a lower level of oxygen during treatment might lead to better outcomes for patients, when compared with the approach currently used in the NHS when treating patients on a ventilator.

How it works

Patients are randomly assigned to either:

  • the conservative group (low to normal levels of oxygen)
  • or usual oxygen therapy group (normal to high levels of oxygen).
  • All patients are followed up to 90 days later by linking study data with routinely collected national records.

The researchers hope to find out whether conservative oxygen therapy was more effective than usual oxygen therapy, by comparing patient outcomes in each group at 90 days following their admission to the critical care unit.

Dr Richard Innes, an intensive care consultant and principal investigator for the trial at Somerset FT, said: The idea of UK-ROX is primarily to investigate whether keeping a critically unwell patient’s oxygen level at a relatively normal or low level is better for them than raising the level higher.

There is some evidence that suggests that giving high levels of oxygen to a critically unwell patient produces certain chemicals that are potentially dangerous to patients, causing worse outcomes for them.

The study will compare the two levels of oxygenation so we can once and for all answer the question as to what oxygen level we should run our patients at when they are critically ill.

It’s a huge study that will hopefully recruit 16,500 patients across the UK and will go hand in hand with two similar studies in Australia and the United States. Depending on the results, it could result in a significant change in practice for the first time in a generation.”

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