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Evaluating the clinical and cost-effectiveness of a conservative approach to oxygen therapy for invasively ventilated adults in intensive care: protocol for the UK-ROX trial

Evaluating the clinical and cost-effectiveness of a conservative approach to oxygen therapy for invasively ventilated adults in intensive care: protocol for the UK-ROX trial
Evaluating the clinical and cost-effectiveness of a conservative approach to oxygen therapy for invasively ventilated adults in intensive care: protocol for the UK-ROX trial

Background: in the United Kingdom, around 184,000 adults are admitted to an intensive care unit (ICU) each year with over 30% receiving mechanical ventilation. Oxygen is the commonest therapeutic intervention provided to these patients but it is unclear how much oxygen should be administered for the best clinical outcomes. 

Methods: the UK-ROX trial will evaluate the clinical and cost-effectiveness of conservative oxygen therapy (the minimum oxygen concentration required to maintain an oxygen saturation of 90% ± 2%) versus usual oxygen therapy in critically ill adults receiving supplemental oxygen when invasively mechanically ventilated in ICUs in England, Wales and Northern Ireland. The trial will recruit 16,500 patients from approximately 100 UK adult ICUs. Using a deferred consent model, enrolled participants will be randomly allocated (1:1) to conservative or usual oxygen therapy until ICU discharge or 90 days after randomisation. 

Objectives: the primary clinical outcome is all cause mortality at 90 days following randomisation. 

Discussion: the UK-ROX trial has received ethical approval from the South Central – Oxford C Research Ethics Committee (Reference: 20/SC/0423) and the Confidentiality Advisory Group (Reference: 22/CAG/0154). The trial commenced in May 2021 and, at the time of publication, 95 sites had opened to recruitment.

critical care, hypoxaemia, intensive care, mechanical ventilation, Oxygen
1751-1437
223-230
Martin, Daniel S.
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Shahid, Tasnin
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Gould, Doug W.
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Richards-Belle, Alvin
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Doidge, James C.
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Camsooksai, Julie
349a1e0f-25a3-4a7b-9b35-0820efa49246
Charles, Walton N.
50614629-0c63-4988-8b56-9438f37b4d04
Davey, Miriam
741d4fc7-2591-4c1b-bb17-759deb856f68
Francis Johnson, Amelia
063ce30f-b30a-4908-bb59-0f9a20955612
Garrett, Roger M.
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Grocott, Michael P.W.
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Jones, Joanne
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Lampro, Lamprini
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Miller, Lorna
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O’Driscoll, B. Ronan
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Rostron, Anthony J.
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Sadique, Zia
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Szakmany, Tamas
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Young, Paul J.
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Rowan, Kathryn M.
cfa2982f-ac08-4e89-81c1-f45fd8244760
Harrison, David A.
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Mouncey, Paul R.
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Martin, Daniel S.
3e441b48-9221-4308-8ae6-49cbde20753f
Shahid, Tasnin
8bed7f4b-5c2e-44b1-8d2a-04d64aac58d7
Gould, Doug W.
96580ea6-9040-47c3-90ae-15e1e4968e18
Richards-Belle, Alvin
03332fca-2611-4f39-97e8-00fdfd6fe112
Doidge, James C.
24c6f231-b0eb-46bb-aa00-97dc1e67d91f
Camsooksai, Julie
349a1e0f-25a3-4a7b-9b35-0820efa49246
Charles, Walton N.
50614629-0c63-4988-8b56-9438f37b4d04
Davey, Miriam
741d4fc7-2591-4c1b-bb17-759deb856f68
Francis Johnson, Amelia
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Garrett, Roger M.
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Grocott, Michael P.W.
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Jones, Joanne
9d7cf830-b4f3-4cdf-bdfa-434b3b457d5f
Lampro, Lamprini
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Miller, Lorna
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O’Driscoll, B. Ronan
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Rostron, Anthony J.
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Sadique, Zia
cd77e961-1c90-47b9-af27-e99ce83ea236
Szakmany, Tamas
e4c4c4bd-5224-427b-879c-03acce668376
Young, Paul J.
64513de1-ed86-47cf-8791-84fa25ef676a
Rowan, Kathryn M.
cfa2982f-ac08-4e89-81c1-f45fd8244760
Harrison, David A.
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Mouncey, Paul R.
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Martin, Daniel S., Shahid, Tasnin, Gould, Doug W., Richards-Belle, Alvin, Doidge, James C., Camsooksai, Julie, Charles, Walton N., Davey, Miriam, Francis Johnson, Amelia, Garrett, Roger M., Grocott, Michael P.W., Jones, Joanne, Lampro, Lamprini, Miller, Lorna, O’Driscoll, B. Ronan, Rostron, Anthony J., Sadique, Zia, Szakmany, Tamas, Young, Paul J., Rowan, Kathryn M., Harrison, David A. and Mouncey, Paul R. (2024) Evaluating the clinical and cost-effectiveness of a conservative approach to oxygen therapy for invasively ventilated adults in intensive care: protocol for the UK-ROX trial. Journal of the Intensive Care Society, 25 (2), 223-230. (doi:10.1177/17511437241239880).

Record type: Article

Abstract

Background: in the United Kingdom, around 184,000 adults are admitted to an intensive care unit (ICU) each year with over 30% receiving mechanical ventilation. Oxygen is the commonest therapeutic intervention provided to these patients but it is unclear how much oxygen should be administered for the best clinical outcomes. 

Methods: the UK-ROX trial will evaluate the clinical and cost-effectiveness of conservative oxygen therapy (the minimum oxygen concentration required to maintain an oxygen saturation of 90% ± 2%) versus usual oxygen therapy in critically ill adults receiving supplemental oxygen when invasively mechanically ventilated in ICUs in England, Wales and Northern Ireland. The trial will recruit 16,500 patients from approximately 100 UK adult ICUs. Using a deferred consent model, enrolled participants will be randomly allocated (1:1) to conservative or usual oxygen therapy until ICU discharge or 90 days after randomisation. 

Objectives: the primary clinical outcome is all cause mortality at 90 days following randomisation. 

Discussion: the UK-ROX trial has received ethical approval from the South Central – Oxford C Research Ethics Committee (Reference: 20/SC/0423) and the Confidentiality Advisory Group (Reference: 22/CAG/0154). The trial commenced in May 2021 and, at the time of publication, 95 sites had opened to recruitment.

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e-pub ahead of print date: 11 April 2024
Published date: May 2024
Additional Information: Publisher Copyright: © The Intensive Care Society 2024.
Keywords: critical care, hypoxaemia, intensive care, mechanical ventilation, Oxygen

Identifiers

Local EPrints ID: 490053
URI: http://eprints.soton.ac.uk/id/eprint/490053
ISSN: 1751-1437
PURE UUID: 7f3db16a-6ca2-49fb-8183-0bda33319ee2
ORCID for Michael P.W. Grocott: ORCID iD orcid.org/0000-0002-9484-7581

Catalogue record

Date deposited: 14 May 2024 16:33
Last modified: 05 Jun 2024 01:42

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Contributors

Author: Daniel S. Martin
Author: Tasnin Shahid
Author: Doug W. Gould
Author: Alvin Richards-Belle
Author: James C. Doidge
Author: Julie Camsooksai
Author: Walton N. Charles
Author: Miriam Davey
Author: Amelia Francis Johnson
Author: Roger M. Garrett
Author: Joanne Jones
Author: Lamprini Lampro
Author: Lorna Miller
Author: B. Ronan O’Driscoll
Author: Anthony J. Rostron
Author: Zia Sadique
Author: Tamas Szakmany
Author: Paul J. Young
Author: Kathryn M. Rowan
Author: David A. Harrison
Author: Paul R. Mouncey

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