Long-term cognitive and pulmonary functions following a lower versus a higher oxygenation target in the HOT-ICU trial: protocol and statistical analysis plan.

BACKGROUND: Although supplemental oxygen can be lifesaving, liberal oxygen administration causing hyperoxaemia may be harmful. The targets for oxygenation in patients with acute hypoxaemic respiratory failure acutely admitted to the intensive care unit (ICU) are strongly debated, and consensus on which targets to recommend has not been reached. The Handling Oxygenation Targets in the ICU (HOT-ICU) trial is a multicentre, randomised, parallel-group trial of a lower oxygenation target (arterial partial pressure of oxygen [PaO2 ] = 8 kPa) versus a higher oxygenation target (PaO2  = 12 kPa) in adult ICU patients with acute hypoxaemic respiratory failure. In this study, we aim to evaluate the effects of these targets on long-term cognitive and pulmonary function in Danish patients, enrolled in the HOT-ICU trial and surviving to 1-year follow-up. We hypothesise that a lower oxygenation target throughout the ICU stay may result in cognitive impairment, whereas a higher oxygenation target may result in impaired pulmonary function. METHODS: All patients enrolled in the HOT-ICU trial at Danish sites and surviving to 1 year after randomisation are eligible to participate. The last patient is expected to be included by November 2021. A Repeatable Battery for the Assessment of Neuropsychological Status and a body plethysmography, including diffusion capacity for carbon monoxide, both pre-planned secondary long-term outcomes of the HOT-ICU trial, will be obtained. CONCLUSION: This study will provide important information on the long-term effects of a lower versus a higher oxygenation target on cognitive and pulmonary function in adult ICU patients with acute hypoxaemic respiratory failure.

Prevalence of depression after moderate to severe traumatic brain injury among adolescents and young adults: A systematic review.

To review the prevalence of depression among adolescents and young adults after moderate to severe TBI. A systematic literature search was conducted on literature published up to December 2018 in PubMed, EMBASE, Cochrane and PsychInfo. A systematic review of the identified literature was based on PRISMA guidelines. Risk of Bias was evaluated based on the aspects of Risk of Bias assessment described by the Agency of Health Research and Quality. Seven studies were deemed eligible and information on the prevalence of depression among adolescents and young adults (age 13-35) after moderate to severe TBI was extracted. Depression was assessed at 12 months (n = 2), >12 months (n = 2) or at varying times (n = 3) after TBI. The identified studies reported a prevalence proportion of depression from 1.6% to 60%. The Risk of Bias assessment showed a range of study quality with the selection of subjects and analysis of attrition being problematic. Although literature is sparse and of varying quality, depression was found to be common among adolescents and young adults with moderate to severe TBI which implies a need to focus on depression in the rehabilitation process and calls for further research.