Contributor: Aaron Lessen, MD

Educational Pearls:

Many trauma patients are placed on oxygen via non-rebreather
A large, multicenter, controlled trial evaluated the outcomes of oxygen administration in trauma patients
Patients were randomized to two groups
- 1. 8-hour restrictive oxygen strategy: only receiving oxygen when the patient’s saturation dropped below 94%
  2. 8-hour liberal oxygen strategy: 12-15 liters of oxygen per minute or fraction of inspired oxygen of 0.6-1.0
The study evaluated rates of death or major respiratory complications at 30 days
There was no statistical difference between the two groups
- Therefore, there is no clear benefit to administering liberal amounts of oxygen to trauma patients, but there is also no clear harm
Ultimately, trauma patients do not need to be on oxygen via non-rebreather unless they are hypoxic or short of breath

References

Arleth T, Baekgaard J, Siersma V, et al. Early Restrictive vs Liberal Oxygen for Trauma Patients: The TRAUMOX2 Randomized Clinical Trial. JAMA. 2025;333(6):479-489. doi:10.1001/jama.2024.25786

Summarized by Meg Joyce, MS2 | Edited by Meg Joyce & Jorge Chalit, OMS4

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Episode 965: Oxygen Administration in Trauma Patients

Emergency Medical Minute