Evidence map›Paper›PMID 39701658›Full record

Trial reportThe Lancet. Child & adolescent health2025

Longer-term survival, quality of life, and cost-effectiveness of conservative versus liberal oxygenation targets in critically ill children: a pre-specified analysis from Oxy-PICU, a multicentre, open, parallel-group, randomised controlled trial.

Silvia Moler-Zapata, Mark J Peters, Doug W Gould, Elisa Giallongo, Marzena Orzol, Samiran Ray, Karen Thomas, Irene Chang, Lauran O'Neill, Rachel Agbeko and 12 more

Abstract readMulticenter StudyRandomized Controlled TrialPragmatic Clinical Trial
PubMed Publisher
In one paragraph

Trial report in The Lancet. Child & adolescent health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. The Paediatric Intensive Care Adaptive Platform Trial (PIVOTAL): Turning Pediatric Critical Care Practice Into Clinical Research.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2026
    Article
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

22 authors.

Silvia Moler-ZapataDepartment of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK. Electronic address: silvia.moler@lshtm.ac.uk.
Mark J PetersPaediatric Intensive Care Unit, Great Ormond Street Hospital for Children NHS Foundation Trust and NIHR Biomedical Research Centre, London, UK; University College London Great Ormond St Institute of Child Health, London, UK; Children's Acute Transport Service, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Doug W GouldClinical Trials Unit, Intensive Care National Audit & Research Centre, London, UK.
Elisa GiallongoClinical Trials Unit, Intensive Care National Audit & Research Centre, London, UK.
Marzena OrzolClinical Trials Unit, Intensive Care National Audit & Research Centre, London, UK.
Samiran RayPaediatric Intensive Care Unit, Great Ormond Street Hospital for Children NHS Foundation Trust and NIHR Biomedical Research Centre, London, UK.
Karen ThomasRoyal Marsden NHS Foundation Trust, London, UK.
Irene ChangClinical Trials Unit, Intensive Care National Audit & Research Centre, London, UK.
Lauran O'NeillPaediatric Intensive Care Unit, Great Ormond Street Hospital for Children NHS Foundation Trust and NIHR Biomedical Research Centre, London, UK.
Rachel AgbekoDepartment of Paediatric Intensive Care, Great North Children's Hospital, The Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
Carly AuClinical Trials Unit, Intensive Care National Audit & Research Centre, London, UK.
Elizabeth DraperDepartment of Population Health Sciences, University of Leicester, Leicester, UK.
Lee Elliot-MajorParent Representative, London, UK.
Lamprini LamproClinical Trials Unit, Intensive Care National Audit & Research Centre, London, UK.
Jon PappachanPaediatric Intensive Care Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Sam PetersClinical Trials Unit, Intensive Care National Audit & Research Centre, London, UK.
Padmanabhan RamnarayanChildren's Acute Transport Service, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
Kathryn M RowanClinical Trials Unit, Intensive Care National Audit & Research Centre, London, UK.
David A HarrisonClinical Trials Unit, Intensive Care National Audit & Research Centre, London, UK.
Paul R MounceyClinical Trials Unit, Intensive Care National Audit & Research Centre, London, UK.
Zia SadiqueDepartment of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Oxy-PICU Investigators of the Paediatric Critical Care Society Study Group (PCCS-SG)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeripheral oxygen saturation (SpO

methodsOxy-PICU was a pragmatic, multicentre, open-label, randomised controlled trial in England and Scotland. Eligible children were older than 38 weeks and younger than 16 years and had been admitted for emergency care in one of 15 participating PICUs, where they received invasive respiratory support for abnormal gas exchange. Participants were randomly assigned (1:1) to either a conservative oxygenation target (SpO

findings2040 children were enrolled between Sept 1, 2020 and May 15, 2022. 1868 (91·6%) children were included in the 90-day survival analysis; of these 930 (49·8%) had been assigned liberal oxygen and 938 (50·2%) conservative oxygen. 1867 (91·5%) children were included in the 1-year survival analysis; 930 (49·8%) had been assigned liberal oxygenation and 937 (50·2%) conservative oxygen. At 90 days, 35 (3·7%) patients in the conservative oxygenation group and 45 (4·8%) patients in the liberal oxygenation group had died (adjusted hazard ratio [aHR] 0·75 [95% CI 0·48 to 1·17]). By 1 year, 52 (5·5%) patients in the conservative oxygenation group and 66 (7·1%) patients in the liberal oxygenation group had died (aHR 0·77 [95%CI 0·53 to 1·10]). Overall, mean HRQoL, life-years, and QALYs at 1 year were similar in the two groups. The adjusted incremental effect on cost of conservative oxygenation versus liberal oxygenation was -£879 (95% CI -9036 to 7278), whereas the incremental difference in QALYs was estimated at 0·001 (-0·010 to 0·011), leading to an incremental net monetary benefit of £894 (-7290 to 9078) associated with conservative oxygenation relative to liberal oxygenation. These results did not vary by age (<12 months vs ≥12 months), comorbidity at baseline, age-adjusted heart rate, or haemoglobin level at admission and were robust to alternative assumptions.

interpretationCompared with usual care (SpO

fundingUK National Institute for Health and Social Care Research Health Technology Assessment Programme.

Indexed as

Cost-Benefit AnalysisCritical IllnessIntensive Care Units, PediatricQuality of LifeAdolescentChildChild, PreschoolEnglandFemaleHumansInfantMaleOxygen Inhalation TherapyOxygen SaturationRespiration, ArtificialScotland

Identifiers

PMID39701658

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.