Gelissen H, de Grooth HJ, Smulders Y, et al. - No statistically significant reduction in organ dysfunction was conferred by treatment with a low-normal PaO₂ target vs a high-normal PaO₂ target in critically ill patients with 2 or more systemic inflammatory response syndrome (SIRS) criteria.

• Increase in organ dysfunction in critically ill patients may result from hyperoxemia.

• This randomized clinical trial included 400 patients in the ICU with at least 2 positive SIRS criteria.

• SOFA _RANK , a ranked outcome of nonrespiratory organ failure quantified by the nonrespiratory components of SOFA score, summed over the first 14 study days, was the primary endpoint.

• Randomization of patients to a target PaO₂ range of 8 to 12 kPa vs 14 to 18 kPa led to a median SOFA _RANK score of −35 vs −40 (lower score implies less organ failure severity), a difference that was not statistically significant.

• In terms of median duration of mechanical ventilation and in-hospital mortality, no significant difference was observed between groups.

• In the low-normal and high-normal PaO₂ groups, occurrence of acute kidney failure was seen in 20 patients (10%) and 21 patients (11%), respectively, and that of acute myocardial infarction in 6 patients (2.9%) and 7 patients (3.6%), respectively.