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

1. 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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