PP002 Topic: AS01–Brain: Neuroimaging/Trauma/Monitoring/Status Epilepticus/CNS Infections/Other: CONSERVATIVE VS STANDARD OXYGEN THERAPY IN CHILDREN WITH NON-TRAUMATIC COMA–AN OPEN LABELLED RANDOMIZED CONTROLLED TRIAL

Aims & Objectives: The optimal systemic oxygenation target for critically ill ventilated children, especially those with non-traumatic coma, is unknown. We aimed to compare Conservative (Spo2 88-92%; Pao2 55-70mmHg) and Standard (Spo2 93-99%; Pao2 71-100mmHg) oxygenation therapy in children ventilated with NTC. Methods: A tertiary PICU ran an open-label RCT from July 2022 to September 2023. All NTC children aged 28 days to 12 years who needed invasive ventilation were enrolled within 48 hours. Eligible children were randomized 1:1 online. Ventilator-free days, mortality, length of stay, SOFA and VIS scores, HUI-2, and POPC/PCPC scores were secondary outcomes to GOS-E at discharge and 3 months. The trial was registered (CTRI/2022/10/046432). The calculated sample size was 142, 71 per group. Results: We enrolled 88 children. Except for higher lactate and FiO2 in the standard oxygenation group, baseline characteristics were similar. Conservative vs. standard: Median mean SpO2 (94 vs. 97; p=0.012), Median mean PaO2 (82 vs. 90; p=0.024), Median mean FiO2 (21 vs 35; p=0.105). Conservative and standard groups had similar median GOS-E scores at discharge (5 vs 6, p=0.447) and 90-day follow-up (7 vs 8, p=0.447). Secondary outcomes showed a significant difference in 90-day mortality (12% vs 53%, p=0.02) and ventilator-free days (24 vs 21, p=0.017). No significant differences were found in 28-day mortality, SOFA/VIS, HUI-2, or POPC/PCPC scores. Conclusions: Both groups of ventilated NTC children had similar GOS-E levels at discharge and 3 months. Secondary outcomes were similar. However, the standard oxygenation group had higher 90-day mortality. Keywords: Conservative Oxygen, Non Traumatic Coma, Standard Oxygen, CNS Infection