The Israel Association for Emergency Medicine

PODCAST: Oxygen Administration in Trauma Patients

trauma bay

Jul 14, 2025

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
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