Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Effects of Hyperoxia on Organ Dysfunction and Outcome in Critically Ill Patients With SIRS
Brief Summary: Objectives:

1. To study the short- and long-term effect of two different PaO2 targets on circulatory status, organ dysfunction and outcome in patient admitted to the ICU with Systemic Inflammatory Response Syndrome (SIRS) criteria.
2. To study underlying mechanisms of hyperoxia by determining differences in oxidative stress response between the hyperoxic and the normoxic patients.

Study design:

Randomized, prospective multicentre clinical trial

Study population:

Patients admitted to the Intensive Care unit with ≥ 2 positive SIRS-criteria and an expected ICU stay of more than 48 hours

Intervention:

Group 1: target PaO2 120 (105 - 135) mmHg (high-normal)

Group 2: target PaO2 75 (60 - 90) mmHg (low-normal)

Primary endpoints:

The primary endpoint will be cumulative daily delta SOFA score (CDDS) from day 1 to day 14.


Options:
A: Inclusion Criteria:

* patients with less than 6 hours septic shock according criteria of Bone
* minimal dose of catecholamines at least 0.1 µg/Kg/min
* patient with mechanical ventilation
* written informed consent

Exclusion Criteria:

* age \< 18 years
* pregnancy
* participation in other trial with the same endpoint
* moribund
* absence of registration in french health care system
* patient protected by law
* hypernatremia \< 130 mmol/l ou \> 145 mmol/l
* patient with P/F \< 100 mm Hg with PEEP \> 5 cms of water
* intracranial hypertension
* patient admitted for cardiac arrest
* overt cardiac failure
B: Inclusion Criteria:

* Major patients with mechanical ventilation
* ARDS according to Berlin definition:Hypoxemia defined with PaO2 FiO2 ratio less or equal to 300 mmHg with Positive End Expiratory Pressure higher or equal to 5 cmH20, Less than seven days between a known clinical insult or new or worsening of respiratory symptoms, Bilateral opacities on chest Imaging not fully explained by effusions, lobar or lung collapse, or nodules, Respiratory failure not fully explained by cardiac failure or fluid overload
* Less than twelve hours following initiation of mechanical ventilation.

Exclusion Criteria:

* Pregnancy
* Patient less than 18 years old
* Sickle cell disease
* Patient deprived of freedom, Under a legal protective measure
* Cardiac arrest as the reason for ICU hospitalisation
* Traumatic brain injury as the reason for ICU hospitalisation
* Hemoptysis with embolization or surgery
* Extracorporeal life support or Extracorporeal Membrane Oxygenation before randomization
* Chronic Obstructive Pulmonary Disease with oxygen or non invasive ventilation at home (obstructive sleep apnoea syndrome is not an exclusion criteria)
* Patient with very high risk of death with IGS II (Simplified Severity Index II) than 90
* Indication of hyperbaric oxygenation : carbon monoxide intoxication, gas embolism, necrotizing fasciitis
* Cyanide intoxication, methemoglobinemia
* Untreated pneumothorax
* Lymphangitis carcinomatosa
* Eosinophilic pneumonia
* Intensive care management for organ donation
* Participation in another interventional study with mortality as a major outcome to avoid confounding factor
* Patient not affiliated to social security
C: Inclusion Criteria:

* Age 18 years or older.
* Laparotomy, acute or elective. In case of gynaecological surgery only if malignancy is suspected (defined as risk of ovarian malignancy index \>200 or a specimen with atypical or neoplastic cells).

Exclusion Criteria:

* Other surgery within 30 days (except surgery in local anaesthesia).
* Chemotherapy within 3 months.
* Inability to give informed consent.
* Inability to keep oxygen saturation above 90% without supplemental oxygen (measured preoperatively by pulse oximetry).
D: Inclusion Criteria:

* ≥2 positive SIRS-criteria:

  * Temperature \>38 deg.C or hypothermia \<36 deg.C
  * Heart rate \>90 bpm
  * Respiratory rate \>20 /min or pCO2 \<32 mmHg (4.3 kPa)
  * Number of leucocytes \>12 x 10\^9/l of \<4 x 10\^9/l of \>10% bands
* Within 12 hours of admittance to the ICU
* Expected stay of more than 48 hours as estimated by the attending physician

Exclusion Criteria:

* Elective surgery
* Carbon monoxide poisoning
* Cyanide intoxication
* Methemoglobinemia
* Sickle cell anemia
* Severe pulmonary arterial hypertension (WHO class III or IV)
* Known severe Acute Respiratory Distress Syndrome (ARDS) (PaO2/FiO2 ≤100 mmHg and PEEP ≥ 5 cm H2O)
* Known cardiac right to left shunting
* Pregnancy
* Severe Chronic Obstructive Pulmonary Disease (COPD) (Gold class III or IV) or other severe chronic pulmonary disease
* Patients participating in other interventional trials

Answer: D