Reduced atelectasis does not establish comparative safety of lower pre-extubation oxygen

Impact The trial shows that 50% inspired oxygen reduces immediate ultrasound-detected atelectasis compared with 100% oxygen before extubation, but it was not designed or powered to compare clinical safety. Zero desaturation events among 32 children given 50% oxygen are compatible with an underlying risk of up to about 9%, so an adequately powered non-inferiority evaluation is needed before a safety claim is made.