Hyperoxemia reduces cerebrovascular accidents post coronary artery bypass graft surgery: a retrospective cohort study
| Autor: | Hannah Kempton, Ruan Vlok, Leigh White, Calum W. K. Chong, Rhys S. Holyoak, Thomas M Melhuish |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
business.industry Retrospective cohort study Odds ratio Perioperative Transient ischaemic attacks Critical Care and Intensive Care Medicine medicine.disease Surgery Sepsis medicine.anatomical_structure Emergency Medicine Medicine Myocardial infarction business Adverse effect Artery |
| Zdroj: | Journal of Emergency and Critical Care Medicine. 4:16-16 |
| ISSN: | 2521-3563 |
| Popis: | Cerebrovascular accidents (CVAs) including strokes and transient ischaemic attacks (TIAs) form a major portion of perioperative morbidity in patients undergoing coronary artery bypass graft (CABG) surgery. The aim of this article was to: (I) to examine the relationship between providing increased intraoperative partial pressure of arterial oxygen (PaO 2 ) and the risk of perioperative CVA following CABG surgery; (II) to examine the relationship between intraoperative PaO 2 and other perioperative adverse outcomes. This was a retrospective cohort study involving 2,253 consecutive CABG patients located within a single cardiothoracic unit of a tertiary hospital. All patients underwent CABG surgery. A multivariate analysis was undertaken to assess the relationship between the PaO 2 (intra-operative mean and nadir) and its associated risk of perioperative CVA. Results were reported as odds ratios (OR) with 95% confidence interval (95% CI). There was a significant (but clinically limited) inverse correlation between average intra-operative PaO 2 and reducing peri-operative CVA (OR 0.99; P=0.029; 95% CI: 0.98–1.00), indicating a reduction in stroke risk with increasing PaO 2 . There was no significant association with PaO 2 nadir and CVA. There was no significant association between increasing hyperoxia and the following adverse events: pneumonia, prolonged postoperative ventilation, perioperative myocardial infarction or cardiac arrest, sternal wound infection, sepsis and renal failure. We report a significant inverse correlation between increasing average intra-operative PaO 2 and reducing peri-operative CVA. Further, hyperoxia was not associated with any adverse effects or infective outcomes. This finding is likely to have preventative and therapeutic implications through reducing stroke risk. |
| Databáze: | OpenAIRE |
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