| Popis: |
The World Health Organization recommends hyperoxia (80% fraction of inspired oxygen, FiO2) during and for 2-6 hours following surgery to reduce surgical site infection (SSI). However, some studies suggest increased cardiovascular complications with such a high perioperative FiO2. The goal of our study was to compare the appearance of cardiovascular complications in elective adult colorectal surgery comparing the use of FiO20.8 versus conventional therapy (FiO20.4).We performed a randomized controlled trial in intubated patients undergoing elective major colorectal surgery. Patients were randomly assigned to receive perioperative FiO20.8 or FiO20.4. The primary outcome, expressed as Odds Ratio (OR) ± 95% Confidence Interval (95%CI), was the incidence of MINS (myocardial injury after noncardiac surgery evaluated for the first 4 postoperative days). Secondary outcomes included MACCE (major adverse cardiovascular and cerebral events) up to 30 postoperative days, SSI, other postoperative complications (according to Clavien-Dindo classification) and length of stay.We included in the final analyses 403 patients. Comparing the FiO20.8 and FiO20.4 groups, there was no difference in the appearance of MINS (6.0 % vs. 10.4%; OR 0.55; 95% CI 0.26 - 1.14; p=0.945). There were no differences between the groups for important secondary outcomes including MACCE to 30 days, SSI, postoperative complications or length of stay.Perioperative hyperoxia therapy (FiO20.8) with the aim of decreasing SSI did not increase cardiovascular complications after elective colorectal surgery in a general population. |
