Supplemental oxygen and surgical-site infections: an alternating intervention controlled trial
| Autor: | R. Reigert, Jing You, C. Vlah, Allen L. Keebler, Tatyana Kopyeva, L. Muzie, R. Khatib, Emre Gorgun, Attila Podolyak, M. Seuffert, Daniel I. Sessler, Luca Stocchi, B. Lewis, Andrea Kurz, S. Drahuschak, I. Suliman, Alparslan Turan |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Supplemental oxygen 030230 surgery Risk Assessment Perioperative Care law.invention 03 medical and health sciences 0302 clinical medicine Oxygen Consumption Randomized controlled trial 030202 anesthesiology Deep tissue law Surgical site Medicine Humans Surgical Wound Infection Intestine Large Digestive System Surgical Procedures Aged Wound Healing business.industry Incidence Middle Aged Clinical trial Intestines Oxygen Anesthesiology and Pain Medicine Tissue oxygenation Anesthesia Relative risk Female Molecular oxygen business Colorectal Surgery Negative Results |
| Zdroj: | British journal of anaesthesia. 120(1) |
| ISSN: | 1471-6771 |
| Popis: | Background The main defence against bacterial infection is oxidative killing by neutrophils, which requires molecular oxygen in wounded tissues. High inspired-oxygen fractions increase tissue oxygenation. But, whether improving tissue oxygenation actually reduces surgical-site infection (SSI) remains controversial. We therefore tested the primary hypothesis that supplemental oxygen (80% vs 30%) reduces the risk of a 30-day composite of deep tissue or organ–space SSI, healing-related wound complications, and mortality. Methods In an isolated suite of operating rooms, the inspired-oxygen concentration was alternated between 30% and 80% at 2-week intervals for 39 months. The analysis was restricted to patients who had major intestinal surgery lasting at least 2 h. Qualifying operations (5749) were analysed, including 2843 (49%) colorectal resections, 1866 (32%) lower gastrointestinal therapeutic procedures, 373 (6%) small-bowel resections, and 667 (13%) other colorectal procedures. Results The 80% and 30% oxygen groups were well balanced on all of the demographic, baseline, and procedural variables. The oxygen intervention had no effect on the composite primary outcome or any of its components. The overall observed incidence of the composite outcome was 10.8% (314/2896) in the 80% oxygen group and 11.0% (314/2853) in the 30% group. The estimated relative risk was 0.99 (95% CI: 0.85, 1.14) for 80% vs 30%, P=0.85. Conclusions Supplemental oxygen does not prevent major infection and healing-related complications after major intestinal surgery. Clinical trial registration NCT01777568. |
| Databáze: | OpenAIRE |
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