Maximizing or minimizing patient oxygenation during cardiac surgery may not affect postoperative organ injury: JAMA
Researchers found that while intraoperative hyperoxia did increase oxidative stress during cardiac surgery, there was no effect on kidney injury or other organ dysfunctions. This was from a study published in JAMA Surgery by Marcos G. Lopez and co-researchers. The result puts in doubt the therapeutic benefit of the routine administration of high inspired oxygen concentrations during surgery.
Liberal oxygen administration also known as hyperoxia is commonly used in the surgical setting to ensure adequate oxygenation. However, the consequence of such hyperoxia on the mechanisms of organ injury in the perioperative period has recently come into question. Thus, the current study investigated the effects of intraoperative hyperoxia versus normoxia on post-cardiac surgery oxidative stress, kidney injury, and other organ dysfunctions.
The objective of this randomized clinical trial was to assess the effect of intraoperative hyperoxia versus normoxia on oxidative stress, kidney injury, and other organ dysfunctions following cardiac surgery.
This participant and assessor-blinded, randomized clinical trial was conducted from April 2016 to October 2020 at a single tertiary care medical center. Adult patients (≥18 years) scheduled for elective open cardiac surgery were eligible for inclusion, provided they did not have preoperative oxygen requirements, acute coronary syndrome, carotid stenosis, or were on dialysis. Out of 3919 patients assessed, 2501 were eligible, and 213 consented to participate. After exclusions, 200 patients were randomized to either hyperoxia, where fraction of inspired oxygen was set to a value of 1.00, or normoxia, which maintained a minimum FiO2 to keep oxygen saturation within the range of 95% to 97% during surgery.
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