Ahmed Al-Niaimi1, Nasia Safdar. 1. Department of Medicine, University of Wisconsin Medical School, Madison, WI, USA.
Abstract
OBJECTIVE: To assess the efficacy of supplemental perioperative oxygenation for prevention of surgical site infection (SSI). Data sources Computerized PUBMED and MEDLINE search supplemented by manual searches for relevant articles. Study selection Randomized, controlled trials evaluating efficacy of supplemental perioperative oxygenation versus standard care for prevention of SSI in patients' undergoing colorectal surgery. Data synthesis Data on incidence of SSI were abstracted as dichotomous variables. Pooled estimates of the relative risk (RR) and 95% confidence interval (CI) were obtained using the DerSimonian and Laird random effects model and the Mantel-Haenzel fixed effects model. Heterogeneity was assessed using the Cochran Q statistic and I(2). RESULTS: Four randomized controlled trials met the inclusion criteria. Supplemental perioperative oxygenation resulted in a reduced incidence of SSI [RR 0.70 (95% CI 0.52-0.94), P = 0.01], using a fixed effects model. Using the more conservative random effects model, the point estimate was similar [RR 0.74 (95% CI 0.39-1.43), P = 0.37], but the results failed to achieve statistical significance. The I(2) test showed moderate heterogeneity. CONCLUSIONS: Our analysis showed that supplemental perioperative oxygenation is beneficial in preventing SSI in patients undergoing colorectal surgery. Because of heterogeneity in study design and patient population, additional randomized trials are needed to determine whether this confers benefit in all patient populations undergoing other types of surgery. Supplemental perioperative oxygenation is a low-cost intervention that we recommend be implemented in patients undergoing colorectal surgery pending the results of further studies. Further research is needed to determine whether or not supplemental hyperoxia may cause unanticipated adverse effects.
OBJECTIVE: To assess the efficacy of supplemental perioperative oxygenation for prevention of surgical site infection (SSI). Data sources Computerized PUBMED and MEDLINE search supplemented by manual searches for relevant articles. Study selection Randomized, controlled trials evaluating efficacy of supplemental perioperative oxygenation versus standard care for prevention of SSI in patients' undergoing colorectal surgery. Data synthesis Data on incidence of SSI were abstracted as dichotomous variables. Pooled estimates of the relative risk (RR) and 95% confidence interval (CI) were obtained using the DerSimonian and Laird random effects model and the Mantel-Haenzel fixed effects model. Heterogeneity was assessed using the Cochran Q statistic and I(2). RESULTS: Four randomized controlled trials met the inclusion criteria. Supplemental perioperative oxygenation resulted in a reduced incidence of SSI [RR 0.70 (95% CI 0.52-0.94), P = 0.01], using a fixed effects model. Using the more conservative random effects model, the point estimate was similar [RR 0.74 (95% CI 0.39-1.43), P = 0.37], but the results failed to achieve statistical significance. The I(2) test showed moderate heterogeneity. CONCLUSIONS: Our analysis showed that supplemental perioperative oxygenation is beneficial in preventing SSI in patients undergoing colorectal surgery. Because of heterogeneity in study design and patient population, additional randomized trials are needed to determine whether this confers benefit in all patient populations undergoing other types of surgery. Supplemental perioperative oxygenation is a low-cost intervention that we recommend be implemented in patients undergoing colorectal surgery pending the results of further studies. Further research is needed to determine whether or not supplemental hyperoxia may cause unanticipated adverse effects.
Authors: Jeffrey S Kroin; Jinyuan Li; Josef W Goldufsky; Kajal H Gupta; Masoomeh Moghtaderi; Asokumar Buvanendran; Sasha H Shafikhani Journal: J Med Microbiol Date: 2016-06-14 Impact factor: 2.472
Authors: Jørn Wetterslev; Christian S Meyhoff; Lars N Jørgensen; Christian Gluud; Jane Lindschou; Lars S Rasmussen Journal: Cochrane Database Syst Rev Date: 2015-06-25
Authors: Lars H Lundstrøm; Christophe Hv Duez; Anders K Nørskov; Charlotte V Rosenstock; Jakob L Thomsen; Ann Merete Møller; Søren Strande; Jørn Wetterslev Journal: Cochrane Database Syst Rev Date: 2017-05-17
Authors: Zhenmi Liu; Jo C Dumville; Gill Norman; Maggie J Westby; Jane Blazeby; Emma McFarlane; Nicky J Welton; Louise O'Connor; Julie Cawthorne; Ryan P George; Emma J Crosbie; Amber D Rithalia; Hung-Yuan Cheng Journal: Cochrane Database Syst Rev Date: 2018-02-06