BACKGROUND: A high perioperative inspiratory oxygen fraction (80%) has been recommended to prevent postoperative wound infections. However, the most recent and one of the largest trials, the PROXI trial, found no reduction in surgical site infection, and 30-day mortality was higher in patients given 80% oxygen. In this follow-up study of the PROXI trial we assessed the association between long-term mortality and perioperative oxygen fraction in patients undergoing abdominal surgery. METHODS:From October 8, 2006, to October 6, 2008, 1386 patients underwent elective or emergency laparotomy and were randomized to receive either 80% or 30% oxygen during and for 2 hours after surgery. The follow-up date was February 24, 2010. Survival was analyzed using Kaplan-Meier statistics and the Cox proportional hazards model. RESULTS:Vital status was obtained in 1382 of 1386 patients after a median follow-up of 2.3 years (range 1.3 to 3.4 years). One hundred fifty-nine of 685 patients (23.2%) died in the 80% oxygen group compared to 128 of 701 patients (18.3%) assigned to 30% oxygen (HR, 1.30 [95% confidence interval, 1.03 to 1.64], P = 0.03). In patients undergoing cancer surgery, the HR was 1.45; 95% confidence interval, 1.10 to 1.90; P = 0.009; and after noncancer surgery, the HR was 1.06; 95% confidence interval, 0.69 to 1.65; P = 0.79. CONCLUSIONS: Administration of 80% oxygen in the perioperative period was associated with significantly increased long-term mortality and this appeared to be statistically significant in patients undergoing cancer surgery but not in noncancer patients.
RCT Entities:
BACKGROUND: A high perioperative inspiratory oxygen fraction (80%) has been recommended to prevent postoperative wound infections. However, the most recent and one of the largest trials, the PROXI trial, found no reduction in surgical site infection, and 30-day mortality was higher in patients given 80% oxygen. In this follow-up study of the PROXI trial we assessed the association between long-term mortality and perioperative oxygen fraction in patients undergoing abdominal surgery. METHODS: From October 8, 2006, to October 6, 2008, 1386 patients underwent elective or emergency laparotomy and were randomized to receive either 80% or 30% oxygen during and for 2 hours after surgery. The follow-up date was February 24, 2010. Survival was analyzed using Kaplan-Meier statistics and the Cox proportional hazards model. RESULTS: Vital status was obtained in 1382 of 1386 patients after a median follow-up of 2.3 years (range 1.3 to 3.4 years). One hundred fifty-nine of 685 patients (23.2%) died in the 80% oxygen group compared to 128 of 701 patients (18.3%) assigned to 30% oxygen (HR, 1.30 [95% confidence interval, 1.03 to 1.64], P = 0.03). In patients undergoing cancer surgery, the HR was 1.45; 95% confidence interval, 1.10 to 1.90; P = 0.009; and after noncancer surgery, the HR was 1.06; 95% confidence interval, 0.69 to 1.65; P = 0.79. CONCLUSIONS: Administration of 80% oxygen in the perioperative period was associated with significantly increased long-term mortality and this appeared to be statistically significant in patients undergoing cancer surgery but not in noncancer patients.
Authors: Deverick J Anderson; Kelly Podgorny; Sandra I Berríos-Torres; Dale W Bratzler; E Patchen Dellinger; Linda Greene; Ann-Christine Nyquist; Lisa Saiman; Deborah S Yokoe; Lisa L Maragakis; Keith S Kaye Journal: Infect Control Hosp Epidemiol Date: 2014-06 Impact factor: 3.254
Authors: Ozan Akca; Lorenzo Ball; F Javier Belda; Peter Biro; Andrea Cortegiani; Arieh Eden; Carlos Ferrando; Luciano Gattinoni; Zeev Goldik; Cesare Gregoretti; Thomas Hachenberg; Göran Hedenstierna; Harriet W Hopf; Thomas K Hunt; Paolo Pelosi; Motaz Qadan; Daniel I Sessler; Marina Soro; Mert Şentürk Journal: Turk J Anaesthesiol Reanim Date: 2017-08-01
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: Martina Nowak-Machen; Moritz Schmelzle; Dusan Hanidziar; Wolfgang Junger; Mark Exley; Leo Otterbein; Yan Wu; Eva Csizmadia; Glen Doherty; Michail Sitkovsky; Simon C Robson Journal: Am J Respir Cell Mol Biol Date: 2013-05 Impact factor: 6.914
Authors: Marija Barbateskovic; Olav L Schjørring; Sara Russo Krauss; Janus C Jakobsen; Christian S Meyhoff; Rikke M Dahl; Bodil S Rasmussen; Anders Perner; Jørn Wetterslev Journal: Cochrane Database Syst Rev Date: 2019-11-27
Authors: Hendrik J F Helmerhorst; Marcus J Schultz; Peter H J van der Voort; Evert de Jonge; David J van Westerloo Journal: Crit Care Date: 2015-08-17 Impact factor: 9.097