TY - JOUR

T1 - Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery

T2 - the PROXI randomized clinical trial

AU - Meyhoff, Christian S

AU - Wetterslev, Jørn

AU - Jorgensen, Lars N

AU - Henneberg, Steen W

AU - Høgdall, Claus

AU - Lundvall, Lene

AU - Svendsen, Poul-Erik

AU - Mollerup, Hannah

AU - Lunn, Troels H

AU - Simonsen, Inger

AU - Martinsen, Kristian R

AU - Pulawska, Therese

AU - Bundgaard, Lars

AU - Bugge, Lasse

AU - Hansen, Egon G

AU - Riber, Claus

AU - Gocht-Jensen, Peter

AU - Walker, Line R

AU - Bendtsen, Asger

AU - Johansson, Gun

AU - Skovgaard, Nina

AU - Heltø, Kim

AU - Poukinski, Andrei

AU - Korshin, André

AU - Walli, Aqil

AU - Bulut, Mustafa

AU - Carlsson, Palle S

AU - Rodt, Svein A

AU - Lundbech, Liselotte B

AU - Rask, Henrik

AU - Buch, Niels

AU - Perdawid, Sharafaden K

AU - Reza, Joan

AU - Jensen, Kirsten V

AU - Carlsen, Charlotte G

AU - Jensen, Frank S

AU - Rasmussen, Lars S

AU - PROXI Trial Group

AU - Perdawood, Sharaf

PY - 2009/10/14

Y1 - 2009/10/14

N2 - CONTEXT: Use of 80% oxygen during surgery has been suggested to reduce the risk of surgical wound infections, but this effect has not been consistently identified. The effect of 80% oxygen on pulmonary complications has not been well defined.OBJECTIVE: To assess whether use of 80% oxygen reduces the frequency of surgical site infection without increasing the frequency of pulmonary complications in patients undergoing abdominal surgery.DESIGN, SETTING, AND PATIENTS: The PROXI trial, a patient- and observer-blinded randomized clinical trial conducted in 14 Danish hospitals between October 2006 and October 2008 among 1400 patients undergoing acute or elective laparotomy.INTERVENTIONS: Patients were randomly assigned to receive either 80% or 30% oxygen during and for 2 hours after surgery.MAIN OUTCOME MEASURES: Surgical site infection within 14 days, defined according to the Centers for Disease Control and Prevention. Secondary outcomes included atelectasis, pneumonia, respiratory failure, and mortality.RESULTS: Surgical site infection occurred in 131 of 685 patients (19.1%) assigned to receive 80% oxygen vs 141 of 701 (20.1%) assigned to receive 30% oxygen (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.72-1.22; P = .64). Atelectasis occurred in 54 of 685 patients (7.9%) assigned to receive 80% oxygen vs 50 of 701 (7.1%) assigned to receive 30% oxygen (OR, 1.11; 95% CI, 0.75-1.66; P = .60), pneumonia in 41 (6.0%) vs 44 (6.3%) (OR, 0.95; 95% CI, 0.61-1.48; P = .82), respiratory failure in 38 (5.5%) vs 31 (4.4%) (OR, 1.27; 95% CI, 0.78-2.07; P = .34), and mortality within 30 days in 30 (4.4%) vs 20 (2.9%) (OR, 1.56; 95% CI, 0.88-2.77; P = .13).CONCLUSION: Administration of 80% oxygen compared with 30% oxygen did not result in a difference in risk of surgical site infection after abdominal surgery.TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00364741.

AB - CONTEXT: Use of 80% oxygen during surgery has been suggested to reduce the risk of surgical wound infections, but this effect has not been consistently identified. The effect of 80% oxygen on pulmonary complications has not been well defined.OBJECTIVE: To assess whether use of 80% oxygen reduces the frequency of surgical site infection without increasing the frequency of pulmonary complications in patients undergoing abdominal surgery.DESIGN, SETTING, AND PATIENTS: The PROXI trial, a patient- and observer-blinded randomized clinical trial conducted in 14 Danish hospitals between October 2006 and October 2008 among 1400 patients undergoing acute or elective laparotomy.INTERVENTIONS: Patients were randomly assigned to receive either 80% or 30% oxygen during and for 2 hours after surgery.MAIN OUTCOME MEASURES: Surgical site infection within 14 days, defined according to the Centers for Disease Control and Prevention. Secondary outcomes included atelectasis, pneumonia, respiratory failure, and mortality.RESULTS: Surgical site infection occurred in 131 of 685 patients (19.1%) assigned to receive 80% oxygen vs 141 of 701 (20.1%) assigned to receive 30% oxygen (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.72-1.22; P = .64). Atelectasis occurred in 54 of 685 patients (7.9%) assigned to receive 80% oxygen vs 50 of 701 (7.1%) assigned to receive 30% oxygen (OR, 1.11; 95% CI, 0.75-1.66; P = .60), pneumonia in 41 (6.0%) vs 44 (6.3%) (OR, 0.95; 95% CI, 0.61-1.48; P = .82), respiratory failure in 38 (5.5%) vs 31 (4.4%) (OR, 1.27; 95% CI, 0.78-2.07; P = .34), and mortality within 30 days in 30 (4.4%) vs 20 (2.9%) (OR, 1.56; 95% CI, 0.88-2.77; P = .13).CONCLUSION: Administration of 80% oxygen compared with 30% oxygen did not result in a difference in risk of surgical site infection after abdominal surgery.TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00364741.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Female

KW - Humans

KW - Intraoperative Period

KW - Laparotomy

KW - Male

KW - Middle Aged

KW - Oxygen

KW - Oxygen Inhalation Therapy

KW - Perioperative Care

KW - Pneumonia

KW - Postoperative Complications

KW - Postoperative Period

KW - Pulmonary Atelectasis

KW - Respiratory Insufficiency

KW - Risk

KW - Surgical Wound Infection

U2 - 10.1001/jama.2009.1452

DO - 10.1001/jama.2009.1452

M3 - Journal article

C2 - 19826023

VL - 302

SP - 1543

EP - 1550

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0098-7484

IS - 14

ER -