Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery: the PROXI randomized clinical trial

Christian S Meyhoff; Jørn Wetterslev; Lars N Jorgensen; Steen W Henneberg; Claus Høgdall; Lene Lundvall; Poul-Erik Svendsen; Hannah Mollerup; Troels H Lunn; Inger Simonsen; Kristian R Martinsen; Therese Pulawska; Lars Bundgaard; Lasse Bugge; Egon G Hansen; Claus Riber; Peter Gocht-Jensen; Line R Walker; Asger Bendtsen; Gun Johansson; Nina Skovgaard; Kim Heltø; Andrei Poukinski; André Korshin; Aqil Walli; Mustafa Bulut; Palle S Carlsson; Svein A Rodt; Liselotte B Lundbech; Henrik Rask; Niels Buch; Sharafaden K Perdawid; Joan Reza; Kirsten V Jensen; Charlotte G Carlsen; Frank S Jensen; Lars S Rasmussen; PROXI Trial Group; Sharaf Perdawood

doi:10.1001/jama.2009.1452

Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery: the PROXI randomized clinical trial

Christian S Meyhoff, Jørn Wetterslev, Lars N Jorgensen, Steen W Henneberg, Claus Høgdall, Lene Lundvall, Poul-Erik Svendsen, Hannah Mollerup, Troels H Lunn, Inger Simonsen, Kristian R Martinsen, Therese Pulawska, Lars Bundgaard, Lasse Bugge, Egon G Hansen, Claus Riber, Peter Gocht-Jensen, Line R Walker, Asger Bendtsen, Gun JohanssonNina Skovgaard, Kim Heltø, Andrei Poukinski, André Korshin, Aqil Walli, Mustafa Bulut, Palle S Carlsson, Svein A Rodt, Liselotte B Lundbech, Henrik Rask, Niels Buch, Sharafaden K Perdawid, Joan Reza, Kirsten V Jensen, Charlotte G Carlsen, Frank S Jensen, Lars S Rasmussen, PROXI Trial Group, Sharaf Perdawood

Institut for Klinisk Medicin

262 Citationer (Scopus)

Abstract

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.

Originalsprog	Engelsk
Tidsskrift	JAMA - Journal of the American Medical Association
Vol/bind	302
Udgave nummer	14
Sider (fra-til)	1543-50
Antal sider	8
ISSN	0098-7484
DOI	https://doi.org/10.1001/jama.2009.1452
Status	Udgivet - 14 okt. 2009

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10.1001/jama.2009.1452

Citationsformater

Meyhoff, C. S., Wetterslev, J., Jorgensen, L. N., Henneberg, S. W., Høgdall, C., Lundvall, L., Svendsen, P.-E., Mollerup, H., Lunn, T. H., Simonsen, I., Martinsen, K. R., Pulawska, T., Bundgaard, L., Bugge, L., Hansen, E. G., Riber, C., Gocht-Jensen, P., Walker, L. R., Bendtsen, A., ... Perdawood, S. (2009). Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery: the PROXI randomized clinical trial. JAMA - Journal of the American Medical Association, 302(14), 1543-50. https://doi.org/10.1001/jama.2009.1452

Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery: the PROXI randomized clinical trial. / Meyhoff, Christian S; Wetterslev, Jørn; Jorgensen, Lars N et al.
I: JAMA - Journal of the American Medical Association, Bind 302, Nr. 14, 14.10.2009, s. 1543-50.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Meyhoff, CS, Wetterslev, J, Jorgensen, LN, Henneberg, SW, Høgdall, C, Lundvall, L, Svendsen, P-E, Mollerup, H, Lunn, TH, Simonsen, I, Martinsen, KR, Pulawska, T, Bundgaard, L, Bugge, L, Hansen, EG, Riber, C, Gocht-Jensen, P, Walker, LR, Bendtsen, A, Johansson, G, Skovgaard, N, Heltø, K, Poukinski, A, Korshin, A, Walli, A, Bulut, M, Carlsson, PS, Rodt, SA, Lundbech, LB, Rask, H, Buch, N, Perdawid, SK, Reza, J, Jensen, KV, Carlsen, CG, Jensen, FS, Rasmussen, LS, PROXI Trial Group & Perdawood, S 2009, 'Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery: the PROXI randomized clinical trial', JAMA - Journal of the American Medical Association, bind 302, nr. 14, s. 1543-50. https://doi.org/10.1001/jama.2009.1452

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title = "Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery: the PROXI randomized clinical trial",

abstract = "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.",

keywords = "Adult, Aged, Aged, 80 and over, Female, Humans, Intraoperative Period, Laparotomy, Male, Middle Aged, Oxygen, Oxygen Inhalation Therapy, Perioperative Care, Pneumonia, Postoperative Complications, Postoperative Period, Pulmonary Atelectasis, Respiratory Insufficiency, Risk, Surgical Wound Infection",

author = "Meyhoff, {Christian S} and J{\o}rn Wetterslev and Jorgensen, {Lars N} and Henneberg, {Steen W} and Claus H{\o}gdall and Lene Lundvall and Poul-Erik Svendsen and Hannah Mollerup and Lunn, {Troels H} and Inger Simonsen and Martinsen, {Kristian R} and Therese Pulawska and Lars Bundgaard and Lasse Bugge and Hansen, {Egon G} and Claus Riber and Peter Gocht-Jensen and Walker, {Line R} and Asger Bendtsen and Gun Johansson and Nina Skovgaard and Kim Helt{\o} and Andrei Poukinski and Andr{\'e} Korshin and Aqil Walli and Mustafa Bulut and Carlsson, {Palle S} and Rodt, {Svein A} and Lundbech, {Liselotte B} and Henrik Rask and Niels Buch and Perdawid, {Sharafaden K} and Joan Reza and Jensen, {Kirsten V} and Carlsen, {Charlotte G} and Jensen, {Frank S} and Rasmussen, {Lars S} and {PROXI Trial Group} and Sharaf Perdawood",

year = "2009",

month = oct,

day = "14",

doi = "10.1001/jama.2009.1452",

language = "English",

volume = "302",

pages = "1543--50",

journal = "JAMA - Journal of the American Medical Association",

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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

SN - 0098-7484

VL - 302

SP - 1543

EP - 1550

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

IS - 14

ER -

Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery: the PROXI randomized clinical trial

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