TY - JOUR
T1 - Inspiratory oxygen fraction and postoperative complications in obese patients: a subgroup analysis of the PROXI trial
AU - Staehr, Anne K
AU - Meyhoff, Christian Sylvest
AU - Rasmussen, Lars S
AU - PROXI Trial Group
AU - Jørgensen, Lars Nannestad
PY - 2011/6/1
Y1 - 2011/6/1
N2 - Background: Obese patients are at a high risk of postoperative complication, including surgical site infection (SSI). Our aim was to evaluate the effect of a high inspiratory oxygen fraction (80%) on SSI and pulmonary complications in obese patients undergoing laparotomy. Methods: This study was a planned analysis of the obese patients (body mass index ≥ 30 kg/m) recruited in the Danish multicenter, patient- and observer-blinded, PROXI Trial of 1,400 patients undergoing acute or elective laparotomy. Patients were randomized to receive either 80% or 30% oxygen during and for 2 h after surgery. The primary outcome was SSI within 14 days. Secondary outcomes were atelectasis, pneumonia, and respiratory failure. Results: Two hundred thirteen patients had a body mass index ≥ 30 kg/m. The median (5-95% range) body mass index was 34 kg/m (30-44) and 33 kg/m (30-41) in patients allocated to the 80% and 30% oxygen group. SSI occurred in 32 of 102 (31%) versus 29 of 111 (26%) patients given 80% and 30% oxygen, respectively (odds ratio, 1.29; 95% CI, 0.71-2.34; P = 0.40). In addition, the incidence of pulmonary complications was not significantly different, with atelectasis occurring in 9% versus 6%, pneumonia in 6% versus 5%, and respiratory failure in 8% versus 5% in patients given 80% and 30% oxygen, respectively. Conclusion: Administration of 80% oxygen, compared with 30% oxygen, did not reduce the frequency of SSI in obese patients. Moreover, no significant association was found between oxygen fraction and the risk of pulmonary complications.
AB - Background: Obese patients are at a high risk of postoperative complication, including surgical site infection (SSI). Our aim was to evaluate the effect of a high inspiratory oxygen fraction (80%) on SSI and pulmonary complications in obese patients undergoing laparotomy. Methods: This study was a planned analysis of the obese patients (body mass index ≥ 30 kg/m) recruited in the Danish multicenter, patient- and observer-blinded, PROXI Trial of 1,400 patients undergoing acute or elective laparotomy. Patients were randomized to receive either 80% or 30% oxygen during and for 2 h after surgery. The primary outcome was SSI within 14 days. Secondary outcomes were atelectasis, pneumonia, and respiratory failure. Results: Two hundred thirteen patients had a body mass index ≥ 30 kg/m. The median (5-95% range) body mass index was 34 kg/m (30-44) and 33 kg/m (30-41) in patients allocated to the 80% and 30% oxygen group. SSI occurred in 32 of 102 (31%) versus 29 of 111 (26%) patients given 80% and 30% oxygen, respectively (odds ratio, 1.29; 95% CI, 0.71-2.34; P = 0.40). In addition, the incidence of pulmonary complications was not significantly different, with atelectasis occurring in 9% versus 6%, pneumonia in 6% versus 5%, and respiratory failure in 8% versus 5% in patients given 80% and 30% oxygen, respectively. Conclusion: Administration of 80% oxygen, compared with 30% oxygen, did not reduce the frequency of SSI in obese patients. Moreover, no significant association was found between oxygen fraction and the risk of pulmonary complications.
U2 - http://dx.doi.org/10.1097/ALN.0b013e31821bdb82
DO - http://dx.doi.org/10.1097/ALN.0b013e31821bdb82
M3 - Journal article
SN - 0003-3022
VL - 114
SP - 1313
EP - 1319
JO - Anesthesiology
JF - Anesthesiology
IS - 6
ER -