RT Journal Article
T1 Effects of oxygen on post-surgical infections during an individualised perioperative open-lung ventilatory strategy: a randomised controlled trial.
A1 Ferrando, Carlos
A1 Aldecoa, César
A1 Unzueta, Carmen
A1 Belda, F Javier
A1 Librero, Julián
A1 Tusman, Gerardo
A1 Suárez-Sipmann, Fernando
A1 Peiró, Salvador
A1 Pozo, Natividad
A1 Brunelli, Andrea
A1 Garutti, Ignacio
A1 Gallego, Clara
A1 Rodríguez, Aurelio
A1 García, Jose Ignacio
A1 Díaz-Cambronero, Oscar
A1 Balust, Jaume
A1 Redondo, Francisco J
A1 de la Matta, Manuel
A1 Gallego-Ligorit, Lucía
A1 Hernández, Javier
A1 Martínez, Pascual
A1 Pérez, Ana
A1 Leal, Sonsoles
A1 Alday, Enrique
A1 Monedero, Pablo
A1 González, Rafael
A1 Mazzirani, Guido
A1 Aguilar, Gerardo
A1 López-Baamonde, Manuel
A1 Felipe, Mar
A1 Mugarra, Ana
A1 Torrente, Jara
A1 Valencia, Lucia
A1 Varón, Viviana
A1 Sánchez, Sergio
A1 Rodríguez, Benigno
A1 Martín, Ana
A1 India, Inmaculada
A1 Azparren, Gonzalo
A1 Molina, Rodrigo
A1 Villar, Jesús
A1 Soro, Marina
A1 iPROVE-O2 Network, 
K1 anaesthesia
K1 inspiratory oxygen fraction
K1 positive end-expiratory pressure
K1 postoperative complications
K1 recruitment manoeuvres
K1 sepsis
K1 surgery
K1 surgical site infection
AB We aimed to examine whether using a high fraction of inspired oxygen (FIO2) in the context of an individualised intra- and postoperative open-lung ventilation approach could decrease surgical site infection (SSI) in patients scheduled for abdominal surgery. We performed a multicentre, randomised controlled clinical trial in a network of 21 university hospitals from June 6, 2017 to July 19, 2018. Patients undergoing abdominal surgery were randomly assigned to receive a high (0.80) or conventional (0.3) FIO2 during the intraoperative period and during the first 3 postoperative hours. All patients were mechanically ventilated with an open-lung strategy, which included recruitment manoeuvres and individualised positive end-expiratory pressure for the best respiratory-system compliance, and individualised continuous postoperative airway pressure for adequate peripheral oxyhaemoglobin saturation. The primary outcome was the prevalence of SSI within the first 7 postoperative days. The secondary outcomes were composites of systemic complications, length of intensive care and hospital stay, and 6-month mortality. We enrolled 740 subjects: 371 in the high FIO2 group and 369 in the low FIO2 group. Data from 717 subjects were available for final analysis. The rate of SSI during the first postoperative week did not differ between high (8.9%) and low (9.4%) FIO2 groups (relative risk [RR]: 0.94; 95% confidence interval [CI]: 0.59-1.50; P=0.90]). Secondary outcomes, such as atelectasis (7.7% vs 9.8%; RR: 0.77; 95% CI: 0.48-1.25; P=0.38) and myocardial ischaemia (0.6% [n=2] vs 0% [n=0]; P=0.47) did not differ between groups. An oxygenation strategy using high FIO2 compared with conventional FIO2 did not reduce postoperative SSIs in abdominal surgery. No differences in secondary outcomes or adverse events were found. NCT02776046.
YR 2019
FD 2019-11-22
LK http://hdl.handle.net/10668/14741
UL http://hdl.handle.net/10668/14741
LA en
DS RISalud
RD Apr 14, 2025