Perioperative supplemental oxygen and oxidative stress in patients undergoing moderate- to high-risk major abdominal surgery - A subanalysis of randomized clinical trial
Christian Reiterer, Edith Fleischmann, Alexander Taschner, Nikolas Adamowitsch, Markus Falkner von Sonnenburg, Alexandra Graf, Melanie Fraunschiel, Patrick Starlinger, Julius Goschin, Barbara Kabon, Christian Reiterer, Edith Fleischmann, Alexander Taschner, Nikolas Adamowitsch, Markus Falkner von Sonnenburg, Alexandra Graf, Melanie Fraunschiel, Patrick Starlinger, Julius Goschin, Barbara Kabon
Abstract
Study objective: Oxidative stress plays a pivotal role in the development and aggravation of cardiovascular diseases. The influence of intraoperative inspired oxygen concentrations on oxidative stress is still not entirely known. Therefore, we evaluated in this sub-study if supplemental oxygen affects the oxidation-reduction potential in patients at-risk for cardiovascular complications undergoing moderate- to high-risk major abdominal surgery.
Design: Sub-study of a prospective parallel-arm double-blinded single-center superiority randomized trial.
Setting: Operating room and postoperative recovery area.
Intervention: Administration of 0.8 FiO2 versus 0.3 FiO2 throughout surgery and for the first two postoperative hours.
Measurements: The primary outcome was the static oxidation-reduction potential (sORP) and the oxidation-reduction potential capacity (cORP) between both groups. The secondary outcome was the trend of sORP and cORP in the overall study population. We assessed sORP and cORP before induction of anesthesia, 2 h after induction of anesthesia, within 2 h after surgery and on the first and third postoperative day.
Main results: 258 patients were analyzed. 128 patients were randomly assigned to the 80% oxygen group and 130 patients were randomly assigned to the 30% oxygen group. Postoperative sORP values did not differ significantly between the 80% and 30% oxygen group (effect estimate: -1.162 mV,95% CI: -2.584 to 0.260; p = 0.109). On average, we observed a change in sORP of 5.288 mV (95% CI:4.633 to 5.913, p < 0.001) per day. cORP values did not differ significantly between the 80% and 30% oxygen group (effect estimate: -0.015μC, (95%CI: -0.062 to 0.032; p = 0.524). On average, we observed a change in cORP values of -0.170μC (95%CI: -0.194 to -0.147, p < 0.001) per day.
Conclusion: In contrast to previous reports, we could not find any evidence of an association between intraoperative supplemental oxygen and perioperative oxidative stress assessed by sORP and cORP.
Trial registration: clinicaltrials.gov: NCT03366857https://ichgcp.net/clinical-trials-registry/NCT03366857?term=vienna&cond=oxygen&draw=2&rank=1.
Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.
Source: PubMed