Perioperative supplemental oxygen and NT-proBNP concentrations after major abdominal surgery - A prospective randomized clinical trial
Christian Reiterer, Barbara Kabon, Alexander Taschner, Markus Falkner von Sonnenburg, Alexandra Graf, Nikolas Adamowitsch, Patrick Starlinger, Julius Goshin, Melanie Fraunschiel, Edith Fleischmann, Christian Reiterer, Barbara Kabon, Alexander Taschner, Markus Falkner von Sonnenburg, Alexandra Graf, Nikolas Adamowitsch, Patrick Starlinger, Julius Goshin, Melanie Fraunschiel, Edith Fleischmann
Abstract
Study objective: Supplemental oxygen is a simple method to improve arterial oxygen saturation and might therefore improve myocardial oxygenation. Thus, we tested whether intraoperative supplemental oxygen reduces the risk of impaired cardiac function diagnosed with NT-proBNP and myocardial injury after noncardiac surgery (MINS) diagnosed with high-sensitivity Troponin T.
Design: Parallel-arm double-blinded single-centre superiority randomized trial.
Setting: Operating room and postoperative recovery area.
Patients: 260 patients over the age of 45 years at-risk for cardiovascular complications undergoing major abdominal surgery.
Intervention: Administration of 80% versus 30% oxygen throughout surgery and for the first two postoperative hours.
Measurements: The primary outcome was the postoperative maximum NT-proBNP concentration in both groups, which was assessed within 2 h after surgery, and on the first and third postoperative day. The secondary outcome was the incidence of MINS in both groups.
Main results: 128 patients received 80% oxygen and 130 received 30% oxygen throughout surgery and for the first two postoperative hours. There was no significant difference in the median postoperative maximum NT-proBNP concentration between the 80% and the 30% oxygen group (989 pg.mL-1 [IQR 499; 2005] and 810 pg.mL-1 [IQR 409; 2386], effect estimate: 159 pg.mL-1, 95%CI -123, 431, p = 0.704). There was no difference in the incidence of MINS between both groups. (p = 0.703).
Conclusions: There was no beneficial effect of perioperative supplemental oxygen administration on postoperative NT-proBNP concentration and MINS. It seems likely that supplemental oxygen has no effect on the release of NT-proBNP in patients at-risk for cardiovascular complications undergoing major abdominal surgery.
Trial registration: ClinicalTrials.gov: NCT03366857. https://clinicaltrials.gov/ct2/results?cond=NCT+03366857&term=&cntry=&state=&city=&dist=.
Keywords: Cardiovascular risk; MINS; Major abdominal surgery; NT-proBNP; Supplemental oxygen.
Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.
Source: PubMed