Hyperoxemia During Cardiac Surgery Is Associated With Postoperative Pulmonary Complications
David J Douin1, Jack Pattee2, Benjamin Scott1
1Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO.
Critical Care Explorations
|March 6, 2023
Summary
Intraoperative hyperoxemia during cardiac surgery is common and linked to higher risks of pulmonary complications. Limiting excessive intraoperative oxygen exposure may improve patient outcomes post-surgery.
Area of Science:
- Cardiology
- Pulmonology
- Anesthesiology
Background:
- Intraoperative hyperoxemia use in cardiac surgery is debated.
- This study investigates the association between intraoperative hyperoxemia and postoperative pulmonary complications.
Purpose of the Study:
- To test the hypothesis that intraoperative hyperoxemia increases the risk of postoperative pulmonary complications in adult cardiac surgery patients.
Main Methods:
- Retrospective cohort study of 21,632 adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) from 2014-2019.
- Intraoperative oxygenation was assessed, quantifying hyperoxemia exposure (area under the curve) before, during, and after CPB.
- Association with 30-day postoperative pulmonary complications (acute respiratory insufficiency/failure, ARDS, reintubation, pneumonia) was analyzed.
Main Results:
- Hyperoxemia was nearly universal, occurring in 96.4% of patients.
- Increased hyperoxemia exposure correlated with higher odds of pulmonary complications.
- A linear association was observed during CPB, and a U-shaped relationship was found before and after CPB.
Conclusions:
- Hyperoxemia is prevalent during cardiac surgery.
- Continuous intraoperative hyperoxemia exposure, especially during CPB, is linked to increased postoperative pulmonary complications.
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