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Hyperoxemia post thoracic surgery - Does it matter?

Kristian Brat1,2,3, Zdenek Chovanec2,4, Ladislav Mitas2,5

  • 1Department of Respiratory Diseases, University Hospital Brno, Czech Republic.

Heliyon
|July 7, 2023
PubMed
Summary
This summary is machine-generated.

Post-operative hyperoxemia, defined as high arterial partial pressure of oxygen (PaO2), is common after lung surgery. This study found no association between hyperoxemia and increased post-operative complications or mortality in thoracic surgery patients.

Keywords:
HyperoxemiaLung resection surgeryPost-operative complications

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Area of Science:

  • Thoracic Surgery
  • Anesthesiology
  • Critical Care Medicine

Background:

  • Post-operative oxygen therapy is standard for preventing hypoxemia and surgical site infections.
  • The necessity and benefits of routine oxygen administration are being re-evaluated due to declining hypoxemia rates and questioned efficacy for infection prevention.
  • Potential adverse effects of hyperoxemia on pulmonary and cardiovascular systems warrant investigation.

Purpose of the Study:

  • To investigate the association between post-operative hyperoxemia and pulmonary/cardiovascular complications following thoracic surgery.
  • To determine if hyperoxemia impacts patient outcomes such as mortality and length of hospital stay.

Main Methods:

  • A post-hoc analysis of consecutive lung resection patients was conducted.
  • Post-operative complications were assessed within 30 days. Arterial blood gases (PaO2) were measured at 1, 6, and 12 hours post-surgery.
  • Hyperoxemia was defined as PaO2 > 100 mmHg, with patients requiring sustained hyperoxemia at adjacent time points classified as hyperoxemic.

Main Results:

  • Of 363 patients, 205 (57%) experienced hyperoxemia.
  • Hyperoxemic patients demonstrated significantly higher PaO2 levels at all measured time points (p < 0.05).
  • No significant differences were observed in complication rates, intensive care unit or hospital length of stay, or 30-day mortality between hyperoxemic and non-hyperoxemic groups.

Conclusions:

  • Hyperoxemia is a frequent occurrence after lung resection surgery.
  • The study found no correlation between post-operative hyperoxemia and adverse pulmonary or cardiovascular complications.
  • Hyperoxemia was not associated with increased 30-day mortality in this patient cohort.