Intraoperative oxygen concentration and postoperative delirium in elderly patients undergoing major abdominal surgery: a prospective randomized controlled clinical trial
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View abstract on PubMed
Summary
This summary is machine-generated.High-concentration inspired oxygen (FiO₂) did not reduce postoperative delirium (POD) in elderly patients undergoing major abdominal surgery. Titrating FiO₂ based on individual patient needs is recommended, as 100% oxygen offered no clinical benefits over 40% FiO₂.
Area Of Science
- Anesthesiology and Perioperative Medicine
- Neuroscience
- Critical Care Medicine
Background
- Postoperative delirium (POD) is a significant concern in elderly surgical patients.
- Cerebral hypoxia and hypoperfusion are identified as key contributors to POD pathophysiology.
- Optimizing intraoperative oxygenation is crucial for mitigating neurological complications.
Purpose Of The Study
- To compare the effects of 40% versus 100% inspired oxygen (FiO₂) on POD incidence in elderly patients undergoing major abdominal surgery.
- To evaluate the impact of different FiO₂ concentrations on neuroinflammation and clinical outcomes.
- To determine if higher FiO₂ levels reduce the risk of POD and associated complications.
Main Methods
- A randomized trial involving 160 elderly patients undergoing major abdominal surgery.
- Patients were assigned to receive either 40% or 100% FiO₂ during general anesthesia.
- Primary outcome was POD incidence within 3 days; secondary outcomes included oxygenation, neuroinflammation markers, and clinical outcomes.
Main Results
- No significant difference in POD incidence was observed between the 40% FiO₂ (6.4%) and 100% FiO₂ (3.9%) groups (P=0.72).
- The 40% FiO₂ group showed lower perioperative oxygenation parameters compared to the 100% FiO₂ group.
- No significant differences were found in neuroinflammatory markers, pulmonary infections, pain scores, or hospitalization duration between groups.
Conclusions
- Intraoperative administration of 100% FiO₂ does not reduce POD incidence or neuroinflammatory markers compared to 40% FiO₂ in this patient cohort.
- High-concentration oxygen did not increase pulmonary complications but provided no additional clinical benefits.
- Intraoperative FiO₂ should be individualized based on patient-specific requirements rather than a universal high-concentration approach.
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