Key result
Hyperoxemia after lung resection is not linked to pulmonary and cardiovascular complications or 30-day mortality.
Why the study?
Post-operative hypoxemia is declining and oxygen benefits are questioned, while hyperoxemia might adversely affect pulmonary and cardiovascular systems, prompting investigation into its association with post-operative complications after thoracic surgery.
Is hyperoxemia post thoracic surgery associated with increased post-operative pulmonary and cardiovascular complications in lung resection patients?
Cohort (n=363)
Is hyperoxemia post thoracic surgery associated with increased post-operative pulmonary and cardiovascular complications in lung resection patients?
Hyperoxemia after lung resection surgery is common but does not appear to be associated with increased post-operative pulmonary or cardiovascular complications or 30-day mortality.
Hyperoxemia after lung resection warrants no practice change in oxygen targets; leaves open need for randomized trials on perioperative oxygenation.
IntroductionPost-operative oxygen therapy is used to prevent hypoxemia and surgical site infection. However, with improvements of anesthesia techniques, post-operative hypoxemia incidence is declining and the benefits of oxygen on surgical site infection have been questioned. Moreover, hyperoxemia might have adverse effects on the pulmonary and cardiovascular systems. We hypothesized hyperoxemia post thoracic surgery is associated with post-operative pulmonary and cardiovascular complications.MethodsConsecutive lung resection patients were included in this post-hoc analysis. Post-operative pulmonary and cardiovascular complications were prospectively assessed during the first 30 post-operative days, or hospital stay. Arterial blood gases were analyzed at 1, 6 and 12 h after surgery. Hyperoxemia was defined as arterial partial pressure of oxygen (PaO2)>100 mmHg. Patients with hyperoxemia duration in at least two adjacent time points were considered as hyperoxemic. Student t-test, Mann-Whitney U test and two-tailed Fisher exact test were used for group comparison. P values < 0.05 were considered statistically significant.ResultsThree hundred sixty-three consecutive patients were included in this post-hoc analysis. Two hundred five patients (57%), were considered hyperoxemic and included in the hyperoxemia group. Patients in the hyperoxemia group had significantly higher PaO2 at 1, 6 and 12 h after surgery (p < 0.05). Otherwise, there was no significant difference in age, sex, comorbidities, pulmonary function tests parameters, lung surgery procedure, incidence of post-operative pulmonary and cardiovascular complications, intensive care unit and hospital length of stay and 30-day mortality.ConclusionHyperoxemia after lung resection surgery is common and not associated with post-operative complications or 30-day mortality.
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Brat et al. (2023) conducted a cohort in Lung resection (n=363). Hyperoxemia vs. No hyperoxemia was evaluated on Post-operative pulmonary and cardiovascular complications. Hyperoxemia after lung resection surgery (present in 57% of patients) was not associated with significant differences in post-operative pulmonary and cardiovascular complications or 30-day mortality.
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