Oxygen therapy is administered to all patients during general anesthesia to maintain tissue oxygenation and prevent hypoxia and ischemia. However, liberal use of oxygen may lead to hyperoxia and some studies suggest that supranormal levels of arterial oxygen saturation may lead to complications. In this post hoc substudy of the VISION cohort, we plan to assess the association between perioperative inspired oxygen fraction (FiO2) and myocardial injury after non-cardiac surgery (MINS).
Patients will be divided into five groups of median intraoperative FiO2 (quintiles), in which baseline characteristics and outcomes will be illustrated. The odds ratio (OR) for the primary and secondary outcomes will be calculated in a logistic regression analysis with median FiO2 (continuous variable) as independent variable. Analyses are performed with multiple logistic regression with adjustment for the following potentially confounding variables: Age ≥75 years. Male sex. Current atrial fibrillation. History of diabetes. History of congestive heart failure. History of coronary artery disease. History of recent (i.e., \< 6 months) high-risk coronary artery disease. History of stroke. History of peripheral vascular disease. History of hypertension. Preoperative eGFR (\<30 vs. 30-44 vs. 45-59 vs. ≥60 mL/min/1.73m2). Low-risk surgery. Duration of surgery.
Study Type
OBSERVATIONAL
Enrollment
7,700
Median inspiratory oxygen fraction during general anesthesia
Cleveland Clinic
Cleveland, Ohio, United States
Walter C. Mackenzie Health Sciences Centre
Edmonton, Canada
Prince of Wales Hospital
Hong Kong, China
Foundation CardioInfanil
Bogotá, Colombia
Myocardial injury after non-cardiac surgery (MINS)
Number of participants with MINS in the specified oxygen groups. MINS is defined as either ischemic troponin elevation or myocardial infarction after non-cardiac surgery.
Time frame: Within 30 days after surgery.
All-cause mortality
Number of deaths within 30 days after surgery
Time frame: Within 30 days after surgery
Myocardial infarction
Number of participants with myocardial infarction within 30 days after surgery
Time frame: Within 30 days after surgery
MINS
Number of participants with MINS not fulfilling the fourth universal definition of myocardial infarction
Time frame: Within 30 days after surgery
Rehospitalization for vascular reasons
Number of participants rehospitalized for vascular reasons within 30 days after surgery
Time frame: Within 30 days after surgery
Pneumonia
Number of participants with pneumonia within 30 days after surgery
Time frame: Within 30 days after surgery
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