Effect of Intraoperative Arterial Oxygen Targets on Thiol-Disulfide Homeostasis and Ischemia-Modified Albumin

Bursa Yuksek Ihtisas Training and Research Hospital64 enrolled

Overview

This single-center randomized trial compared two intraoperative arterial oxygen tension (PaO2) target strategies in adults undergoing elective isolated coronary artery bypass graft surgery. Sixty-four participants were assigned 1:1 to a higher target (PaO2 200 mmHg or greater) or a lower target (PaO2 80 to less than 200 mmHg). The study evaluated perioperative changes in thiol-disulfide homeostasis and ischemia-modified albumin.

Hyperoxemia is frequently used during cardiac surgery to reduce the risk of hypoxemia, but excessive oxygen exposure may increase oxidative stress and ischemia-reperfusion injury. In this prospective, randomized, parallel-group study, inspired oxygen concentration was adjusted intraoperatively to achieve the assigned PaO2 target. Allocation was generated by computer and concealed with sealed envelopes. The clinical team was aware of group assignment because oxygen administration had to be titrated, whereas laboratory personnel were blinded. Biomarker samples were collected before anesthesia induction, 30 minutes after aortic cross-clamp removal, at the end of surgery, and 6 hours postoperatively. Sixty-four participants were randomized (32 per group), and 59 participants were included in the final analysis.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

SINGLE

Enrollment

Conditions

Coronary Artery Disease

Interventions

Intraoperative Oxygenation Strategy: PaO2 200 mmHg or GreaterOTHER

The fraction of inspired oxygen was actively titrated during anesthesia and cardiopulmonary bypass to achieve an arterial oxygen tension (PaO2) of 200 mmHg or greater. The assigned strategy was maintained intraoperatively, subject to predefined cerebral oxygen saturation safety management.

Intraoperative Oxygenation Strategy: PaO2 80 to Less Than 200 mmHgOTHER

The fraction of inspired oxygen was actively titrated during anesthesia and cardiopulmonary bypass to achieve an arterial oxygen tension (PaO2) from 80 to less than 200 mmHg. The assigned strategy was maintained intraoperatively, subject to predefined cerebral oxygen saturation safety management.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age 18 to 75 years * Scheduled for elective isolated coronary artery bypass graft surgery * American Society of Anesthesiologists physical status III or higher * Left ventricular ejection fraction of 40% or greater Exclusion Criteria: * Valvular heart disease requiring concomitant valve surgery * Left ventricular ejection fraction below 40% * Hemodynamically significant arrhythmia * Previous stroke or transient ischemic attack * End-stage organ failure

Locations (1)

University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital

Bursa, Bursa, Turkey (Türkiye)

Outcomes

Primary Outcomes

Native Thiol Concentration

Serum native thiol concentration measured by the automated spectrophotometric thiol-disulfide homeostasis method and reported in micromoles per liter (micromol/L).