Brat Kristian, Chovanec Zdenek, Mitas Ladislav, Sramek Vladimir, Olson Lyle J, Cundrle Ivan
Department of Respiratory Diseases, University Hospital Brno, Czech Republic.
Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Heliyon. 2023 Jun 25;9(6):e17606. doi: 10.1016/j.heliyon.2023.e17606. eCollection 2023 Jun.
Post-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.
Consecutive 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 (PaO)>100 mmHg. Patients with hyperoxemia duration in at least two adjacent time points were considered as hyperoxemic. Student t-test, Mann-Whitney test and two-tailed Fisher exact test were used for group comparison. values < 0.05 were considered statistically significant.
Three 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 PaO 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.
Hyperoxemia after lung resection surgery is common and not associated with post-operative complications or 30-day mortality.
术后氧疗用于预防低氧血症和手术部位感染。然而，随着麻醉技术的改进，术后低氧血症的发生率正在下降，并且氧气对手术部位感染的益处受到质疑。此外，高氧血症可能对肺和心血管系统产生不利影响。我们假设胸科手术后的高氧血症与术后肺部和心血管并发症相关。
本事后分析纳入了连续的肺切除患者。在术后的前30天或住院期间对术后肺部和心血管并发症进行前瞻性评估。术后1、6和12小时分析动脉血气。高氧血症定义为动脉血氧分压（PaO）>100mmHg。在至少两个相邻时间点出现高氧血症持续时间的患者被视为高氧血症患者。采用学生t检验、曼-惠特尼检验和双侧费舍尔精确检验进行组间比较。P值<0.05被认为具有统计学意义。
本事后分析纳入了363例连续患者。205例患者（57%）被视为高氧血症患者并纳入高氧血症组。高氧血症组患者在术后1、6和12小时的PaO显著更高（P<0.05）。否则，在年龄、性别、合并症、肺功能测试参数、肺手术程序、术后肺部和心血管并发症的发生率、重症监护病房和住院时间以及30天死亡率方面没有显著差异。
肺切除手术后的高氧血症很常见，且与术后并发症或30天死亡率无关。
