Effect of High Inspiratory Oxygen Fraction on Endothelial Function in Healthy Volunteers: A Randomized Controlled Crossover Pilot Study

et al. 2019

Preprint

Background Postoperative pulmonary complications (PPCs) have been the most common perioperative complication following surgical site infection, which prolongs the hospital stay and increases health care cost. Lung-protective ventilation strategy is considered better practice in abdominal surgery to prevent PPCs. The role of inspiratory oxygen fraction (FiO2) in the strategy is currently not clear and remains disputable, despite liberal oxygen administration and hyperoxia is demonstrated to be associated with respiratory mechanism changes and increased mortality in ventilated patients. The trial aims at exploring the effect of FiO2 in lung-protective ventilation strategy on PPCs. Methods PROtective Ventilation with a low versus high Inspiratory Oxygen fraction trial(PROVIO)is a single-center, prospective, randomized, controlled trial planning to recruit 252 patients under abdominal surgery lasting for at least 2 hours. The patients are randomly assigned to (1) a low FiO2 (30% FiO2) group and (2) a high FiO2 (80% FiO2) in lung-protective ventilation strategy. The primary outcome of the study is the occurrence of PPCs within the first 7 days postoperatively. Secondary outcomes include the severity grade of PPCs, the occurrence of postoperative extrapulmonary complications and all-cause mortality within the first 7 and 30 days postoperatively. Discussion PROVIO trial specially assesses the effect of low versus high FiO2 in lung-protective ventilation strategy on PPCs and the results will provide practical approaches to intraoperative oxygen management. Trial registration number Registered at www.ChiCTR.org.cn on 13 February 2018 with identifier no. ChiCTR18 00014901.

Section: Discussionmentioning

confidence: 97%

PROtective Ventilation with a low versus high Inspiratory Oxygen fraction(PROVIO) and its effects on postoperative pulmonary complications:protocol for a randomized controlled trial

et al. 2019

Preprint

“…Romagnoli et al demonstrated that protective ventilation with the lowest level of FiO 2 to keep SpO 2 ≥95% weaken oxygen toxicity by less ROS production [50]. However, there is contradictory view on high FiO 2 's detrimental effect on endothelial dysfunction in healthy volunteers solely [51]. Another interpretation is that high FiO 2 may change pulmonary gas exchange in surgical patients.…”

Section: Discussionmentioning

confidence: 99%

PROtective Ventilation with a low versus high Inspiratory Oxygen fraction(PROVIO) and its effects on postoperative pulmonary complications:protocol for a randomized controlled trial

et al. 2019

Preprint

Background: Postoperative pulmonary complications (PPCs) is the most common perioperative complication following surgical site infection (SSI), which prolongs the hospital stay and increases health care cost. Lung-protective ventilation strategy is considered better practice in abdominal surgery to prevent PPCs. However, the role of inspiratory oxygen fraction (FiO₂) in the strategy remains disputable. Previous trials have focused on reducing SSI by increasing inhaled oxygen concentration but higher FiO₂ (80%) was found to be associated with a greater incidence of atelectasis and mortality in recent researches. The trial aims at evaluating the effect of different FiO₂ added to lung-protective ventilation strategy on the incidence of PPCs during general anesthesia for abdominal surgery. Methods: PROtective Ventilation with a low versus high Inspiratory Oxygen fraction trial（PROVIO）is a single-center, prospective, randomized, controlled trial planning to recruit 252 patients undergoing abdominal surgery lasting for at least 2 hours. The patients will be randomly assigned to (1) a low FiO₂ (30% FiO₂) group and (2) a high FiO₂ (80% FiO₂) group in lung-protective ventilation strategy. The primary outcome of the study is the occurrence of PPCs within the postoperative 7 days. Secondary outcomes include the severity grade of PPCs, the occurrence of postoperative extrapulmonary complications and all-cause mortality within the postoperative 7 and 30 days. Discussion: PROVIO trial assesses the effect of low versus high FiO₂ added to lung-protective ventilation strategy on PPCs for abdominal surgery patients and the results will provide practical approaches to intraoperative oxygen management. Trial registration number: Registered at www.ChiCTR.org.cn on 13 February 2018 with identifier no. ChiCTR18 00014901. Keywords: Postoperative pulmonary complications, Lung-protective ventilation, Fraction of inspired oxygen, Abdominal surgery.

“…weaken oxygen toxicity by less ROS production [48]. However, there is contradictory view on high FiO 2 's detrimental effect on endothelial dysfunction in healthy volunteers solely [49]. Another interpretation is that high FiO 2 may change pulmonary gas exchange in surgical patients.…”

Section: Discussionmentioning

confidence: 99%

PROtective Ventilation with a low versus high Inspiratory Oxygen fraction(PROVIO) and its effects on postoperative pulmonary complications:protocol for a randomized controlled trial

et al. 2019

Preprint

KEYWORDS 2Postoperative pulmonary complications, Lung-protective ventilation, Fraction of inspired oxygen, Abdominal surgery. AbstractBackground: Postoperative pulmonary complications (PPCs) is the most common perioperative complication following surgical site infection (SSI), which prolongs the hospital stay and increases health care cost. Lung-protective ventilation strategy is considered better practice in abdominal surgery to prevent PPCs. However, the role of inspiratory oxygen fraction (FiO₂) in the strategy remains disputable. Previous trials have focused on reducing SSI by increasing inhaled oxygen concentration but higher FiO₂ (80%) was found to be associated with a greater incidence of atelectasis and mortality in recent researches. The trial aims at evaluating the effect of different FiO₂