Perioperative supplemental oxygen and NT-proBNP concentrations after major abdominal surgery – A prospective randomized clinical trial
Christian Reiterer, Barbara Kabon, Alexander Taschner, Markus Falkner von Sonnenburg, Alexandra Gráf, Nikolas Adamowitsch, Patrick Starlinger, Julius Goshin, Melanie Fraunschiel, Edith Fleischmann
Abstract
STUDY OBJECTIVE: Supplemental oxygen is a simple method to improve arterial oxygen saturation and might therefore improve myocardial oxygenation. Thus, we tested whether intraoperative supplemental oxygen reduces the risk of impaired cardiac function diagnosed with NT-proBNP and myocardial injury after noncardiac surgery (MINS) diagnosed with high-sensitivity Troponin T. DESIGN: Parallel-arm double-blinded single-centre superiority randomized trial. SETTING: Operating room and postoperative recovery area. PATIENTS: 260 patients over the age of 45 years at-risk for cardiovascular complications undergoing major abdominal surgery. INTERVENTION: Administration of 80% versus 30% oxygen throughout surgery and for the first two postoperative hours. MEASUREMENTS: The primary outcome was the postoperative maximum NT-proBNP concentration in both groups, which was assessed within 2 h after surgery, and on the first and third postoperative day. The secondary outcome was the incidence of MINS in both groups. MAIN RESULTS: , 95%CI -123, 431, p = 0.704). There was no difference in the incidence of MINS between both groups. (p = 0.703). CONCLUSIONS: There was no beneficial effect of perioperative supplemental oxygen administration on postoperative NT-proBNP concentration and MINS. It seems likely that supplemental oxygen has no effect on the release of NT-proBNP in patients at-risk for cardiovascular complications undergoing major abdominal surgery. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03366857. https://clinicaltrials.gov/ct2/results?cond=NCT+03366857&term=&cntry=&state=&city=&dist=.