PERIOPERATIVE HIGH-DOSE OXYGEN THERAPY IN VASCULAR SURGERY

Background:  Patients undergoing infrainguinal bypass surgery have reduced baseline tissue oxygen tension and high rates of wound infections. The hypoxaemia worsens during surgery, potentially reducing the ability to combat bacterial lodgement. We investigated whether high‐dose perioperative oxygen...

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Bibliographic Details
Published in:ANZ journal of surgery 2007-06, Vol.77 (6), p.433-436
Main Authors: Puckridge, Phillip J., Saleem, Hafees A., Vasudevan, Thodur M., Holdaway, Christopher M., Ferrar, David W.
Format: Article
Language:English
Subjects:
Aged
Female
Humans
Leg - blood supply
Male
Middle Aged
oxygen
Oxygen - administration & dosage
Oxygen - analysis
Oxygen - blood
Partial Pressure
Perioperative Care
surgical site infection
Surgical Wound Infection - prevention & control
vascular
Vascular Surgical Procedures
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Summary:Background:  Patients undergoing infrainguinal bypass surgery have reduced baseline tissue oxygen tension and high rates of wound infections. The hypoxaemia worsens during surgery, potentially reducing the ability to combat bacterial lodgement. We investigated whether high‐dose perioperative oxygen administration to patients undergoing infrainguinal arterial surgery results in increased tissue oxygenation. Methods:  Ten consecutive patients undergoing infrainguinal arterial surgery had transcutaneous partial pressure of oxygen (TcpO2) measured preoperatively, intraoperatively after arterial clamps applied, postoperatively and at discharge. Measurements were taken with inspired oxygen concentration (FiO2) of 30% then 80%. Arterial blood gases were measured at the same times. Results:  Tissue oxygenation showed no difference intraoperatively while arterial clamps were in place, but significantly higher tissue oxygenation was seen with use of high‐dose oxygen (FiO2 80%) postoperatively (P < 0.05). Carbon dioxide levels in tissue increased while arterial clamps were in place (P < 0.01) and pH fell intraoperatively and following reperfusion (P < 0.05). Conclusion:  The administration of high‐dose oxygen to vascular surgical patients undergoing lower‐limb arterial surgery results in increased tissue oxygen concentrations when perfusion is not reduced by the presence of arterial clamps. These results suggest the administration of high‐dose oxygen intraoperatively may be beneficial in reducing wound infections, but further research is required.
ISSN:1445-1433
1445-2197
DOI:10.1111/j.1445-2197.2007.04089.x