Imperial College London

DrHelenLaycock

Faculty of MedicineDepartment of Surgery & Cancer

Honorary Clinical Lecturer
 
 
 
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Contact

 

+44 (0)20 3315 8023h.laycock

 
 
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Location

 

3.41Chelsea and Westminster HospitalChelsea and Westminster Campus

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Summary

 

Publications

Citation

BibTex format

@article{Morkane:2018:10.1186/s13741-018-0098-3,
author = {Morkane, CM and McKenna, H and Cumpstey, AF and Oldman, AH and Grocott, MPW and Martin, DS},
doi = {10.1186/s13741-018-0098-3},
journal = {Perioperative Medicine},
title = {Intraoperative oxygenation in adult patients undergoing surgery (iOPS): a retrospective observational study across 29 UK hospitals},
url = {http://dx.doi.org/10.1186/s13741-018-0098-3},
volume = {7},
year = {2018}
}

RIS format (EndNote, RefMan)

TY  - JOUR
AB - BackgroundConsiderable controversy remains about how much oxygen patients should receive during surgery. The 2016 World Health Organization (WHO) guidelines recommend that intubated patients receive a fractional inspired oxygen concentration (FIO2) of 0.8 throughout abdominal surgery to reduce the risk of surgical site infection. However, this recommendation has been widely criticised by anaesthetists and evidence from other clinical contexts has suggested that giving a high concentration of oxygen might worsen patient outcomes. This retrospective multi-centre observational study aimed to ascertain intraoperative oxygen administration practice by anaesthetists across parts of the UK.MethodsPatients undergoing general anaesthesia with an arterial catheter in situ across hospitals affiliated with two anaesthetic trainee audit networks (PLAN, SPARC) were eligible for inclusion unless undergoing cardiopulmonary bypass. Demographic and intraoperative oxygenation data, haemoglobin saturation and positive end-expiratory pressure were retrieved from anaesthetic charts and arterial blood gases (ABGs) over five consecutive weekdays in April and May 2017.ResultsThree hundred seventy-eight patients from 29 hospitals were included. Median age was 66 years, 205 (54.2%) were male and median ASA grade was 3. One hundred eight (28.6%) were emergency cases. An anticipated difficult airway or raised BMI was documented preoperatively in 31 (8.2%) and 45 (11.9%) respectively. Respiratory or cardiac comorbidity was documented in 103 (27%) and 83 (22%) respectively. SpO2 < 96% was documented in 83 (22%) patients, with 7 (1.9%) patients desaturating < 88% at any point intraoperatively. The intraoperative FIO2 ranged from 0.25 to 1.0, and median PaO2/FIO2 ratios for the first four arterial blood gases taken in each case were 24.6/0.5, 23.4/0.49, 25.7/0.46 and 25.4/0.47 respectively.ConclusionsIntraoperative oxygenation currently varies widely. An intraoperative FIO2 of 0
AU - Morkane,CM
AU - McKenna,H
AU - Cumpstey,AF
AU - Oldman,AH
AU - Grocott,MPW
AU - Martin,DS
DO - 10.1186/s13741-018-0098-3
PY - 2018///
SN - 2047-0525
TI - Intraoperative oxygenation in adult patients undergoing surgery (iOPS): a retrospective observational study across 29 UK hospitals
T2 - Perioperative Medicine
UR - http://dx.doi.org/10.1186/s13741-018-0098-3
UR - http://hdl.handle.net/10044/1/68751
VL - 7
ER -