• Qiliang Jiang, Andrea Kurz, Xiaobao Zhang, Liu Liu, Dongsheng Yang, and Daniel I Sessler.
• Anesthesiology. 2021 May 1; 134 (5): 709-721.

BackgroundWhether supplemental oxygen worsens long-term mortality remains unclear, with contradictory trial results. The authors therefore tested the hypothesis that supplemental oxygen (80% vs. 30%) increases the hazard for long-term mortality.MethodsThe authors conducted a post hoc analysis of a large multiple crossover cluster trial in which more than 5,000 colorectal surgeries on 4,088 adults were allocated to receive either 30% or 80% inspired oxygen during general anesthesia. The authors assessed the effect of 80% versus 30% target-inspired oxygen on long-term mortality and calculated Kaplan-Meier survival estimates. Analysis was restricted to patients with a home address in Ohio because the authors could obtain reliable vital status information from the Ohio Department of Health (Columbus, Ohio) for them.ResultsA total of 3,471 qualifying colorectal surgeries performed in 2,801 patients were analyzed, including 1,753 (51%) surgeries in 1,577 patients given 80% oxygen and 1,718 surgeries in 1,551 patients given 30% oxygen. The observed incidence of death after a median of 3 yr was 13% (234 of 1,753) in the 80% oxygen group and 14% (245 of 1,718) in the 30% oxygen group. The estimated hazard ratio for mortality was 0.94 (95% CI, 0.78 to 1.13; P = 0.493).ConclusionsIn this post hoc analysis of a large, controlled trial, supplemental oxygen did not increase postoperative mortality.Editor’s PerspectiveCopyright © 2021, the American Society of Anesthesiologists, Inc. All Rights Reserved.

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