• Emilie Katrine Kongebro, Lars N Jorgensen, Volkert D Siersma, and Christian Sahlholt Meyhoff.
• Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
• Acta Anaesthesiol Scand. 2019 Feb 1; 63 (2): 164-170.

BackgroundPerioperative hyperoxia has been linked to increased long-term mortality. Vasoconstrictive and cellular side effects to hyperoxia have been suggested to increase the risk of coronary and cerebral ischemia. The aim of this post-hoc analysis of a large randomized trial was to compare the effects of 80% vs 30% perioperative oxygen on the long-term risk of stroke or transient cerebral ischemia (TCI) in patients undergoing abdominal surgery.MethodsA total of 1386 patients were randomized to 80% or 30% perioperative oxygen during acute or elective open abdominal surgery. Median follow-up was 3.9 years. Primary outcome was a composite of the long-term occurrence of stroke or TCI. Secondary outcomes included long-term mortality without stroke or TCI, and incidences of neurological admission, psychiatric admission, and dementia. Outcomes were analyzed in Cox regression models.ResultsStroke or TCI occurred in 20 (3.0%) patients given 80% oxygen vs 22 (3.2%) patients given 30% oxygen with an adjusted hazard ratio (HR) of 0.96 [95% CI 0.52-1.76]. Composite secondary outcome of death, stroke, or TCI had a HR of 1.21 [95% CI 1.00-1.47] for 80% compared to 30% oxygen. HRs for secondary outcomes were HR 1.14 [95% CI 0.79-1.64] for neurological admission, 1.34 [95% CI 0.95-1.88] for psychiatric admission and 0.54 [95% CI 0.16-1.80] for dementia.ConclusionStroke or TCI did not seem related to perioperative inspiratory oxygen fraction. Due to few events, this study cannot exclude that perioperative hyperoxia increases risk of mortality, stroke, or TCI after abdominal surgery.© 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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