title: Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery: the PROXI randomized clinical trial.
abstract: BACKGROUND
  Use of 80% oxygen during surgery has been suggested to reduce the risk of surgical wound infections, but this effect has not been consistently identified. The effect of 80% oxygen on pulmonary complications has not been well defined.
  
  
  OBJECTIVE
  To assess whether use of 80% oxygen reduces the frequency of surgical site infection without increasing the frequency of pulmonary complications in patients undergoing abdominal surgery.
  
  
  METHODS
  The PROXI trial, a patient- and observer-blinded randomized clinical trial conducted in 14 Danish hospitals between October 2006 and October 2008 among 1400 patients undergoing acute or elective laparotomy.
  
  
  METHODS
  Patients were randomly assigned to receive either 80% or 30% oxygen during and for 2 hours after surgery.
  
  
  METHODS
  Surgical site infection within 14 days, defined according to the Centers for Disease Control and Prevention. Secondary outcomes included atelectasis, pneumonia, respiratory failure, and mortality.
  
  
  RESULTS
  Surgical site infection occurred in 131 of 685 patients (19.1%) assigned to receive 80% oxygen vs 141 of 701 (20.1%) assigned to receive 30% oxygen (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.72-1.22; P = .64). Atelectasis occurred in 54 of 685 patients (7.9%) assigned to receive 80% oxygen vs 50 of 701 (7.1%) assigned to receive 30% oxygen (OR, 1.11; 95% CI, 0.75-1.66; P = .60), pneumonia in 41 (6.0%) vs 44 (6.3%) (OR, 0.95; 95% CI, 0.61-1.48; P = .82), respiratory failure in 38 (5.5%) vs 31 (4.4%) (OR, 1.27; 95% CI, 0.78-2.07; P = .34), and mortality within 30 days in 30 (4.4%) vs 20 (2.9%) (OR, 1.56; 95% CI, 0.88-2.77; P = .13).
  
  
  CONCLUSIONS
  Administration of 80% oxygen compared with 30% oxygen did not result in a difference in risk of surgical site infection after abdominal surgery.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00364741.
authors.affiliation: Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Christian S
authors.initials: CS
authors.lastname: Meyhoff
authors.forename: Jørn
authors.initials: J
authors.lastname: Wetterslev
authors.forename: Lars N
authors.initials: LN
authors.lastname: Jorgensen
authors.forename: Steen W
authors.initials: SW
authors.lastname: Henneberg
authors.forename: Claus
authors.initials: C
authors.lastname: Høgdall
authors.forename: Lene
authors.initials: L
authors.lastname: Lundvall
authors.forename: Poul-Erik
authors.initials: PE
authors.lastname: Svendsen
authors.forename: Hannah
authors.initials: H
authors.lastname: Mollerup
authors.forename: Troels H
authors.initials: TH
authors.lastname: Lunn
authors.forename: Inger
authors.initials: I
authors.lastname: Simonsen
authors.forename: Kristian R
authors.initials: KR
authors.lastname: Martinsen
authors.forename: Therese
authors.initials: T
authors.lastname: Pulawska
authors.forename: Lars
authors.initials: L
authors.lastname: Bundgaard
authors.forename: Lasse
authors.initials: L
authors.lastname: Bugge
authors.forename: Egon G
authors.initials: EG
authors.lastname: Hansen
authors.forename: Claus
authors.initials: C
authors.lastname: Riber
authors.forename: Peter
authors.initials: P
authors.lastname: Gocht-Jensen
authors.forename: Line R
authors.initials: LR
authors.lastname: Walker
authors.forename: Asger
authors.initials: A
authors.lastname: Bendtsen
authors.forename: Gun
authors.initials: G
authors.lastname: Johansson
authors.forename: Nina
authors.initials: N
authors.lastname: Skovgaard
authors.forename: Kim
authors.initials: K
authors.lastname: Heltø
authors.forename: Andrei
authors.initials: A
authors.lastname: Poukinski
authors.forename: André
authors.initials: A
authors.lastname: Korshin
authors.forename: Aqil
authors.initials: A
authors.lastname: Walli
authors.forename: Mustafa
authors.initials: M
authors.lastname: Bulut
authors.forename: Palle S
authors.initials: PS
authors.lastname: Carlsson
authors.forename: Svein A
authors.initials: SA
authors.lastname: Rodt
authors.forename: Liselotte B
authors.initials: LB
authors.lastname: Lundbech
authors.forename: Henrik
authors.initials: H
authors.lastname: Rask
authors.forename: Niels
authors.initials: N
authors.lastname: Buch
authors.forename: Sharafaden K
authors.initials: SK
authors.lastname: Perdawid
authors.forename: Joan
authors.initials: J
authors.lastname: Reza
authors.forename: Kirsten V
authors.initials: KV
authors.lastname: Jensen
authors.forename: Charlotte G
authors.initials: CG
authors.lastname: Carlsen
authors.forename: Frank S
authors.initials: FS
authors.lastname: Jensen
authors.forename: Lars S
authors.initials: LS
authors.lastname: Rasmussen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage; D010102:Oxygen Inhalation Therapy; D019990:Perioperative Care; D011014:Pneumonia / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D011184:Postoperative Period; D001261:Pulmonary Atelectasis / Q000453:epidemiology*; D012131:Respiratory Insufficiency / Q000453:epidemiology; D012306:Risk; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D010100:Oxygen