Oxygen “therapy” for infection in liver transplant surgery
15 Mar 2023 • In patients after liver transplantation (LT), a higher amount of postoperative supplemental oxygen is unsuccessful in lowering infection risk, according to the most recent research paper published in BMC Medicine. Surgery patients are at risk for infection in the future, which is a concern for global public health. WHO guidelines and CDC recommendations for preventive strategy include the provision of an 80% fraction in all adults of inspired oxygen (FiO2) for 2- 6 h postoperatively. In their study, Figiel et al. sought to decrease postoperative infection by giving liver transplant recipients with additional high concentration oxygen in the initial postoperative phase. 193 patients in total were randomly divided into two groups, with FiO2 at 80% vs. 28% for the first 6 hours following surgery.The 30-day postoperative infection rate served as the primary end measure, while one of the supplementary outcome measures was the 90-day severe morbidity rate. As the primary outcome measure, postoperative infections in the 30-day post-transplant period were greater in the 80% group (34% vs. 23.2%, no statistical significance) than in the 28% group. Also, the 80% group spent more time in the intensive care unit, had greater bilirubin concentration over the first five post-transplant days, and experienced more severe complications (43.6% vs. 28.3%) in the 90 days following transplantation. To sum up, routine high-dose oxygen supplementation is inefficient at preventing infections and ought to be avoided in liver transplant postoperative settings.
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