Effects of different fractions of inspired oxygen on delayed neurocognitive recovery in patients with one-lung ventilation: a randomized clinical trial.
Chujun Wu, Wangzhi Zhang, Jun Lin et al.
✦ AI-curated · Sources linked
In 30 seconds
This randomized clinical trial compared 70% with 100% inspired oxygen during one-lung ventilation in 88 patients aged 30–70 years undergoing thoracoscopic pulmonary lobectomy. The primary clinical focus was delayed neurocognitive recovery on postoperative days 1 and 3; cerebral oxygen desaturation and perioperative physiological and biochemical measures were also assessed. Delayed neurocognitive recovery and cerebral oxygen desaturation occurred at similar rates in both groups. The authors concluded that 100% oxygen did not increase delayed neurocognitive recovery on either postoperative day.
Key findings
- Delayed neurocognitive recovery on postoperative days 1 and 3 was similar with 70% and 100% FiO2.
- Cerebral oxygen desaturation incidence was similar between the two oxygen groups.
- With 100% FiO2, oxygenation index was higher at 30 and 60 minutes, while arterial carbon dioxide partial pressure was lower at 15, 30, and 60 minutes.
- Superoxide dismutase levels were lower with 100% FiO2 at 15 minutes after one-lung ventilation.
Why it matters
The findings address whether using 100% rather than 70% inspired oxygen during one-lung ventilation is associated with early postoperative cognitive harm. Similar observed rates of delayed neurocognitive recovery provide relevant short-term evidence, while the differences in oxygenation and measured biochemical variables show that oxygen concentration also affects perioperative physiology.
What to keep in mind
The study included 88 patients at a single hospital, and neurocognitive recovery was assessed only on postoperative days 1 and 3.