Perioperative hyperoxia- impact on myocardial biomarkers, strain and outcome in high-risk patients undergoing non-cardiac surgery: Protocol for a prospective randomized controlled trial.

Friess, Jan O; Stiffler, Sandra; Mikasi, Jan; Erdoes, Gabor; Nagler, Michael; Gräni, Christoph; Weiss, Salome; Fischer, Kady; Guensch, Dominik P (2024). Perioperative hyperoxia- impact on myocardial biomarkers, strain and outcome in high-risk patients undergoing non-cardiac surgery: Protocol for a prospective randomized controlled trial. (In Press). Contemporary clinical trials communications, 140(107512), p. 107512. Elsevier 10.1016/j.cct.2024.107512

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BACKGROUND

Supplemental oxygen is used during every general anesthesia. However, for the maintenance phase of a general anesthesia, in most cases the longest part of anesthesia, only scarce evidence of dosing supplemental oxygen exists. Oxygen is a well-known coronary vasoconstrictor and thus may contribute to cardiovascular complications especially in vulnerable high-risk patients with coronary artery disease undergoing major non-cardiac surgery. Myocardial biomarkers are early indicators of myocardial injury. Oxygen supply demand mismatches due to coronary artery disease aggravated by hyperoxia might be displayed by changes from the biomarker's baseline-values. This study is designed to detect changes in myocardial biomarkers levels associated with perioperative hyperoxia.

METHODS

This prospective randomized controlled interventional trial investigates the impact of maintaining perioperative high oxygen supplementation in high-risk patients undergoing non-cardiac vascular surgery on cardiac biomarkers, myocardial strain and outcome in 110 patients. Patients are allocated to be supplemented with either 0.3 (normal) or 0.8 (high) fraction of inspired oxygen (FiO2) perioperatively. Included is a short crossover phase during which transesophageal echocardiography is used to evaluate myocardial function at FiO2 0.3 and 0.8 by strain analysis in each patient. Patients will be followed up for complications at 30 days and 1 year.

CONCLUSION

The trial is designed to evaluate perioperative changes from baseline myocardial biomarkers associated with perioperative FiO2. Furthermore, exploration and correlation of changes in biomarkers, acute early changes in myocardial function and clinical outcomes induced by different FiO2 may be possible.

Item Type:

 Journal Article (Original Article)

Division/Institute:

 04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy > Partial clinic Insel
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute of Clinical Chemistry
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

 Friess, Jan-Oliver, Stiffler, Sandra, Mikasi, Jan, Erdoes, Gabor (B), Nagler, Michael, Gräni, Christoph, Fischer, Kady Anne, Günsch, Dominik

Subjects:

 600 Technology > 610 Medicine & health

ISSN:

 2451-8654

Publisher:

 Elsevier

Language:

 English

Submitter:

 Pubmed Import

Date Deposited:

 28 Mar 2024 08:33

Last Modified:

 05 Apr 2024 00:17

Publisher DOI:

 10.1016/j.cct.2024.107512

PubMed ID:

 38537904

Uncontrolled Keywords:

 General anesthesia Hyperoxia Myocardial biomarker Myocardial injury Myocardial strain Normoxemia Troponin

BORIS DOI:

 10.48350/195055

URI:

 https://boris.unibe.ch/id/eprint/195055

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