Objective: To conduct a meta-analysis of randomized controlled trials in which high inspired oxygen concentrations were compared with standard concentrations to assess the effect on the development of surgical site infections (SSIs).
Data Sources: A systematic literature search was conducted using the MEDLINE, EMBASE, and Cochrane databases and included a manual search of references of original articles, poster presentations, and abstracts from major meetings ("gray" literature).
Study Selection: Twenty-one of 2167 articles met the inclusion criteria. Of these, 5 randomized controlled trials (3001 patients) assessed the effect of perioperative supplemental oxygen use on the SSI rate. Studies used a treatment-inspired oxygen concentration of 80%. Maximum follow-up was 30 days.
Data Extraction: Data were abstracted by 3 independent reviewers using a standardized data collection form. Relative risks were reported using a fixed-effects model. Results were subjected to publication bias testing and sensitivity analyses.
Data Synthesis: Infection rates were 12.0% in the control group and 9.0% in the hyperoxic group, with relative risk reduction of 25.3% (95% confidence interval [CI], 8.1%-40.1%) and absolute risk reduction of 3.0% (1.1%-5.3%). The overall risk ratio was 0.742 (95% CI, 0.599-0.919; P = .006). The benefit from increasing oxygen concentration was greater in colorectal-specific procedures, with a risk ratio of 0.556 (95% CI, 0.383-0.808; P = .002).
Conclusions: Perioperative supplemental oxygen therapy exerts a significant beneficial effect in the prevention of SSIs. We recommend its use along with maintenance of normothermia, meticulous glycemic control, and preservation of intravascular volume perioperatively in the prevention of SSIs.
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http://dx.doi.org/10.1001/archsurg.2009.1 | DOI Listing |
World J Oncol
February 2025
Department of Obstetrics and Gynecology, Rajavithi Hospital, Bangkok, Thailand.
Background: Whey protein's biochemical properties make it an ideal nutritional supplement for patients with cancer, especially in perioperative care. Thus, the present study aims to assess the efficacy of whey protein supplementation (WPS) compared to standard care in enhancing postoperative outcomes for patients undergoing comprehensive surgical staging for gynecological cancer.
Methods: In an open-label, randomized controlled trial conducted at Rajavithi Hospital between November 28, 2023 and July 8, 2024, 61 patients scheduled for comprehensive surgical staging were enrolled.
Int J Obstet Anesth
January 2025
Department of Anesthesiology, Baylor Scott & White Medical Center-Temple, 2401 S. 31st Street, Temple, TX 76508, United States of America. Electronic address:
Introduction: There are multiple variables known to be associated with pain during cesarean delivery (PDCD), including patient-related factors, obstetrical and surgical factors, and anesthetic technique. The primary aim of this prospective patient-reported outcome study was to evaluate patient-related factors, including expectations and anxiety, and clinical variables associated with PDCD.
Methods: Patients undergoing cesarean delivery from December 1, 2023 to March 31, 2024 were enrolled 24 to 72 hours postoperatively.
Orthopadie (Heidelb)
January 2025
Sporthopaedicum Straubing und Regensburg, Regensburg, Deutschland.
Pre- and perioperative management of malnutrition is crucial for the success of hip and knee arthroplasties. Various studies indicate that malnutrition, particularly when associated with vitamin D deficiency, significantly increases the risk of postoperative complications such as periprosthetic fractures and infections, prolonged hospital stays, and higher mortality rates. Adequate preoperative nutritional intake, including vitamin D supplementation, can improve arthroplasty outcomes.
View Article and Find Full Text PDFEssential amino acid (EAA) supplementation, including conditionally essential amino acid (CEAA) and branched-chain amino acids (BCAA) supplementation, has been suggested as a mechanism to optimize patient outcomes by counteracting the atrophy associated with orthopedic procedures. We sought to investigate the effect of EAA supplementation in the perioperative period on patients undergoing orthopedic and spine surgery, specifically whether it is associated with (1) reductions in postoperative muscle atrophy and (2) improved postoperative function including range of motion, strength, and mobility. We conducted a systematic review of the literature.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Anesthesiology, Perioperative, and Pain Medicine, School of Medicine, Stanford University, Stanford, USA.
Nicotinamide Adenine Dinucleotide (NAD) is implicated in bioenergetics, DNA repair, and senescence. Depletion of NAD is associated with aging and neurodegenerative disease, prompting a growing interest in NAD supplementation. With rising over-the-counter use of NAD, understanding their impact on anesthetic recovery becomes essential.
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