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Reuter's Health, October 2005

Patients who are given an 80 percent concentration of oxygen during and after surgery have a lower risk of developing an infection than do patients given 30 percent oxygen, according to a Spanish study.

Two recent trials assessing the value of increased oxygen have yielded conflicting results.

To further explore this issue, Dr. F. Javier Belda, from Hospital Clinico Universitario in Valencia, and colleagues randomly assigned 291 adult patients undergoing elective colorectal surgery to either 30 percent or 80 percent oxygen during surgery and for 6 hours afterwards.

All patients were given antibiotics prior to surgery and continuing for up to 48 hours.

Belda's group reports their findings in this week's Journal of the American Medical Association.

During the first 14 days after surgery, surgical wound infections were documented in 35 (24.4 percent) of those in the 30 percent oxygen group and 22 (14.9 percent) in those given 80 percent oxygen.

Also, two patients in the 30 percent group died of complications related to severe infection.

After factoring in other variables, the researchers calculated that the risk of infection was reduced by 54 percent in the patients who received 80 percent oxygen.

"Supplemental oxygen appears to confer few risks to the patient, has little associated cost, and should be considered part of ongoing quality improvement activities related to surgical care," Belda's team concludes.

Dr. E. Patchen Dellinger, from the University of Washington School of Medicine, Seattle, agrees with this conclusion. He notes in an editorial that "additional, larger trials addressing these issues need to be performed," but he cautions that "surgeons should not wait for this issue to be resolved before moving forward with this...intervention," while continuing to monitor its effectiveness.

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