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- Ferrando, Carlos, et al.
(författare)
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Effects of oxygen on post-surgical infections during an individualised perioperative open-lung ventilatory strategy : a randomised controlled trial
- 2020
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Ingår i: British Journal of Anaesthesia. - : ELSEVIER SCI LTD. - 0007-0912 .- 1471-6771. ; 124:1, s. 110-120
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Tidskriftsartikel (refereegranskat)abstract
- Background: We aimed to examine whether using a high fraction of inspired oxygen (FIO2) in the context of an individualised intra- and postoperative open-lung ventilation approach could decrease surgical site infection (SSI) in patients scheduled for abdominal surgery. Methods: We performed a multicentre, randomised controlled clinical trial in a network of 21 university hospitals from June 6, 2017 to July 19, 2018. Patients undergoing abdominal surgery were randomly assigned to receive a high (0.80) or conventional (0.3) FIO2 during the intraoperative period and during the first 3 postoperative hours. All patients were mechanically ventilated with an open-lung strategy, which included recruitment manoeuvres and individualised positive end-expiratory pressure for the best respiratory-system compliance, and individualised continuous postoperative airway pressure for adequate peripheral oxyhaemoglobin saturation. The primary outcome was the prevalence of SSI within the first 7 postoperative days. The secondary outcomes were composites of systemic complications, length of intensive care and hospital stay, and 6-month mortality. Results: We enrolled 740 subjects: 371 in the high FIO2 group and 369 in the low FIO2 group. Data from 717 subjects were available for final analysis. The rate of SSI during the first postoperative week did not differ between high (8.9%) and low (9.4%) FIO2 groups (relative risk [RR]: 0.94; 95% confidence interval [CI]: 0.59-1.50; P=0.90]). Secondary outcomes, such as atelectasis (7.7% vs 9.8%; RR: 0.77; 95% CI: 0.48-1.25; P=0.38) and myocardial ischaemia (0.6% [n=2] vs 0% [n=0]; P=0.47) did not differ between groups. Conclusions: An oxygenation strategy using high FIO2 compared with conventional FIO2 did not reduce postoperative SSIs in abdominal surgery. No differences in secondary outcomes or adverse events were found.
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| 2. |
- Lundström, Mats, et al.
(författare)
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Validation of the Spanish Catquest-9SF in patients with a monofocal or trifocal intraocular lens
- 2016
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Ingår i: Journal of Cataract and Refractive Surgery. - : Ovid Technologies (Wolters Kluwer Health). - 0886-3350. ; 42:12, s. 1791-1796
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To validate the Spanish Catquest-9SF and study patient-reported visual function after implantation of a trifocal versus a monofocal intraocular lens (IOL). setting Clinica Baviera, Valencia and Madrid, Spain. Design Prospective case series. Methods The Catquest-9SF was translated from English to Spanish according to a standard procedure. The Spanish version was validated through Rasch analysis. Patients completed the Catquest-9SF before cataract surgery and 3 months after the surgery. The change in patient-reported visual function caused by surgery, the level of achieved visual function, and satisfaction with vision after surgery were assessed for bilaterally implanted trifocal IOLs versus monofocal IOLs. Results The Spanish Catquest-9SF showed very good psychometric properties. Patient-reported achieved visual function was significantly better for those with a trifocal IOL than for those with a monofocal IOL (P < .001). This was also true when the groups were matched for age and ocular comorbidity (P = .006). In multivariate analyses of all cases and matched cases (the same age and no comorbidity), the reported visual function was significantly better with trifocal IOLs than with monofocal IOLs (P = .001 and P = .008, respectively). There was greater improvement after trifocal IOL implantation in the matched cases, although not significant (P = .103). Conclusions Results show the Spanish version of Catquest-9SF is a valid patient questionnaire with good psychometric properties. Patients with a trifocal IOL implanted bilaterally reported better visual function than those with a monofocal IOL implanted bilaterally. The change in visual function after surgery was also greater in patients with a trifocal IOL. Financial Disclosure None of the authors has a financial or proprietary interest in any material or method mentioned.
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