RESUMO
PURPOSE: Despite the use of different surgical methods, surgical site infection is still an important cause of mortality and morbidity in patients and imposes a considerable cost on the healthcare system. Administration of supplemental oxygen during surgery has been reported to reduce surgical site infection (SSI); however, that result is still controversial. This study was performed to evaluate the effect of hyperoxygenation during colorectal surgery on the incidence of wound infection. METHODS: This study was a prospective double-blind case-control study. The main aim of the study was to evaluate the effect of hyperoxygenation during colorectal surgery on the incidence of SSI. Also, secondary outcomes, such as atelectasis, pneumonia, respiratory failure, length of hospital stay, and required hospitalization in the intensive care unit were evaluated. RESULTS: SSI was recorded in 2 patients (2 of 40, 5%) in the hyperoxygenation group (FiO2 80%) and 6 patients (6 of 40, 15%) in the control group (FiO2 30%) (P < 0.05). Time of hospitalization was 6 ± 6.4 days in the hyperoxygenation group and 9.2 ± 2.4 days in the control group (P < 0.05). CONCLUSION: This study showed a positive effect of hyperoxygenation in reducing SSI in colorectal surgery, especially surgery in an emergency setting. When the low risk, low cost, and effectiveness of this method in patients undergoing a laparotomy are considered, it is recommended for all patients undergoing colorectal surgery.
Assuntos
Humanos , Anestesia , Estudos de Casos e Controles , Cirurgia Colorretal , Atenção à Saúde , Emergências , Hospitalização , Incidência , Unidades de Terapia Intensiva , Laparotomia , Tempo de Internação , Métodos , Mortalidade , Oxigênio , Pneumonia , Estudos Prospectivos , Atelectasia Pulmonar , Insuficiência Respiratória , Infecção da Ferida Cirúrgica , Infecção dos FerimentosRESUMO
Background: Erythropoietin [EPO] is known as a regulating hormone for the production of red blood cells, called erythropoiesis. Some studies have shown that EPO exerts some non-hematopoietic protective effects on ischemia-reperfusion injuries in myocytes. Using echocardiography, we evaluated the effect of EPO infusion on reducing ischemia-reperfusion injuries and improvement of the cardiac function shortly after coronary artery bypass graft surgery [CABG]
Methods: Forty-three patients were recruited in this study and randomly divided into two groups: the EPO group, receiving standard medication and CABG surgery plus EPO [700 IU/ kg], and the control group, receiving standard medication and CABG surgery plus normal saline [10 cc] as placebo. The cardiac function was assessed through echocardiography before as well as at 4 and 30 days after CABG
Results: Echocardiography indicated that the ejection fraction had no differences between the EPO and control groups at 4 days [47.05 +/- 6.29 vs. 45.90 +/- 4.97; P=0.334] and 30 days after surgery [47.27 +/- 28 vs. 46.62 +/- 5.7; P=0.69]. There were no differences between the EPO and control groups in the wall motion score index at 4 [P=0.83] and 30 days after surgery [P=0.902]. In the EPO group, there was a reduction in left ventricular end-systolic and end-diastolic diameters [LVESD and LVEDD, respectively], as compared to the control group
Conclusion: Our results indicated that perioperative exogenous EPO infusion could not improve the ventricular function and wall motion index in the immediate post-CABG weeks. Nevertheless, a reduction in LVEDD and LVESD at 4 days and 30 days after CABG in the EPO group, by comparison with the control group, suggested that EPO correlated with a reduction in the remodeling of myocytes and reperfusion injuries early after CABG