Trial reportAnesthesiology2021
Intraoperative Oxygen Concentration and Neurocognition after Cardiac Surgery.
Trial report in Anesthesiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Perioperative hyperoxia versus normoxia during cardiopulmonary bypass in adult cardiac surgery: a systematic review and meta-analysis of randomized controlled trials.Journal of cardiothoracic surgery · 2026Pooled it
- Perioperative oxygen therapy in patients undergoing surgical procedures: an overview of systematic reviews and meta-analyses.Health technology assessment (Winchester, England) · 2025Pooled it
- Effects of different fractions of inspired oxygen on delayed neurocognitive recovery in patients with one-lung ventilation: a randomized clinical trial.Medical gas research · 2026Trial
- Restrictive versus liberal oxygenation in patients undergoing cardiopulmonary bypass-assisted heart surgery: a randomised controlled trial.British journal of anaesthesia · 2025Trial
- Association Between Postoperative Delirium and Long-Term Subjective Cognitive Decline in Older Patients Undergoing Cardiac Surgery: A Secondary Analysis of the Minimizing Intensive Care Unit Neurological Dysfunction with Dexmedetomidine-Induced Sleep Trial.Journal of cardiothoracic and vascular anesthesia · 2023Trial
- Longitudinal assessment of preoperative dexamethasone administration on cognitive function after cardiac surgery: a 4-year follow-up of a randomized controlled trial.BMC anesthesiology · 2021Trial
- Intraoperative Oxygen Concentration and Postoperative Delirium After Laparoscopic Gastric and Colorectal Malignancies Surgery: A Randomized, Double-Blind, Controlled Trial.Clinical interventions in aging · 2021Trial
- Perioperative neurocognitive disorders in older patients: a narrative review of current knowledge in 2026.Perioperative medicine (London, England) · 2026Review
- Article
- Effects of spontaneous breathing anesthesia on postoperative cognitive dysfunction in elderly patients: a narrative review.Frontiers in surgery · 2026Review
- Effect of inspired oxygen fraction during anesthesia on inflammation and antioxidant enzyme activity in the mouse cortex and hippocampus.Frontiers in aging neuroscience · 2026Article
- Whole-blood transcriptomic analysis reveals preoperative complement inhibitor deficiencies linked to postoperative delirium.Molecular psychiatry · 2025Article
- Association between intraoperative hyperoxia and liver function in patients undergoing hepatectomy: a multicenter observational study.Langenbeck's archives of surgery · 2025Observational
- Silicone ventilation catheter for high-frequency jet ventilation in interventional pulmonology; a new approach.BMC pulmonary medicine · 2025Article
- Effect of different ventilation modes on postoperative cognitive dysfunction in elderly patients undergoing laparoscopic abdominal wall herniorrhaphy.International journal of clinical and experimental pathology · 2025Article
- Incidence and risk factors of hyperoxemia among potentially critically ill patients treated in hospital wards: a retrospective study.Turkish journal of medical sciences · 2025Article
- Is Too Much Oxygen a Bad Thing?JAMA surgery · 2024Article
- Determinants and Practice Variability of Oxygen Administration during Surgery in the United States: A Retrospective Cohort Study.Anesthesiology · 2024Article
- Effect of postoperative oxygen therapy regimen modification on oxygenation in patients with acute type A aortic dissection.Heliyon · 2024Article
- Postoperative cognitive dysfunction in elderly postcardiac surgery patients: progress in rehabilitation application research.Frontiers in rehabilitation sciences · 2024Review
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundDespite evidence suggesting detrimental effects of perioperative hyperoxia, hyperoxygenation remains commonplace in cardiac surgery. Hyperoxygenation may increase oxidative damage and neuronal injury leading to potential differences in postoperative neurocognition. Therefore, this study tested the primary hypothesis that intraoperative normoxia, as compared to hyperoxia, reduces postoperative cognitive dysfunction in older patients having cardiac surgery.
methodsA randomized double-blind trial was conducted in patients aged 65 yr or older having coronary artery bypass graft surgery with cardiopulmonary bypass. A total of 100 patients were randomized to one of two intraoperative oxygen delivery strategies. Normoxic patients (n = 50) received a minimum fraction of inspired oxygen of 0.35 to maintain a Pao2 above 70 mmHg before and after cardiopulmonary bypass and between 100 and 150 mmHg during cardiopulmonary bypass. Hyperoxic patients (n = 50) received a fraction of inspired oxygen of 1.0 throughout surgery, irrespective of Pao2 levels. The primary outcome was neurocognitive function measured on postoperative day 2 using the Telephonic Montreal Cognitive Assessment. Secondary outcomes included neurocognitive function at 1, 3, and 6 months, as well as postoperative delirium, mortality, and durations of mechanical ventilation, intensive care unit stay, and hospital stay.
resultsThe median age was 71 yr (interquartile range, 68 to 75), and the median baseline neurocognitive score was 17 (16 to 19). The median intraoperative Pao2 was 309 (285 to 352) mmHg in the hyperoxia group and 153 (133 to 168) mmHg in the normoxia group (P < 0.001). The median Telephonic Montreal Cognitive Assessment score on postoperative day 2 was 18 (16 to 20) in the hyperoxia group and 18 (14 to 20) in the normoxia group (P = 0.42). Neurocognitive function at 1, 3, and 6 months, as well as secondary outcomes, were not statistically different between groups.
conclusionsIn this randomized controlled trial, intraoperative normoxia did not reduce postoperative cognitive dysfunction when compared to intraoperative hyperoxia in older patients having cardiac surgery. Although the optimal intraoperative oxygenation strategy remains uncertain, the results indicate that intraoperative hyperoxia does not worsen postoperative cognition after cardiac surgery. EDITOR’S PERSPECTIVE:
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