Hyperoxemia reduces cerebrovascular accidents post coronary artery bypass graft surgery: a retrospective cohort study
Publication Details
Kempton, H.,
Chong, C.,
Vlok, R.,
Melhuish, T.,
Holyoak, R.,
&
White, L.
(2020).
Hyperoxemia reduces cerebrovascular accidents post coronary artery bypass graft surgery: a retrospective cohort study.
Journal of Emergency and Critical Care Medicine, 4.
Abstract
Cerebrovascular accidents (CVAs) including strokes and transient ischaemic attacks (TIAs) form a major portion of perioperative morbidity in patients undergoing coronary artery bypass graft (CABG) surgery. The aim of this article was to: (I) to examine the relationship between providing increased intraoperative partial pressure of arterial oxygen (PaO2) and the risk of perioperative CVA following CABG surgery; (II) to examine the relationship between intraoperative PaO2 and other perioperative adverse outcomes. This was a retrospective cohort study involving 2,253 consecutive CABG patients located within a single cardiothoracic unit of a tertiary hospital. All patients underwent CABG surgery. A multivariate analysis was undertaken to assess the relationship between the PaO2 (intra-operative mean and nadir) and its associated risk of perioperative CVA. Results were reported as odds ratios (OR) with 95% confidence interval (95% CI). There was a significant (but clinically limited) inverse correlation between average intra-operative PaO2 and reducing peri-operative CVA (OR 0.99; P=0.029; 95% CI: 0.98–1.00), indicating a reduction in stroke risk with increasing PaO2. There was no significant association with PaO2 nadir and CVA. There was no significant association between increasing hyperoxia and the following adverse events: pneumonia, prolonged postoperative ventilation, perioperative myocardial infarction or cardiac arrest, sternal wound infection, sepsis and renal failure. We report a significant inverse correlation between increasing average intra-operative PaO2 and reducing peri-operative CVA. Further, hyperoxia was not associated with any adverse effects or infective outcomes. This finding is likely to have preventative and therapeutic implications through reducing stroke risk.
Keywords
Cerebrovascular accident (CVAs), Hyperoxemia, Hyperoxia, Stroke, Transient ischaemic attack (TIAs)
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