Supplemental Oxygen and Complications After Abdominal Surgery (The PROXI-trial)
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Purpose
Aim: To investigate the effect of high intra- and postoperative oxygen concentration (80%, as opposed to normally 30%) on surgical wound infection and pulmonary complications after abdominal surgery.
Background: Surgical wound infection is a common and serious complication. Tissue oxygen tension is often low after surgery and the resistance against infection depends on this factor through bacterial killing by neutrophils. Oxygen is a substrate in this reaction, and it is hypothesized that by increasing the arterial oxygen tension, the risk of surgical wound infection is reduced. Previous studies to test this hypothesis have shown entirely different results. Hence, the clinical decision between high and normal oxygen concentration is still controversial.
Primary hypothesis of study: Use of 80% oxygen decreases the incidence of surgical wound infection after abdominal surgery.
Secondary objectives: To investigate the effect 80% oxygen on pulmonary complications (atelectasis, pneumonia, respiratory insufficiency), second operation, mortality and length of postoperative hospitalization and admission to intensive care unit after abdominal surgery.
| Condition | Intervention | Phase |
|---|---|---|
|
Laparotomy |
Drug: Oxygen |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator, Outcomes Assessor) Primary Purpose: Prevention |
| Official Title: | PeRioperative OXygen Fraction - Effect on Surgical Site Infection and Pulmonary Complications After Abdominal Surgery (The PROXI-trial) |
- Surgical wound infection [ Time Frame: 14 days after surgery ] [ Designated as safety issue: No ]
- Atelectasis, pneumonia, respiratory insufficiency, second operation, mortality, length of postoperative hospitalization, admission to intensive care unit. [ Time Frame: 30 days after surgery ] [ Designated as safety issue: Yes ]
| Enrollment: | 1400 |
| Study Start Date: | October 2006 |
| Study Completion Date: | November 2008 |
| Primary Completion Date: | October 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: A
Fraction of inspired oxygen (FiO2) = 0.30
|
Drug: Oxygen
During and 2 hours after surgery
|
|
Active Comparator: B
FiO2 = 0.80
|
Drug: Oxygen
During and 2 hours after surgery
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age 18 years or older.
- Laparotomy, acute or elective. In case of gynaecological surgery only if malignancy is suspected (defined as risk of ovarian malignancy index >200 or a specimen with atypical or neoplastic cells).
Exclusion Criteria:
- Other surgery within 30 days (except surgery in local anaesthesia).
- Chemotherapy within 3 months.
- Inability to give informed consent.
- Inability to keep oxygen saturation above 90% without supplemental oxygen (measured preoperatively by pulse oximetry).
Contacts and Locations| Denmark | |
| Aarhus Sygehus | |
| Aarhus, Denmark, DK-8000 | |
| Copenhagen University Hospital, Rigshospitalet | |
| Copenhagen, Denmark, DK-2100 | |
| Copenhagen University Hospital, Amager | |
| Copenhagen, Denmark, DK-2300 | |
| Copenhagen University Hospital, Bispebjerg | |
| Copenhagen, Denmark, DK-2400 | |
| Copenhagen University Hospital, Gentofte | |
| Hellerup, Denmark, DK-2900 | |
| Copenhagen University Hospital, Herlev | |
| Herlev, Denmark, DK-2730 | |
| Holbaek Hospital | |
| Holbaek, Denmark, DK-4300 | |
| Kolding Hospital | |
| Kolding, Denmark, DK-6000 | |
| Naestved Hospital | |
| Naestved, Denmark, DK-4700 | |
| Nykoebing Falster Hospital | |
| Nykoebing Falster, Denmark, DK-4800 | |
| Slagelse Hospital | |
| Slagelse, Denmark, DK-4200 | |
| Funen County Hospital | |
| Svendborg, Denmark, DK-5700 | |
| Vejle Hospital | |
| Vejle, Denmark, DK-7100 | |
| Viborg Hospital | |
| Viborg, Denmark, DK-8800 | |
| Study Chair: | Lars S. Rasmussen, MD,DMSc,PHD | Dept. of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark |
| Study Director: | Jørn Wetterslev, MD, PHD | Copenhagen Trial Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark |
| Study Director: | Lars N. Jørgensen, MD, DMSc | Dept. of Surgery, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark |
| Principal Investigator: | Christian S. Meyhoff, MD, PhD | Dept. of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark |
More Information
Publications:
| Responsible Party: | Lars S. Rasmussen, Department of Anaesthesia, HOC, Copenhagen University Hospital, Rigshospitalet |
| ClinicalTrials.gov Identifier: | NCT00364741 History of Changes |
| Other Study ID Numbers: | 2006-001710-32, GCP-2006-101, KF 02 306766 |
| Study First Received: | August 15, 2006 |
| Last Updated: | October 15, 2009 |
| Health Authority: | Denmark: National Board of Health |
ClinicalTrials.gov processed this record on May 21, 2013