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Supplemental Postoperative Oxygen and Tissue Oxygen Tension in Morbidly Obese Patients

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Abstract

Background

Subcutaneous tissue oxygen tension (PsqO2) is a major predictor for wound healing and the occurrence of wound infections. Perioperative subcutaneous wound and tissue oxygen tension is significantly reduced in morbidly obese patients. Even during intraoperative supplemental oxygen administration, PsqO2 remains low. Tissue hypoxia is pronounced during surgery and might explain the substantial increase in infection risk in obese patients. It remains unknown whether long-term supplemental postoperative oxygen augments tissue oxygen tension. Consequently, we tested the hypothesis that 80% inspired oxygen administration during 12–18 postoperative hours significantly increases PsqO2 compared to 30% inspired oxygen fraction.

Methods

After IRB approval and informed consent, 42 patients undergoing laparoscopic bariatric surgery were randomly assigned to receive either 80% inspired oxygen via a PULMANEX Hi-Ox™ Mask (Viasys MedSystems, Wheeling, IL) (10 L/min) or 30% oxygen via nasal cannula (2 L/min) after surgery until the next morning. PsqO2 was measured with a temperature-corrected Clark-type electrode in the subcutaneous tissue of the upper arm and adjacent to the wound.

Results

Postoperative subcutaneous tissue oxygen tension was significantly increased in the Hi-Ox group: 58 (47.7, 74.1) mmHg vs. 43 (38.7, 55.2) mmHg, P = 0.002. Also, wound tissue oxygen tension was improved during supplemental oxygen administration: 75.2 (69.8, 95.5) mmHg vs. 52.4 (46.3, 66.1) mmHg, P < 0.001.

Conclusion

Subcutaneous tissue oxygen tension was significantly increased by supplemental postoperative oxygen administration. Whether there is an effect on the incidence of wound infection in morbidly obese patients is matter of further research.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Anesthesiology and General Intensive Care, Medical University of Vienna, Waehringerguertel 18-20, 1090, Vienna, Austria

    Barbara Kabon, Romana Rozum, Corinna Marschalek, Edith Fleischmann & Astrid Chiari

  2. Department of General Surgery, Medical University of Vienna, Vienna, Austria

    Gerhard Prager

  3. Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA

    Andrea Kurz

Authors
  1. Barbara Kabon
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  2. Romana Rozum
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  3. Corinna Marschalek
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  4. Gerhard Prager
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  5. Edith Fleischmann
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  6. Astrid Chiari
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  7. Andrea Kurz
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Corresponding author

Correspondence to Barbara Kabon.

Additional information

Received from the Department of Anesthesiology and General Intensive Care, Medical University of Vienna, Austria, and the Outcomes Research Department, Anesthesiology Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.

The study equipment was bought through an institutional research grant. None of the authors has any personal financial interest in this research.

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Kabon, B., Rozum, R., Marschalek, C. et al. Supplemental Postoperative Oxygen and Tissue Oxygen Tension in Morbidly Obese Patients. OBES SURG 20, 885–894 (2010). https://doi.org/10.1007/s11695-010-0168-1

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  • DOI: https://doi.org/10.1007/s11695-010-0168-1

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