Risk of Oxygen During Cardiac Surgery Trial

Risk of Oxygen During Cardiac Surgery (ROCS) Trial

The investigators will recruit and randomize 200 elective cardiac surgery patients to receive physiologic oxygenation (normoxia) or hyper-oxygenation (hyperoxia) during surgery to test the hypothesis that intraoperative physiologic oxygenation decreases the generation of reactive oxygen species, oxidative damage, and postoperative organ injury compared to hyper-oxygenation.

Inclusion Criteria:

• Open-heart cardiac surgery, defined as surgery on the heart or aorta that requires sternotomy or thoracotomy.

Exclusion Criteria:

• Current acute coronary syndrome (defined as ST elevation myocardial infarction or non-ST elevation myocardial infarction (troponin leak within 72 hours of surgery or consent +/- EKG changes consistent with myocardial ischemia)).
• Home supplemental oxygen use.
• Preoperative supplemental oxygen requirement to maintain arterial O2 sat of 92%.
• Right to left intracardiac shunt including atrial septal defect and ventricular septal defect with Cor Pulmonale.
• Carotid stenosis defined as >50% stenosis.
• Cardiac surgery that requires intraoperative circulatory arrest, such as aortic arch replacement.
• Current use of hemo- or peritoneal dialysis.
• Pregnancy