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Before extubation during the anesthesia recovery period, 100% oxygen is routinely inhaled to increase the oxygen reserves, maximizing the time window for anesthesiologists to adjust strategies when they encounter hypoxemia after extubation.
However, even inhaling a short period of pure oxygen can cause absorptive atelectasis, and may even impair the effectiveness of intraoperative protective ventilation measures continuing to post-operative period. The purpose of this study is to determine whether 30% oxygen before extubation after abdominal surgery could reduce hypoxemia incidence after extubation during the recovery period or not, compared to 100% oxygen. 590 patients scheduled to abdominal surgeries, will be randomly assigned to receive 30% or 100% oxygen concentration from the end of surgery to extubation after general anesthesia in the post-anesthesia care unit. The incidence of hypoxemia (SpO2 < 90%) from extubation to leaving the post-anesthesia care unit (PACU) is the primary outcome.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control group : 100% oxygen concentration | Active Comparator | Patients will inhale 100% oxygen from the end of surgery to tracheal extubation in the recovery period. |
|
| Experimental group: 30% oxygen concentration | Experimental | Patients will inhale 30% oxygen from the end of surgery to extubation in the recovery period. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 100% oxygen concentration inhaled | Other | Oxygen concentration inhaled from the end of surgery to tracheal extubation after general anesthesia in the recovery period is 100%. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of hypoxemia | At the day of surgery from tracheal extubation to leaving the post-anesthesia care unit |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of post operative pulmonary-related complications | Within 7 days after surgery | |
| Incidence of severe hypoxemia | At the day of surgery from tracheal extubation to leaving the post-anesthesia care unit |
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Inclusion Criteria:
Exclusion Criteria:
History thoracic surgery and fractures of the sternum or ribs, chest deformity, difficulty in raising both upper limbs, or scoliosis.
High risk of reflux aspiration. Severe hepatic or renal dysfunction (e.g., Child-Pugh class C liver disease, or requiring dialysis).
Limb movement disorders. Mask ventilation or intubation difficulty during anesthesia induction. Occurrence of severe allergy, massive bleeding, suspected pulmonary embolism, pulmonary edema, myocardial injury, or cardiopulmonary arrest during surgery.
Currently participating in other clinical studies, which may have an impact on this study.
Inability to cooperate well for mental disorder, or hypophrenia.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Sanqing Jin | Contact | +86 13719366863 | sanqingjin@hotmail.com | |
| Yanna Pi | Contact | +86 18819186153 | piyanna@126.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| the Sixth Affiliated Hospital of Sun Yat-Sen University | Guangzhou | Guangdong | China |
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| 30% oxygen concentration inhaled | Other | Oxygen concentration inhaled from the end of surgery to tracheal extubation after general anesthesia in the recovery period is 30%. |
|
| Arterial partial pressure of oxygen (PaO2) | At the day of surgery after tracheal extubation in the post-anesthesia care unit |
| Score of lung ultrasound | The score of lung ultrasound ranges from 0 to 36, and a higher score means a worse ventilation. | At the day of surgery after tracheal extubation in the post-anesthesia care unit |
| Area of atelectasis shown on chest CT | At the day of surgery after tracheal extubation |
| Number of patients unplanned transfers to the ICU | 30 days after surgery |
| Length of postoperative stay | At hospital discharge |
| Number of patients return to the hospital after discharge | 30 days after surgery |
| Number of deaths | 30 days after surgery |
| Number of patients with important organ disfunction after surgery, including arrhythmia, acute myocardial injury, heart failure, renal function injury, liver function injury, and cerebrovascular accident. | 30 days after surgery |
| ID | Term |
|---|---|
| D000860 | Hypoxia |
| D001261 | Pulmonary Atelectasis |
| ID | Term |
|---|---|
| D012818 | Signs and Symptoms, Respiratory |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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