Automated oxygen administration versus conventional oxygen therapy after major abdominal or thoracic surgery: study protocol for an international multicentre randomised controlled study.

Abstract

Hypoxemia and hyperoxia may occur after surgery with potential related complications. The FreeO₂ PostOp trial is a prospective, multicentre, randomised controlled trial that evaluates the clinical impact of automated O₂ administration versus conventional O₂ therapy after major abdominal or thoracic surgeries. The study is powered to demonstrate benefits of automated oxygen titration and weaning in term of oxygenation, which is an important surrogate for complications after such interventions. After extubation, patients are randomly assigned to the <i>Standard</i> (manual O₂ administration) or <i>FreeO₂</i> group (automated closed-loop O₂ administration). Stratification is performed for the study centre and a medical history of chronic obstructive pulmonary disease (COPD). Primary outcome is the percentage of time spent in the target zone of oxygen saturation, during a 3-day time frame. In both groups, patients will benefit from continuous oximetry recordings. The target zone of oxygen saturation is SpO₂=88%-92% for patients with COPD and 92%-96% for patients without COPD. Secondary outcomes are the nursing workload assessed by the number of manual O₂ flow adjustments, the time spent with severe desaturation (SpO₂ <85%) and hyperoxia area (SpO₂ >98%), the time spent in a hyperoxia area (SpO₂ >98%), the VO₂, the duration of oxygen administration during hospitalisation, the frequency of use of mechanical ventilation (invasive or non-invasive), the duration of the postrecovery room stay, the hospitalisation length of stay and the survival rate. The FreeO₂ PostOp study is conducted in accordance with the declaration of Helsinki and was registered on 11 September 2015 (http://www.clinicaltrials.gov). First patient inclusion was performed on 14 January 2016. The results of the study will be presented at academic conferences and submitted to peer-reviewed journals. NCT02546830.