Randomized controlled trial of the effect of 30% versus 80% fraction of inspired oxygen on cesarean delivery surgical site infection.

OBJECTIVE: To determine if supplemental perioperative oxygen will reduce surgical site infection (SSI) following cesarean delivery. METHODS: This is a randomized, controlled trial evaluating SSI following either 30% or 80% fraction of inspired oxygen (FIO2) during and 2 hours after cesarean delivery. Anesthesia providers administered FIO2 via a high-flow oxygen blender. Subjects, surgeons, and wound evaluation teams were blinded. Serial wound evaluations were performed. Data were analyzed using logistic regression models, Fisher exact test, and t test. RESULTS: In all, 179 women were randomized, and 160 subjects were included in the analysis. There were 12/83 (14.5%) SSIs in the control group versus 10/77 (13.0%) in the investigational group (p = 0.82). Caucasian race, increased body mass index, and longer operative time were identified as significant risk factors for infection (p = 0.026, odds ratio 0.283; p = 0.05, odds ratio = 1.058; p = 0.037, odds ratio = 1.038, respectively). CONCLUSION: Perioperative oxygenation with 80% Fio2 is not effective in reducing SSI following cesarean delivery.

Utility of near infrared spectroscopy for the screening of the growth restricted fetus.

A myriad of factors have been linked to increased risk for intrauterine growth restriction and the associated complications; the majority of which are based on observational statistics of demographics, socioeconomics and patient history. Unfortunately, there is a paucity of factors available that can appropriately address the underlying anatomy and physiology responsible for intrauterine growth restriction. To this point, it becomes necessary to use data acquisition modalities capable of addressing both the etiology and pathology in an effort to improve clinical management strategies. Near-infrared spectroscopy, although not traditionally used in standard, clinical screening has proven valuable for risk assessment in a number of recent investigational studies. Simulations based on the current literature are presented to assess near infrared spectroscopy utility regarding the ability to distinguish between the normal fetus and the growth restricted fetus. Findings are presented for all simulated data as well as the equipment-specific data derived from the NIRO-100 system (Hamamatsu Photonics, Hamamatsu, Japan). Results suggest an overall sensitivity and specificity on the order of 62% and 58%, respectively, and NIRO-100 sensitivity and specificity on the order of 85% and 92%, respectively.