Cardiothoracic & vascular anesthesia
Restrictive versus liberal oxygenation in patients undergoing cardiopulmonary bypass-assisted heart surgery: a randomised controlled trial
Primary resultResult — go to the resultHazard ratio 1.01 95% CI 0.8–1.3Authors' conclusion
Among patients undergoing elective or urgent CPB-assisted coronary artery bypass grafting, aortic valve replacement, or both, no significant differences were observed in mortality, dialysis-dependent renal failure, stroke, or new-onset or worsening heart failure between a restrictive oxygenation strategy (Fio2 50%) and a liberal oxygenation strategy (Fio2 100%) during CPB and the subsequent weaning period.
Study context
- Population
- Adults undergoing cardiopulmonary bypass (CPB)-assisted coronary artery bypass grafting, aortic valve replacement, or both
- Participants
- 1,389 adults
- Comparison
- Restrictive vs Liberal
- Restrictiven = 695
- Liberaln = 694reference
- Primary endpoint
- Time to composite of:
- Death
- Stroke
- Renal failure requiring dialysis
- New-onset or worsening HF
- Follow-up
- Median 5.9 yr (IQR 2.5-8.3)
Methodological detailssingle-centre, patient- and assessor-blinded
- Single-centre
- Patient- and assessor-blinded
Primary result
As reported in the abstract
Hazard ratio
1.01
95% CI 0.8–1.3
P = 0.92
Events by treatment group
Restrictive vs Liberal
HR 1.01 (95% CI 0.8–1.3); P = 0.92
Further findings
| Outcome | Restrictive | Liberal |
|---|---|---|
| PaO2 during CPB | median 19-23 kPa | median >60 kPa |
Safety
- No difference in adverse event rates between restrictive and liberal oxygen therapy
Original publication
Restrictive versus liberal oxygenation in patients undergoing cardiopulmonary bypass-assisted heart surgery: a randomised controlled trial. Br J Anaesth. Published 19 September 2025. doi:10.
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