Palabras clave
Infección del sitio quirúrgico
Anestesia general
Meta-análisis
Análisis secuencial de experimentos Supplemental oxygen
Surgical site infection
General anesthesia
Meta-analysis
Trial
Sequential analysis
Cómo citar
Resumen
Introducción: en todos los procedimientos anestésicos de rutina se administra oxígeno. Sin embargo, la concentración varía entre el 30 y 100%. Se ha considerado que la administración de una fracción inspirada de oxígeno (FiO2) alta puede disminuir el riego de infección del sitio operatorio (ISO). Objetivo: evaluar la efectividad de la FiO2 alta (≥ 60%) comparada con FiO2 baja (≤ 40%) para disminuir el riesgo de ISO. Materiales y métodos: se realizó un análisis secuencial de experimentos mediante una revisión sistemática con la metodología de la Colaboración Cochrane, y las recomendaciones de la declaración PRISMA, el instrumento R-AMSTAR y el grupo del Doctor Wetterslev. Resultados: se encontraron siete estudios que agruparon 4480 pacientes. No se encontró diferencias entre FiO2 cuando se agruparon todos los estudios (OR 0.73 [0.50, 1.05]). Sin embargo, cuando solo se tuvieron en cuenta estudios en los que todos los participantes fueron sometidos a resección intestinal, se encontró una reducción significativa en el riesgo de ISQ (OR 0.45 [0.30, 0.69]). Este efecto no se modificó cuando se analizaron exclusivamente estudios con bajo riesgo de sesgo (OR 0.46 [0.29, 0.74]). No se encontró evidencia de sesgo de publicación. El análisis secuencial de experimentos permite establecer que este meta-análisis aporta evidencia firme. Conclusiones: el oxígeno suplementario intraoperatorio con FiO2 alta (≈ 80%) durante la anestesia general disminuye el riesgo de ISQ exclusivamente en cirugías en la que se realiza resección intestinal (p. ej. cirugía colorrectal), aunque este efecto no se produce cuando se analiza una población quirúrgica general.
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