- Poster presentation
- Open Access
Effects of induced relative hypoxia during the postoperative period of abdominal oncologic surgery, on hemoglobin and reticulocyte levels: a prospective, randomized controlled clinical trial
© Khalife et al.; licensee BioMed Central Ltd. 2012
- Published: 20 March 2012
- Reduce Glutathione
- Free Oxygen Radical
- Oncologic Patient
- Free Oxygen
Anemia is a frequent complication in oncologic patients. Erythropoietin (EPO) stimulating agents are known as alternatives to transfusion. However, they expose patients to thrombosis and are expensive. Recently, a new phenomenon, the normobaric oxygen paradox (NOP), has been described. In brief, transient hyperoxia followed by a prolonged return to normoxia acts as an effective trigger for EPO production. The mechanism depends on free oxygen radicals and on reduced glutathione (GSH) availabilities. Also, N-acetylcystein (NAC) is known to regenerate the stock of GSH. Very few clinical trials have investigated this phenomenon . The goal of this study was to test the NOP theory on the evolution of hemoglobin and reticulocytes in patients receiving intermittent oxygen with or without NAC compared to a control group.
This prospective, randomized study included 78 patients (three groups). The first group (G1; n = 26) received 60% FiO2 for 2 consecutive hours on the first, third, and fifth days postoperatively. The second group (G2; n = 26) in addition to oxygen received NAC 200 mg/day for 5 days. The third group (G3; n = 26) was the control group which did not receive any oxygen variation. On postoperative day 6, hemoglobin, hematocrit and reticulocytes were measured and compared to the baseline values. A total of five patients (three in G1 and two in G2) were excluded for discontinuing oxygen and/or early discharge from hospital.
Induced relative hypoxia seems to be an effective stimulus for reticulocyte synthesis. However, further investigations are needed to confirm these findings and their impact on hemoglobin.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.