Effects of different fractions of inspired oxygen on delayed neurocognitive recovery in patients with one-lung ventilation: a randomized clinical trial.

Delayed neurocognitive recovery is an important cause of morbidity and disability after surgery. This perspective randomized clinical study mainly explored the effects of different fractions of inspired oxygen (FiO2) on Delayed neurocognitive recovery in patients with one-lung ventilation. Between December 2021 and July 2022, 88 patients aged 30-70 years who underwent thoracoscopic pulmonary lobectomy with one-lung ventilation at the First Affiliated Hospital of Sun Yat-sen University, China, were divided into two groups. One group received 70% FiO2 (70% FiO2 group), while the other received 100% FiO2 (100% FiO2 group) during one-lung ventilation. The outcomes were the incidence of delayed neurocognitive recovery on postoperative days 1 and 3, the incidence of cerebral oxygen desaturation during surgery, and the perioperative level of blood gas, inflammatory response, and oxidative stress. The incidence rates of cerebral oxygen desaturation and delayed neurocognitive recovery on postoperative days 1 and 3 were similar between the two groups. Compared with the 70% FiO2 group, in the 100% FiO2 group, the oxygenation index was significantly higher at 30 minutes after one-lung ventilation and 60 minutes after one-lung ventilation, and the arterial partial pressure of carbon dioxide was significantly lower at 15, 30 and 60 minutes after one-lung ventilation, while that of superoxide dismutase was significantly lower at 15 minutes after one-lung ventilation. Compared with 70% FiO2, 100% FiO2 did not increase the incidence of delayed neurocognitive recovery on days 1 and 3 post-operatively in patients with one-lung ventilation.