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Phase 3 Completed N=201 Randomized Double-blind Prevention

Risk of Oxygen During Cardiac Surgery Trial

Source: ClinicalTrials.gov NCT02361944 ↗
Enrolled (actual)
201
Serious AEs
9.5%
Results posted
Aug 2023
Primary outcomePrimary: Intraoperative Systemic Oxidative Damage — 69; 83 pg/ml
◆ Published Evidence
Established
25citations · ~3 / year
The Risk of Oxygen during Cardiac Surgery (ROCS) trial: study protocol for a randomized clinical trial.
Trials · 2017 · Open access · Likely link

Summary

The investigators will recruit and randomize 200 elective cardiac surgery patients to receive physiologic oxygenation (normoxia) or hyper-oxygenation (hyperoxia) during surgery to test the hypothesis that intraoperative physiologic oxygenation decreases the generation of reactive oxygen species, oxidative damage, and postoperative organ injury compared to hyper-oxygenation.

Linked Publications (3)

  • The Risk of Oxygen during Cardiac Surgery (ROCS) trial: study protocol for a randomized clinical trial.
    Trials · 2017 · 25 citations · Open access · Likely link
  • Intraoperative Oxygen Treatment, Oxidative Stress, and Organ Injury Following Cardiac Surgery: A Randomized Clinical Trial.
    JAMA surgery · 2024 · 22 citations · Open access · Likely link
  • Effects of Oxygen on Perioperative Vascular Function: A Randomized Clinical Trial.
    Journal of the American Heart Association · 2025 · 2 citations · Open access · Likely link

Outcome Measures

OutcomeResultp-value
PRIMARY
Intraoperative Systemic Oxidative Damage
69; 83 —
PRIMARY
Acute Kidney Injury
-0.01; 0.01 —
SECONDARY
Vascular Reactivity / Endothelial Function (as Measured by Flow Mediated Dilation)
4.50; 4.71 —
SECONDARY
Mitochondrial Function
1884; 1936 —
SECONDARY
Number of People With Arrhythmia
37; 46 —
SECONDARY
Myocardial Injury or Infarction
27.2; 24.5 —
SECONDARY
Number of People With Stroke
1; 2 —
SECONDARY
Postoperative Cognitive Dysfunction
3; 2 —
SECONDARY
Respiratory Failure
5; 1 —
SECONDARY
Chronic Kidney Disease
63.0; 60.4 —
SECONDARY
Inflammation
31.08; 36.62 —
SECONDARY
Hemolysis
388,030; 433,274 —
SECONDARY
Reactive Oxygen Species Production
17,300; 17,040 —
SECONDARY
Acute Brain Dysfunction (Delirium)
16; 22 —
SECONDARY
Oxygenation and Perfusion (Lactate)
1.5; 1.8 —
SECONDARY
Acute Kidney Injury, According to KDIGO Criteria
21; 21 —
SECONDARY
Acute Kidney Injury Estimated by Urine Concentration of TIMP-2 IGFBP7
0.224; 0.187 —
SECONDARY
Acute Kidney Injury Estimated by Urine Concentration of NGAL
6.9; 4.8 —
SECONDARY
Oxygenation and Perfusion (SpO2)
97; 100 —
SECONDARY
Oxygenation and Perfusion (PaO2)
99; 377 —
SECONDARY
Oxygenation and Perfusion (Cerebral Oximetry)
-7.2; 6.0 —
SECONDARY
Oxygenation and Perfusion (SvO2)
68; 78 —
SECONDARY
Oxygenation and Perfusion (Cardiac Index)
2.56; 2.48 —
SECONDARY
Vascular Reactivity / Endothelial Function (Peripheral Artery Tonometry)
1.41; 1.23 —
SECONDARY
Vascular Reactivity / Endothelial Function (Tension Wire Myography, Endothelial Dependent Vasodilation, EC50)
-6.13; -5.92 —
SECONDARY
Vascular Reactivity / Endothelial Function (Tension Wire Myography, Endothelial Dependent Vasodilation, Emax)
36.2; 39.5 —
SECONDARY
Vascular Reactivity / Endothelial Function (Tension Wire Myography, Endothelial Independent Vasodilation, EC50)
-6.95; -5.75 —
SECONDARY
Vascular Reactivity / Endothelial Function (Tension Wire Myography, Endothelial Independent Vasodilation, Emax)
91.5; 92.6 —
SECONDARY
Vascular Reactivity / Endothelial Function (Tension Wire Myography, sGC Activation Vasodilation, EC50)
-6.89; -6.66 —
SECONDARY
Vascular Reactivity / Endothelial Function (Tension Wire Myography, sGC Activation Vasodilation, Emax)
97.1; 96.0 —
SECONDARY
Vascular Reactivity / Endothelial Function (PAI-1)
31.2; 36.6 —
SECONDARY
Vascular Reactivity / Endothelial Function (E-selectin)
16.4; 16.2 —

Eligibility Criteria

Inclusion Criteria

  • Open-heart cardiac surgery, defined as surgery on the heart or aorta that requires sternotomy or thoracotomy.

Exclusion Criteria

  • Current acute coronary syndrome (defined as ST elevation myocardial infarction or non-ST elevation myocardial infarction (troponin leak within 72 hours of surgery or consent +/- EKG changes consistent with myocardial ischemia)).
  • Home supplemental oxygen use.
  • Preoperative supplemental oxygen requirement to maintain arterial O2 sat of 92%.
  • Right to left intracardiac shunt including atrial septal defect and ventricular septal defect with Cor Pulmonale.
  • Carotid stenosis defined as >50% stenosis.
  • Cardiac surgery that requires intraoperative circulatory arrest, such as aortic arch replacement.
  • Current use of hemo- or peritoneal dialysis.
  • Pregnancy
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02361944) and the linked publication. Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.

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