Anesthesiology ·
Operating room air sterilization fails to cut infections in 110,538-surgery trial; EIT-guided PEEP lowers lung complications
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The ORACLE trial, published in Anesthesiology, found that supplemental air sterilization in 68 operating rooms did not reduce surgical infections or death among 110,538 surgical patients. A randomized trial linked positive end-expiratory pressure guided by electrical impedance tomography to fewer pulmonary complications after laparoscopic colorectal surgery in higher-risk patients, and a pilot study tested tablet-based augmented reality for preoperative anxiety in children.
THE DETAILS
- Research Oct 19, 2026The ORACLE trial, published online Oct. 19 in Anesthesiology, randomized 68 operating rooms in four-week blocks to active or identical-looking sham supplemental air sterilization, enrolling 110,538 inpatients and outpatients, with investigators, clinicians and patients blinded. The primary composite of wound infection, infection-related complications or death occurred in 8.1% of inpatients with active purification versus 8.2% with sham (odds ratio 0.98; 95% CI 0.92 to 1.05; P = .609), and the futility boundary was crossed for inpatients and for all patients. The authors said infection control might better focus on limiting direct wound contamination.Sources: Anesthesiology, PubMed
- Research Oct 20, 2026A single-center randomized trial published online Oct. 20 in the British Journal of Anaesthesia assigned 117 adults at intermediate to high risk of pulmonary complications (ARISCAT score of 26 or higher) undergoing laparoscopic colorectal surgery to positive end-expiratory pressure (PEEP) set with electrical impedance tomography (EIT) or a fixed PEEP of 5 cm H2O. Pulmonary complications within 30 days, the primary end point, occurred in 49.2% (29 of 59) with EIT guidance versus 72.4% (42 of 58) with fixed PEEP (hazard ratio 0.53; 95% CI 0.33 to 0.85; P = .009).Sources: British Journal of Anaesthesia, PubMed
- Technology Oct 20, 2026A single-center quasi-experimental pilot study published online Oct. 20 in the Journal of Clinical Monitoring and Computing allocated 27 children aged 3 to 10 years by surgery month to a tablet-based augmented reality system (13) or a control group (14). Median modified Yale Preoperative Anxiety Scale scores at operating room entry, the primary end point, were 28.3 versus 40.0 (median difference -11.7; 95% CI -18.4 to -1.60; P = .01), with no significant differences in secondary outcomes. The authors said larger randomized trials are required.
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