In accordance with WHO regulations, all members of the Guidelines Development Group (GDG) were required to complete and submit a WHO Declaration of interests form prior to participating in each meeting. External reviewers and members of the Systematic Reviews Expert Group were also required to submit a Declaration of interest form. The secretariat then reviewed and assessed each declaration. In the case of a potential conflict of interest, the reason was presented to the GDG.
Procedures for the management of declared conflicts of interest were undertaken according to the WHO guidelines for declaration of interests (WHO experts). Where a conflict of interest was not considered significant enough to pose any risk to the guideline development process or reduce its credibility, the experts were only required to openly declare the potential conflict at the beginning of the Technical Consultation. However, the declared conflicts were considered irrelevant on all occasions and did not warrant any exclusion from the GDG. Therefore, all members participated fully in the formulation of the recommendations and no further action was taken.
The following interests were declared by GDG members
Joseph Solomkin, chair of the GDG, is also the chief executive officer of OASIS Global (USA), at the time of the guidelines development an organization that provided funds to partially support the salary of a WHO consultant assisting in initiating the guideline development process.
Andreas Widmer declared that he received a research support grant of 200 000 Swiss francs from the Swiss National Science Foundation for a study on antibiotic prophylaxis in 2014.
Peter Nthumba declared that his attendance at a workshop on surgical site infections in 2014 was supported by Ethicon Surgical Care (Johnson & Johnson).
Javier Belda declared that he obtained a research grant of € 132 624 from Air Liquide Sante for the Project iPROVE-O2 (https://clinicaltrials.gov/ct2/show/NCT02776046).
Marja A Boermeester declared that her attendance at a meeting was supported by Johnson & Johnson in 2014 and that she obtained a research grant of € 49 000 from Johnson & Johnson on a subject not related to these guideline recommendations. She also received grants or honoraria for delivering lectures on surgical site infection or serving on scientific advisory boards for Abbott/Mylan, Acelity, Bard, Baxter, GSK, Ipsen and Johnson & Johnson.
E Patchen Dellinger declared that he received honoraria for delivering lectures on surgical site infection. He also received fees for serving on scientific advisory boards for Astellas, Baxter, Cubist, Durata, Merck, Ortho-McNeil, Pfizer, Rib-X, R-Pharm, Targanta, Tetraphase and 3M. These honoraria and fees varied between US$ 1000 and US$ 5000 but the activities were not related to the guideline recommendations.
Robert Greif declared that he is the first author of a paper published in the New England Journal of Medicine in 2000, which demonstrates benefit of use high FiO2 to reduce SSI.
Xavier Guirao declared that he received personal fees of about € 1000 from Merck, Pfizer, Astra-Zeneca, and Novartis; these activities were not related to the guideline recommendations.
Fauzia Khan declared that as the chair of the World Federation of Societies of Anesthesiologists (WFSA) Safety & Quality of Practice Committee, he discussed the WHO recommendation on high FiO2 within this group in the past.
Akca Ozan declared that he contributed to a review article on high FiO2 published in the Turkish Journal of Anaesthesiology and Reanimation in 2017.
Apart from Marja Boermeester, Joseph Solomkin and Xavier Guirao (see above), no member of the Systematic Reviews Expert Group declared any conflict of interest. One external reviewer declared the following interests which were considered irrelevant by the WHO Steering Group: Val Robertson declared that she received a research grant of US$ 3500 from the International Federation of Infection Control in 2015 and that she currently receives a monthly honorarium of US$ 2241 as a technical advisor to the Zimbabwe Infection Prevention and Control Project.
