Document Detail

High intraoperative inspired oxygen does not increase postoperative supplemental oxygen requirements.
MedLine Citation:
PMID:  22569132     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although a high fraction of inspired oxygen (FIO2) could reduce surgical site infection, there is concern it could increase postoperative pulmonary complications, including hypoxemia. Intraoperative positive end-expiratory pressure can improve postoperative pulmonary function. A practical measure of postoperative pulmonary function and the degree of hypoxemia is supplemental oxygen requirement. We performed a double-blind randomized 2 × 2 factorial study on the effects of intraoperative FIO2 0.3 versus more than 0.9 with and without positive end-expiratory pressure on the primary outcome of postoperative supplemental oxygen requirements in patients undergoing lower risk surgery.
METHODS: After Institutional Review Board approval and consent, 100 subjects were randomized using computer-generated lists into four treatment groups (intraoperative FIO2 0.3 vs. more than 0.9, with and without 3-5 cm H2O positive end-expiratory pressure). Thirty minutes and 24 h after extubation, supplemental oxygen was discontinued. Arterial oxygen saturation by pulse oximetry was recorded 15 min later. If oxygen saturation decreased to less than 90%, supplemental oxygen was added incrementally to maintain saturation more than 90%.
RESULTS: Nearly all subjects required supplemental oxygen in the postanesthesia care unit. Nonparametric Wilcoxon rank sum test demonstrated no statistically significant difference between groups in supplemental oxygen requirements at 45 min and 24 h after tracheal extubation (P = 0.56 and 0.98, respectively).
CONCLUSIONS: Use of intraoperative FIO2 more than 0.9 was not associated with increased oxygen requirement, suggesting it does not induce postoperative hypoxemia beyond anesthetic induction and surgery. Therefore, it may be reasonable to use high inspired oxygen in surgical patients with relatively normal pulmonary function.
Natalie Mackintosh; Matthew C Gertsch; Harriet W Hopf; Nathan L Pace; Julia White; Rebecca Morris; Candice Morrissey; Victoria Wilding; Seth Herway
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anesthesiology     Volume:  117     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-26     Completed Date:  2012-10-15     Revised Date:  2013-04-03    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  271-9     Citation Subset:  AIM; IM    
Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City, UT, USA.
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MeSH Terms
Anoxia / blood,  prevention & control
Double-Blind Method
Intraoperative Care / methods*
Oximetry / methods
Oxygen / administration & dosage*,  blood
Oxygen Consumption*
Positive-Pressure Respiration / methods*
Postoperative Complications / blood,  prevention & control*
Pulmonary Circulation*
Pulmonary Gas Exchange
Treatment Outcome
Reg. No./Substance:
Comment In:
Anesthesiology. 2013 Mar;118(3):756   [PMID:  23426215 ]
Anesthesiology. 2013 Mar;118(3):756-7   [PMID:  23426216 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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