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Higher fraction of inspired oxygen in anesthesia induction does not affect functional residual capacity reduction after intubation: a comparative study of higher and lower oxygen concentration.
MedLine Citation:
PMID:  23329406     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Low fraction of inspired oxygen (F(I)O(2)) reduces the atelectasis area during anesthesia induction. However, atelectasis may occur during laryngoscopy and endotracheal intubation because lungs can collapse within a fraction of a second. We assessed the effects of ventilation with 100 and 40 % oxygen on functional residual capacity (FRC) in patients undergoing general anesthesia. METHODS: Twenty patients scheduled for elective open abdominal surgery were randomized into 40 % oxygen (GI, n = 10) and 100 % oxygen (GII, n = 10) groups and FRC was measured. Preoxygenation and mask ventilation with 40 and 100 % oxygen were used in GI and GII, respectively. In both groups, 40 % oxygen was used for anesthesia maintenance after intubation. Bilateral lung ventilation was performed with volume guarantee and low tidal volume (7 ml/kg predicted body weight) using bilevel airway pressure. We measured FRC and blood gas in all patients during preoxygenation, after intubation, and during surgery. RESULTS: FRC decreased from during preoxygenation (GI 2380 ml, GII 2313 ml) to after intubation (GI 1569 ml, GII 1586 ml) and significantly decreased during surgery (GI 1338 ml, GII 1417 ml) (P < 0.05). PaO(2)/F(I)O(2) decreased from during preoxygenation (GI 419 mmHg, GII 427 mmHg) to after intubation (GI 381 mmHg, GII 351 mmHg) and significantly decreased during surgery (GI 333 mmHg, GII 291 mmHg) (P < 0.05). No significant differences were found between the groups in both parameters. CONCLUSIONS: FRC significantly decreased from the awake state to surgery in both groups. FRC was not influenced by F(I)O(2) elevation at anesthesia induction.
Authors:
Akihiro Kanaya; Daizoh Satoh; Shin Kurosawa
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-18
Journal Detail:
Title:  Journal of anesthesia     Volume:  -     ISSN:  1438-8359     ISO Abbreviation:  J Anesth     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Anesthesiology and Intensive Care, Tohoku University Hospital, 1-1 Seiryomachi, Aoba-ku, Sendai, 980-8574, Japan, canal_village0207@yahoo.co.jp.
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