Perioperative Hyperoxyphobia: Justified or Not? Benefits and Harms of Hyperoxia during Surgery.

Autor: Weenink RP; Department of Anaesthesia, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands., de Jonge SW; Department of Surgery, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands., van Hulst RA; Department of Anaesthesia, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Department of Hyperbaric medicine, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands., Wingelaar TT; Department of Anaesthesia, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Diving Medical Center, Royal Netherlands Navy, 1780 CA Den Helder, The Netherlands., van Ooij PAM; Diving Medical Center, Royal Netherlands Navy, 1780 CA Den Helder, The Netherlands.; Department of Pulmonology, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands., Immink RV; Department of Anaesthesia, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands., Preckel B; Department of Anaesthesia, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands., Hollmann MW; Department of Anaesthesia, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2020 Feb 28; Vol. 9 (3). Date of Electronic Publication: 2020 Feb 28.
DOI: 10.3390/jcm9030642
Abstrakt: The use of an inspiratory oxygen fraction of 0.80 during surgery is a topic of ongoing debate. Opponents claim that increased oxidative stress, atelectasis, and impaired oxygen delivery due to hyperoxic vasoconstriction are detrimental. Proponents point to the beneficial effects on the incidence of surgical site infections and postoperative nausea and vomiting. Also, hyperoxygenation is thought to extend the safety margin in case of acute intraoperative emergencies. This review provides a comprehensive risk-benefit analysis for the use of perioperative hyperoxia in noncritically ill adults based on clinical evidence and supported by physiological deduction where needed. Data from the field of hyperbaric medicine, as a model of extreme hyperoxygenation, are extrapolated to the perioperative setting. We ultimately conclude that current evidence is in favour of hyperoxia in noncritically ill intubated adult surgical patients.
Competing Interests: M.H. and S.d.J. are involved in an ongoing trial that investigates the effect of a bundle of interventions, including perioperative hyperoxia, on surgical site infections (Netherlands Trial Register number 5694, www.trialregister.nl). S.d.J. is a member of the WHO committee that wrote the guidelines for the prevention of surgical site infection.
Databáze: MEDLINE
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