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

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...

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Autores principales: Weenink, Robert P., de Jonge, Stijn W., van Hulst, Robert A., Wingelaar, Thijs T., van Ooij, Pieter-Jan A. M., Immink, Rogier V., Preckel, Benedikt, Hollmann, Markus W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141263/
https://www.ncbi.nlm.nih.gov/pubmed/32121051
http://dx.doi.org/10.3390/jcm9030642
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author Weenink, Robert P.
de Jonge, Stijn W.
van Hulst, Robert A.
Wingelaar, Thijs T.
van Ooij, Pieter-Jan A. M.
Immink, Rogier V.
Preckel, Benedikt
Hollmann, Markus W.
author_facet Weenink, Robert P.
de Jonge, Stijn W.
van Hulst, Robert A.
Wingelaar, Thijs T.
van Ooij, Pieter-Jan A. M.
Immink, Rogier V.
Preckel, Benedikt
Hollmann, Markus W.
author_sort Weenink, Robert P.
collection PubMed
description 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.
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spelling pubmed-71412632020-04-10 Perioperative Hyperoxyphobia: Justified or Not? Benefits and Harms of Hyperoxia during Surgery Weenink, Robert P. de Jonge, Stijn W. van Hulst, Robert A. Wingelaar, Thijs T. van Ooij, Pieter-Jan A. M. Immink, Rogier V. Preckel, Benedikt Hollmann, Markus W. J Clin Med Review 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. MDPI 2020-02-28 /pmc/articles/PMC7141263/ /pubmed/32121051 http://dx.doi.org/10.3390/jcm9030642 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Weenink, Robert P.
de Jonge, Stijn W.
van Hulst, Robert A.
Wingelaar, Thijs T.
van Ooij, Pieter-Jan A. M.
Immink, Rogier V.
Preckel, Benedikt
Hollmann, Markus W.
Perioperative Hyperoxyphobia: Justified or Not? Benefits and Harms of Hyperoxia during Surgery
title Perioperative Hyperoxyphobia: Justified or Not? Benefits and Harms of Hyperoxia during Surgery
title_full Perioperative Hyperoxyphobia: Justified or Not? Benefits and Harms of Hyperoxia during Surgery
title_fullStr Perioperative Hyperoxyphobia: Justified or Not? Benefits and Harms of Hyperoxia during Surgery
title_full_unstemmed Perioperative Hyperoxyphobia: Justified or Not? Benefits and Harms of Hyperoxia during Surgery
title_short Perioperative Hyperoxyphobia: Justified or Not? Benefits and Harms of Hyperoxia during Surgery
title_sort perioperative hyperoxyphobia: justified or not? benefits and harms of hyperoxia during surgery
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141263/
https://www.ncbi.nlm.nih.gov/pubmed/32121051
http://dx.doi.org/10.3390/jcm9030642
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