TY - JOUR
T1 - Perioperative Hyperoxyphobia
T2 - Justified or Not? Benefits and Harms of Hyperoxia during Surgery
AU - Weenink, Robert P.
AU - de Jonge, Stijn W.
AU - van Hulst, Robert A.
AU - Wingelaar, Thijs T.
AU - van Ooij, Pieter Jan A.M.
AU - Immink, Rogier V.
AU - Preckel, Benedikt
AU - Hollmann, Markus W.
N1 - Publisher Copyright: © 2020 by the authors. Licensee MDPI, Basel, Switzerland. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2020/2/28
Y1 - 2020/2/28
N2 - 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.
AB - 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.
KW - Hyperbaric oxygenation
KW - Hyperoxia
KW - Oxygen toxicity
KW - Perioperative care
KW - Reactive oxygen species
KW - Surgical wound infection
UR - http://www.scopus.com/inward/record.url?scp=85092675491&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/jcm9030642
DO - https://doi.org/10.3390/jcm9030642
M3 - Review article
C2 - 32121051
SN - 2077-0383
VL - 9
JO - Journal of clinical medicine
JF - Journal of clinical medicine
IS - 3
M1 - 642
ER -