Influence of perioperative oxygen fraction on pulmonary function after abdominal surgery: a randomized controlled trial

BMC Research Notes

Lars S Rasmussen³  Poul L Christensen²  Steen W Henneberg¹  Christian S Meyhoff³  Anne K Staehr³ 

[1]Department of Anaesthesia, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark

[2]Department of Anaesthesia, Næstved Hospital, Ringstedgade 61, 4700, Næstved, Denmark

[3]Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen Ø, Denmark

关键词: Gynaecological;    Surgery;    Partial pressure;    Oxygen;    General;    Anesthesia;    Pulmonary function;    Functional residual capacity;    Pulmonary atelectasis;    Pulmonary gas exchange;   

Others  :  1166070
DOI  :  10.1186/1756-0500-5-383

 received in 2011-11-15, accepted in 2012-07-28,  发布年份 2012

【 摘 要 】

Background

A high perioperative inspiratory oxygen fraction (FiO₂) may reduce the frequency of surgical site infection. Perioperative atelectasis is caused by absorption, compression and reduced function of surfactant. It is well accepted, that ventilation with 100% oxygen for only a few minutes is associated with significant formation of atelectasis. However, it is still not clear if a longer period of 80% oxygen results in more atelectasis compared to a low FiO₂.

Our aim was to assess if a high FiO₂ is associated with impaired oxygenation and decreased pulmonary functional residual capacity (FRC).

Methods

Thirty-five patients scheduled for laparotomy for ovarian cancer were randomized to receive either 30% oxygen (n = 15) or 80% oxygen (n = 20) during and for 2 h after surgery. The oxygenation index (PaO₂/FiO₂) was measured every 30 min during anesthesia and 90 min after extubation. FRC was measured the day before surgery and 2 h after extubation by a rebreathing method using the inert gas SF₆.

Results

Five min after intubation, the median PaO₂/FiO₂ was 69 kPa [53-71] in the 30%-group vs. 60 kPa [47-69] in the 80%-group (P = 0.25). At the end of anesthesia, the PaO₂/FiO₂ was 58 kPa [40-70] vs. 57 kPa [46-67] in the 30%- and 80%-group, respectively (P = 0.10). The median FRC was 1993 mL [1610-2240] vs. 1875 mL [1545-2048] at baseline and 1615 mL [1375-2318] vs. 1633 mL [1343-1948] postoperatively in the 30%- and 80%-group, respectively (P = 0.70).

Conclusion

We found no significant difference in oxygenation index or functional residual capacity between patients given 80% and 30% oxygen for a period of approximately 5 hours.

Trial registration

ClinicalTrials.gov Identifier: NCT00637936.

【 授权许可】

   
2012 Staehr et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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