The influence of perioperative oxygen concentration on postoperative lung function in moderately obese adults

A Special Authors Introduction

By Matin Zoremba

Perioperative admitted oxygen concentration - negligible parameter or therapeutic approach?

In the past decade a lot of studies were performed to evaluate the impact of different oxygen concentrations on several experimental and clinical parameters. Impact on wound infection or PONV as well as molecular effects of free oxygen radicals on parenchymal lung tissue were in focus. There is no doubt about the negative effect of a high fraction of oxygen in regard to atelectasis within the perioperative period. Moreover effects upon functual residual capacity which contributes to atelectasis within a clinical setting were poorly investigated so far.

 Atelectasis are not only defective appearances, they can induce pulmonary inflammation and finally pneumonia. We know that a moderate adjusted FiO2 has lasting clinical effects within the first 24hours. Some may argue this potential effect is negligible and is contrary to a possible loss of safety during critical respiratory events. Anyhow, reflecting all present studies so far, an adjusted FiO2 of 0.8 may be a good compromise which cannot solely affect surrogate parameters (e.g. SpO2 or lung function measurements). Large scaled studies are necessary to reveal possible effects towards outcome relevant parameters (e.g. pneumonia).