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Effects of lowering inspiratory oxygen fraction during microvascular decompression on postoperative gas exchange: A pre-post study.


ABSTRACT:

Background

Despite many previous studies, the optimal oxygen fraction during general anesthesia remains controversial. This study aimed to evaluate the effects of lowering intraoperative fraction of inspired oxygen on postoperative gas exchange in patients undergoing microvascular decompression (MVD).

Methods

We conducted a pre-post study to compare postoperative gas exchange with different intraoperative oxygen fractions. From April 2010 to June 2017, 1456 consecutive patients who underwent MVD were enrolled. Starting in January 2014, routine oxygen fraction was lowered from 1.0 to 0.3 during anesthetic induction/awakening and from 0.5 to 0.3 during anesthetic maintenance. Postoperative gas exchange, presented as the minimum value of PaO2/FIO2 ratio within 48 hours, were compared along with adverse events.

Results

Among 1456 patients, 623 (42.8%) patients were stratified into group H (high FIO2) and 833 (57.2%) patients into group L (low FIO2). Intraoperative positive end-expiratory pressure was used in 126 (15.1%) patients in group H and 90 (14.4%) patients in group L (p = 0.77).The minimum value of PaO2/ FIO2 ratio within 48 hours after surgery was significantly greater in the group L (226.13 vs. 323.12; p < 0.001) without increasing any adverse events.

Conclusion

In patients undergoing MVD, lowering routine FIO2 and avoiding 100% O2 improved postoperative gas exchange.

SUBMITTER: Park J 

PROVIDER: S-EPMC6235305 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Effects of lowering inspiratory oxygen fraction during microvascular decompression on postoperative gas exchange: A pre-post study.

Park Jungchan J   Min Jeong Jin JJ   Kim So Jin SJ   Ahn Jin Hee JH   Kim Keoungah K   Lee Jong-Hwan JH   Park Kwan K   Chung Ik Soo IS  

PloS one 20181114 11


<h4>Background</h4>Despite many previous studies, the optimal oxygen fraction during general anesthesia remains controversial. This study aimed to evaluate the effects of lowering intraoperative fraction of inspired oxygen on postoperative gas exchange in patients undergoing microvascular decompression (MVD).<h4>Methods</h4>We conducted a pre-post study to compare postoperative gas exchange with different intraoperative oxygen fractions. From April 2010 to June 2017, 1456 consecutive patients wh  ...[more]

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