Oxygen Therapy in Anaesthesia
Oxygen Therapy in Anaesthesia
Several studies have recently sought to evaluate the potential benefit of oxygen in the promotion of postoperative wound healing. Early studies suggested that a high fractional concentration of inspired oxygen
reduced surgical site infection after major surgery, but a recent meta-analysis of seven randomized controlled trials (RCTs) incorporating 2728 patients concluded that there was no evidence of overall benefit, although there was a suggestion of benefit in two subgroups (general anaesthesia and colorectal surgery). This is consistent with results from the largest RCT in this area (the PROXI trial) which did not identify any effect on surgical site infection rates in patients receiving perioperative oxygen at 80%
compared with those receiving 30%
. Intriguingly, long-term follow-up (median of 2.3 yr) of patients with cancer within this study revealed reduced survival in the high
group. This result highlights both the potential serious harm of high concentration oxygen therapy in some groups of patients and also the variability in response between different groups of patients.
Perioperative Care
Several studies have recently sought to evaluate the potential benefit of oxygen in the promotion of postoperative wound healing. Early studies suggested that a high fractional concentration of inspired oxygen
reduced surgical site infection after major surgery, but a recent meta-analysis of seven randomized controlled trials (RCTs) incorporating 2728 patients concluded that there was no evidence of overall benefit, although there was a suggestion of benefit in two subgroups (general anaesthesia and colorectal surgery). This is consistent with results from the largest RCT in this area (the PROXI trial) which did not identify any effect on surgical site infection rates in patients receiving perioperative oxygen at 80%
compared with those receiving 30%
. Intriguingly, long-term follow-up (median of 2.3 yr) of patients with cancer within this study revealed reduced survival in the high
group. This result highlights both the potential serious harm of high concentration oxygen therapy in some groups of patients and also the variability in response between different groups of patients.
