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Hyperoxic oxidative stress during abdominal surgery: a randomized trial.
Guniz M Koksal1, Yalim Dikmen1, Emre Erbabacan2
1Department of Anesthesiology and Reanimation, Cerrahpasa Medical Faculty, Istanbul University, Kocamustafapasa, 34040, Istanbul, Turkey.
Journal of Anesthesia
|March 23, 2016
Summary
High oxygen concentrations (80%) during anesthesia increase oxidative stress and decrease lung function compared to lower concentrations (40%). This finding highlights the importance of careful oxygen management in surgical patients to mitigate adverse effects and preserve antioxidant responses.
Area of Science:
- Anesthesiology
- Pulmonary Medicine
- Critical Care
Background:
- High fraction of inspired oxygen (FiO2) is commonly used during anesthesia.
- Potential risks associated with hyperoxia include increased oxidative stress and impaired lung function.
- Understanding the differential effects of varying oxygen concentrations is crucial for patient safety.
Purpose of the Study:
- To investigate whether 80% oxygen concentration during anesthesia increases oxidative stress more than 40% oxygen.
- To compare the impact of different oxygen concentrations on lung function and biochemical markers of oxidative stress.
Main Methods:
- A randomized, single-blind study involving 40 ASA I-II patients.
- Patients received either 0.8 FiO2 (group I) or 0.4 FiO2 (group II) during anesthesia.
- Measurements included expiratory tidal volumes (ETV), arterial blood gases (ABG), and biochemical markers (lactate, MDA, PCO, SOD, T-SH, NPSH) in plasma and mini-bronchoalveolar lavage (mini-BAL) fluid.
Main Results:
- Group II (0.4 FiO2) showed higher ETV and PaO2/FiO2 after extubation.
- Both groups exhibited increased plasma PCO, SOD, and T-SH, but MDA increase was not significant between groups.
- Plasma lactate and certain oxidative stress markers were higher in group I (0.8 FiO2).
- Mini-BAL analysis revealed significant increases in oxidative stress markers in both groups, with higher PCO, T-SH, PSH, and NPSH in group II, and higher MDA in group I.
Conclusions:
- 80% FiO2 during anesthesia significantly decreased ETV and PaO2/FiO2 compared to 40% FiO2.
- Higher oxygen concentration (80%) led to increased lactate levels and exacerbated oxidative stress.
- The findings suggest that 80% FiO2 inhibits the antioxidant response more than 40% FiO2.
Keywords:
Antioxidant response elementsOxidative stressOxygen inhalation therapyPostoperative pulmonary atelectasis
