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A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
Current Ventilator and Oxygen Management during General Anesthesia: A Multicenter, Cross-sectional Observational
Satoshi Suzuki1, Yuko Mihara, Yukiko Hikasa
1From the Department of Anesthesiology and Resuscitology, Okayama University Hospital, Okayama, Japan (S.S., Y.M., Y.H., S.O., H.M.) Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan (T.I., A.S.). Atago Hospital, Kochi Chikamori Hospital, Kochi Fukuyama City Hospital, Hiroshima Fukuyama Medical Center, Hiroshima Himeji Central Hospital, Hyogo Hiroshima City Hiroshima Citizens Hospital, Hiroshima Iwakuni Medical Center, Yamaguchi Japanese Red Cross Kobe Hospital, Hyogo Japanese Red Cross Okayama Hospital, Okayama Japanese Red Cross Society Himeji Hospital, Hyogo Japanese Red Cross Society Mihara Hospital, Hiroshima Jichi Medical University Hospital, Tochigi Kagawa Prefectural Central Hospital, Kagawa Kagawa Rosai Hospital, Kagawa Kajiki Hospital, Okayama Kameda Medical Center, Chiba Kawasaki Medical School General Medical Center, Okayama Kawasaki Medical School Hospital, Okayama Kobe University Hospital, Hyogo Kochi Health Sciences Center, Kochi Kochi Medical School Hospital, Kochi Kurashiki Medical Center, Okayama Maizuru Kyosai Hospital, Kyoto Matsuda Hospital, Okayama Mitoyo General Hospital, Kagawa Mizushima Kyodo Hospital, Okayama National Cancer Center Hospital, Tokyo Okayama City Hospital, Okayama Okayama Kyokuto Hospital, Okayama Okayama Kyoritsu General Hospital, Okayama Okayama Medical Center, Okayama Okayama Rosai Hospital, Okayama Okayama Saiseikai General Hospital, Okayama Onomichi Municipal Hospital, Hiroshima Saiseikai Imabari Hospital, Ehime Shizuoka Cancer Center, Shizuoka Showa University Northern Yokohama Hospital, Kanagawa Takasago Municipal Hospital, Hyogo Takinomiya General Hospital, Kagawa Tottori Municipal Hospital, Tottori Tsuyama Chuo Hospital, Okayama Yashima General Hospital, Kagawa.
Potentially preventable hyperoxemia and substantial oxygen exposure are common during general anesthesia. One-lung ventilation is a significant risk factor, suggesting a need for conservative intraoperative oxygen therapy approaches.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Respiratory Physiology
Background:
- Intraoperative oxygen management practices during general anesthesia are not well understood.
- There is a hypothesis that hyperoxemia and excessive oxygen exposure are frequent during anesthesia.
Purpose of the Study:
- To describe current ventilator and oxygen management practices during general anesthesia in Japan.
- To determine the prevalence of potentially preventable hyperoxemia and substantial oxygen exposure.
- To identify risk factors associated with substantial oxygen exposure.
Main Methods:
- A multicenter, cross-sectional study involving 1,498 adult patients undergoing general anesthesia.
- Data collected 1 hour post-induction included ventilator settings and vital signs.
- Defined potentially preventable hyperoxemia and substantial oxygen exposure based on oxygen saturation and fractional inspired oxygen (FiO2).
Main Results:
- 92% of patients received FiO2 between 0.31 and 0.6.
- 83% experienced potentially preventable hyperoxemia, and 32% had substantial oxygen exposure.
- One-lung ventilation was a strong risk factor for substantial oxygen exposure (aOR 13.35).
Conclusions:
- Potentially preventable hyperoxemia and substantial oxygen exposure are prevalent during general anesthesia.
- One-lung ventilation significantly increases the risk of substantial oxygen exposure.
- Further research is needed to evaluate conservative intraoperative oxygen therapy strategies.
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