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Fraction of inspired oxygen in thoracic surgery: how much is too much?
Jonathan Gorky1, Andres de Lima, Wanda M Popescu
1Department of Anesthesiology, Yale School of Medicine, Yale University, New Haven, Connecticut, USA.
Purpose Of Review:
There is emerging literature suggesting that hyperoxia during anesthesia can lead to worse postoperative outcomes. We examine the subset of this literature pertaining to thoracic surgery, especially in the context of one lung ventilation, lung re-expansion, and the concomitant risk of lung ischemia reperfusion injury in this setting.
Recent Findings:
Higher fraction of inspired oxygen (FiO2) during thoracic surgery is associated with worse postoperative pulmonary outcomes. The period of one lung ventilation leads to relative tissue ischemia, which can lead to tissue injury at the time of expansion because of ischemia-reperfusion injury.
Summary:
It may be beneficial to limit FiO2, possibly during the one lung ventilation phase of thoracic procedures, and in particular during re-expansion, as this is the time when the lung parenchyma may be most susceptible to ischemia reperfusion injury.
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