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[Avoiding hypoxemia during anesthesia].

D N Mihic, E Binkert

    Der Anaesthesist
    |November 1, 1983
    PubMed
    Summary

    Unexpected hypoxemia during anesthesia is common with an inspiratory oxygen fraction (FiO2) of 0.33. Increasing FiO2 to 0.40 significantly reduces hypoxemia risk, particularly in older patients.

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    Area of Science:

    • Anesthesiology
    • Respiratory Physiology

    Background:

    • Unexpected hypoxemia can occur during general anesthesia.
    • Patient factors and oxygen administration influence oxygenation levels.

    Purpose of the Study:

    • To investigate the incidence of unexpected hypoxemia in healthy patients undergoing peripheral surgery.
    • To evaluate the safety of different inspiratory oxygen fractions (FiO2) and compare with anesthesiologists' opinions.

    Main Methods:

    • Studied 230 healthy patients, controlling for age, smoking, anesthesia/surgery type, body position, FiO2, and respiratory parameters.
    • Measured arterial oxygen (paO2) and carbon dioxide (paCO2) tension.
    • Surveyed anesthesiologists in the US, West Germany, and Switzerland regarding safe FiO2 and paO2 limits.

    Main Results:

    • 10% of patients on FiO2 0.33 and 3.3% on FiO2 0.40 experienced hypoxemia (paO2 < 80 mm Hg).
    • Older patients (>60) on FiO2 0.33 had a 25% hypoxemia rate.
    • Most surveyed anesthesiologists use FiO2 0.33, expecting paO2 > 80 mm Hg.

    Conclusions:

    • FiO2 of 0.33 is not consistently safe, with a 10% hypoxemia incidence.
    • Increasing FiO2 to 0.40 reduces hypoxemia, especially in patients over 40.
    • Anesthesiologists' expectations of safe oxygenation may not align with observed patient outcomes.

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