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Open AccessArticle

The Effects of Intraoperative Inspired Oxygen Fraction on Postoperative Pulmonary Parameters in Patients with General Anesthesia: A Systemic Review and Meta-Analysis

by Chang-Hoon Koo 1,2,†, Eun Young Park 3,†, Sun Young Lee 4 and Jung-Hee Ryu 1,2,*
1
Department of Anesthesiology & Pain medicine, Seoul National University College of Medicine, Seoul 03080, Korea
2
Department of Anesthesiology & Pain medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
3
Department of Anesthesiology & Pain medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea
4
Department of Anesthesiology & Pain medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13496, Korea
*
Author to whom correspondence should be addressed.
These two authors equally contributed to this work as co-first authors.
J. Clin. Med. 2019, 8(5), 583; https://doi.org/10.3390/jcm8050583
Received: 28 March 2019 / Revised: 26 April 2019 / Accepted: 26 April 2019 / Published: 28 April 2019
(This article belongs to the Section Anesthesiology)
High intraoperative inspired oxygen concentration is applied to prevent desaturation during induction and recovery of anesthesia. However, high oxygen concentration may lead to postoperative pulmonary complications. The purpose of this study is to compare the postoperative pulmonary parameters according to intraoperative inspired oxygen fraction in patients undergoing general anesthesia. We identified all randomized controlled trials investigating postoperative differences in arterial gas exchange according to intraoperative fraction of inspired oxygen (FiO2). A total of 10 randomized controlled trials were included, and 787 patients were analyzed. Postoperative PaO2 was lower in the high FiO2 group compared with the low FiO2 group (mean difference (MD) −4.97 mmHg, 95% CI −8.21 to −1.72, p = 0.003). Postoperative alveolar-arterial oxygen gradient (AaDO2) was higher (MD 3.42 mmHg, 95% CI 0.95 to 5.89, p = 0.007) and the extent of atelectasis was more severe (MD 2.04%, 95% CI 0.14 to 3.94, p = 0.04) in high intraoperative FiO2 group compared with low FiO2 group. However, postoperative SpO2 was comparable between the two groups. The results of this meta-analysis suggest that high inspired oxygen fraction during anesthesia may impair postoperative pulmonary parameters. Cautious approach in intraoperative inspired oxygen fraction is required for patients susceptible to postoperative pulmonary complications. View Full-Text
Keywords: oxygen; postoperative complications; risk factors oxygen; postoperative complications; risk factors
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Koo, C.-H.; Park, E.Y.; Lee, S.Y.; Ryu, J.-H. The Effects of Intraoperative Inspired Oxygen Fraction on Postoperative Pulmonary Parameters in Patients with General Anesthesia: A Systemic Review and Meta-Analysis. J. Clin. Med. 2019, 8, 583.

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