Department of Anaesthesiology, Copenhagen University Hospital, Herlev, Denmark.
Curr Opin Anaesthesiol. 2012 Jun;25(3):363-70. doi: 10.1097/ACO.0b013e328352b402.
Supplemental oxygen is often administered during anesthesia and in critical illness to treat hypoxia, but high oxygen concentrations are also given for a number of other reasons such as prevention of surgical site infection (SSI). The decision to use supplemental oxygen is, however, controversial, because of large heterogeneity in the reported results and emerging reports of side-effects. The aim of this article is to review the recent findings regarding benefits and harms of oxygen therapy in anesthesia and acute medical conditions.
Large randomized trials have not found significant reductions in SSI with 80% oxygen during and after abdominal surgery and cesarean section. There is no documented benefit of hyperbaric oxygen treatment for acute ischemic stroke, and there is emerging data to suggest increased mortality with normobaric supplemental oxygen for myocardial infarction without heart failure. Survival and neurologic outcome seem to be adversely affected by hyperoxia in patients with return of spontaneous circulation after cardiac arrest.
The benefits of supplemental oxygen are not yet confirmed, and new findings suggest that potential side-effects should be considered if the inspired oxygen concentration is increased above what is needed to maintain normal arterial oxygen saturation.
在麻醉和危重病期间，常给患者补充氧气以治疗缺氧，但出于许多其他原因（如预防手术部位感染[SSI]）也会给予高浓度氧气。然而，由于报告结果存在很大异质性，并且出现了一些副作用的新报告，使用补充氧气的决策存在争议。本文旨在综述麻醉和急性医疗条件下氧疗的益处和危害的最新发现。
大型随机试验并未发现腹部手术和剖宫产期间及之后使用 80%氧气可显著降低 SSI。高压氧治疗急性缺血性脑卒中没有明确的益处，而且有新的数据表明，对于没有心力衰竭的心肌梗死患者，给予常压补充氧气可能会增加死亡率。心跳骤停后自主循环恢复的患者中，高氧似乎会对生存率和神经功能预后产生不利影响。
补充氧气的益处尚未得到证实，新发现表明，如果吸入氧气浓度高于维持正常动脉血氧饱和度所需的浓度，应考虑潜在的副作用。
