Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Acta Anaesthesiol Scand. 2022 Sep;66(8):923-933. doi: 10.1111/aas.14102. Epub 2022 Jun 23.
Controversy exists regarding the effects of a high versus a low intraoperative fraction of inspired oxygen (FiO ) in adults undergoing general anesthesia. This systematic review and meta-analysis investigated the effect of a high versus a low FiO on postoperative outcomes.
PubMed and Embase were searched on March 22, 2022 for randomized clinical trials investigating the effect of different FiO levels in adults undergoing general anesthesia for non-cardiac surgery. Two investigators independently reviewed studies for relevance, extracted data, and assessed risk of bias. Meta-analyses were performed for relevant outcomes, and potential effect measure modification was assessed in subgroup analyses and meta-regression. The evidence certainty was evaluated using GRADE.
This review included 25 original trials investigating the effect of a high (mostly 80%) versus a low (mostly 30%) FiO . Risk of bias was intermediate for all trials. A high FiO did not result in a significant reduction in surgical site infections (OR: 0.91, 95% CI 0.81-1.02 [p = .10]). No effect was found for all other included outcomes, including mortality (OR = 1.27, 95% CI: 0.90-1.79 [p = .18]) and hospital length of stay (mean difference = 0.03 days, 95% CI -0.25 to 0.30 [p = .84). Results from subgroup analyses and meta-regression did not identify any clear effect modifiers across outcomes. The certainty of evidence (GRADE) was rated as low for most outcomes.
In adults undergoing general anesthesia for non-cardiac surgery, a high FiO did not improve outcomes including surgical site infections, length of stay, or mortality. However, the certainty of the evidence was assessed as low.
对于接受全身麻醉的成年人，吸入氧分数（FiO ）高与低对术后结果的影响存在争议。本系统评价和荟萃分析研究了高 FiO 与低 FiO 对术后结果的影响。
于 2022 年 3 月 22 日在 PubMed 和 Embase 上检索了关于非心脏手术全身麻醉成人不同 FiO 水平影响的随机临床试验。两名研究者独立审查了研究的相关性，提取数据，并评估了偏倚风险。对相关结局进行了荟萃分析，并在亚组分析和荟萃回归中评估了潜在的效果衡量修正。使用 GRADE 评估证据确定性。
本综述包括 25 项原始试验，研究了高（大多为 80%）FiO 与低（大多为 30%）FiO 的影响。所有试验的偏倚风险均为中等。高 FiO 并未显著降低手术部位感染的风险（OR：0.91，95%CI 0.81-1.02 [p=0.10]）。其他所有纳入的结局，包括死亡率（OR=1.27，95%CI：0.90-1.79 [p=0.18]）和住院时间（平均差值 0.03 天，95%CI -0.25 至 0.30 [p=0.84]）均无影响。亚组分析和荟萃回归的结果未发现任何明确的结局修正因素。证据确定性（GRADE）的等级评定为大多数结局为低。
在接受非心脏手术全身麻醉的成年人中，高 FiO 并未改善手术部位感染、住院时间或死亡率等结局。然而，证据的确定性被评估为低。
