Causes of Oxygenation Impairment During Anesthesia

  • G. Hedenstierna
Part of the Yearbook of Intensive Care and Emergency Medicine book series (YEARBOOK, volume 2000)


Mild to moderate hypoxemia (arterial oxygen saturation of between 85–90%) occurs in about half of all patients undergoing anesthesia and elective surgery, despite an inspired oxygen fraction (FiO2) of 0.3–0.4 [1]. In 20% of the patients the saturation is below 81% for up to 5 min [1]. It maybe argued that such hypoxemia does not cause any harm in most patients, but it can hardly be considered a desirable condition and the causes of such hypoxemia should be identified and prevented, if possible. Moreover, post-operative pulmonary complications occur in 1–3% of patients undergoing elective thoracic or abdominal surgery, and the complication rate may increase to 20% in emergency surgery [2, 3]. To what extent post-operative complications are caused by a respiratory dysfunction during anesthesia is not clear. However, atelectasis that has developed during anesthesia remains in the post-operative period, and impairment in arterial oxygenation and decrease in forced spirometry correlate to the size of the atelectasis [4]. Moreover, in view of the large number of anesthestics that are given in the western world, some 30–50000 per million inhabitants, a moderate complication rate will have considerable social and economic consequences.


Spontaneous Breathing Functional Residual Capacity Compute Tomog Lung Region Hypoxic Pulmonary Vasoconstriction 
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© Springer-Verlag Berlin Heidelberg 2000

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  • G. Hedenstierna

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