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Causes of Oxygenation Impairment During Anesthesia

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

Abstract

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.

Keywords

Spontaneous Breathing Functional Residual Capacity Compute Tomog Lung Region Hypoxic Pulmonary Vasoconstriction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer-Verlag Berlin Heidelberg 2000

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  • G. Hedenstierna

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