• R Pizov, Y G Weiss, A Oppenheim-Eden, H Glickman, S Goodman, Y Koganov, V Barak, G Merin, and M R Kramer.
• Department of Anesthesiology and CCM, Hadassah Medical Center, Jerusalem, Israel.
• J. Cardiothorac. Vasc. Anesth. 2000 Oct 1; 14 (5): 519-23.

ObjectiveTo investigate the effect of ventilation with 100% oxygen on lung injury associated with surgery involving cardiopulmonary bypass (CPB).DesignA prospective randomized study.SettingUniversity hospital.ParticipantsThirty patients undergoing coronary artery bypass graft surgery with CPB.InterventionsPatients were randomized to receive 100% oxygen (Oxygen group) or 50% oxygen (Air group) throughout surgery. During CPB, patients' lungs in the Air group were flushed with air and in the Oxygen group with 100% oxygen.Measurements And Main ResultsLung injury was evaluated by arterial oxygen tension-inspired oxygen concentration (PaO2-FIO2) ratio and cytokine levels (tumor necrosis factor-alpha and interleukin-8) in blood and bronchoalveolar lavage fluid measured before and after CPB. The lowest PaO2-FIO2 value was observed after 40 minutes following the completion of CPB in both groups. PaO2-FIO2 values 6 hours after CPB were not different from baseline in the Air group but remained lower (359+/-63 mmHg and 298+/-78 mmHg; p = 0.013) in the Oxygen group. Blood cytokine levels rose during surgery in both groups. Bronchoalveolar lavage levels of interleukin-8 did not change, whereas tumor necrosis factor-alpha increased only in the Oxygen group (p = 0.035).ConclusionsA significant decrease of oxygenation was observed in the early post-CPB period in both groups of patients, with delay in recovery in patients treated with 100% oxygen. A larger increase of the proinflammatory cytokines was found in patients treated with 100% oxygen. High oxygen concentrations during surgery with CPB should be used only when specifically required.

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