• Robert P Weenink, Stijn W de Jonge, Robert A van Hulst, Thijs T Wingelaar, Pieter-Jan A M van Ooij, Rogier V Immink, Benedikt Preckel, and Markus W Hollmann.
• Department of Anaesthesia, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
• J Clin Med. 2020 Feb 28; 9 (3).

AbstractThe use of an inspiratory oxygen fraction of 0.80 during surgery is a topic of ongoing debate. Opponents claim that increased oxidative stress, atelectasis, and impaired oxygen delivery due to hyperoxic vasoconstriction are detrimental. Proponents point to the beneficial effects on the incidence of surgical site infections and postoperative nausea and vomiting. Also, hyperoxygenation is thought to extend the safety margin in case of acute intraoperative emergencies. This review provides a comprehensive risk-benefit analysis for the use of perioperative hyperoxia in noncritically ill adults based on clinical evidence and supported by physiological deduction where needed. Data from the field of hyperbaric medicine, as a model of extreme hyperoxygenation, are extrapolated to the perioperative setting. We ultimately conclude that current evidence is in favour of hyperoxia in noncritically ill intubated adult surgical patients.

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