Routinemäßige Verwendung hoher inspiratorischer Sauerstoffkonzentrationen - Pro

O. Danzeisen; H.-J. Priebe

doi:10.1055/s-2005-861245

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Anästhesiol Intensivmed Notfallmed Schmerzther 2005; 40(6): 350-353
DOI: 10.1055/s-2005-861245

Die Kontroverse

Routinemäßige Verwendung hoher inspiratorischer Sauerstoffkonzentrationen - Pro

Routine Use of High Inspired Oxygen Concentration - ProO. Danzeisen¹ , H.-J. Priebe¹

¹ Anästhesiologische Universitätsklinik Freiburg

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Publication History

Publication Date:
08 June 2005 (online)

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Seit der Erstbeschreibung durch den Chemiker Joseph Priestley 1775 und den Apotheker Carl Wilhelm Scheele 1777 wurden dem Sauerstoff viele therapeutische Eigenschaften zugesprochen [1] [2]. Er wurde als „Allheilmittel” propagiert, und selbst die intravenöse Gabe wurde als eine der „Chief methods for the therapeutic employement of oxygen” angesehen [3]. Zwar wissen wir heute weit mehr über Wirkweise und Applikationsformen von Sauerstoff, aber gerade in der Anästhesie gehen nach wie vor die Meinungen über die angemessene intraoperative inspiratorische Sauerstoffkonzentration auseinander. Unserer Überzeugung nach spricht jedoch weit mehr für als gegen die routinemäßige intraoperative Verwendung hoher inspiratorischer Sauerstoffkonzentrationen (FiO₂).

Die entscheidenden, klinisch relevanten Vorteile einer intraoperativen Beatmung mit einer hohen inspiratorischen Sauerstoffkonzentration sind folgende:

Reduktion von postoperativen Wundinfekten, erhöhte Sicherheitsbreite, Reduktion von postoperativer Übelkeit und Erbrechen.

Literatur

1 Priestley J. Experiments and Observations on Different Kinds of Air and Other Branches of Natural Philosophy Connected with the Subject. 2nd edition in three volumes. Birmingham/London; Pearson (1st edition in six volumes: 1775) 1790

Search in Google Scholar
2 Strätling M, Schmucker P. 100 Jahre Sauerstofftherapie (1902 - 2002) - Eine medizinhistorische Neubewertung. AINS. 2002; 37 712-720

PubMed Search in Google Scholar
3 Bainbridge W S. Oxygen in medicine and surgery - a contribution, with report of cases. New York State J Med. 1908; 8 281-295

PubMed Search in Google Scholar
4 Haley R W, Culver D H, Morgan W M. et al . Identifying patients at risk of surgical wound infection: A simple multivariate index of patient susceptibility and wound contamination. Am J Epidemiol. 1985; 121 206-215

PubMed Search in Google Scholar
5 Akça O, Podolsky A, Eisenhuber E, Panzer O, Hetz H, Lampl K, Lackner F X, Wittmann K, Grabenwoeger F, Kurz A, Schultz A M, Negishi C, Sessler D I. Comparable postoperative pulmonary atelectasis in patients given 30 % or 80 % oxygen during and 2 hours after colon resection. Anesthesiology. 1999; 91 991-998

PubMed Search in Google Scholar
6 Zoutman D, McDonald S, Vethanayagan D. Total and attributable costs of surgical wound infections at a Canadian tertiary-care center. Infect Control Hosp Epidemiol. 1998; 19 254-259

PubMed Search in Google Scholar
7 Benhaim P, Hunt T K. Natural resistance to infection: Leucocyte functions. J Burn Care Rehabil. 1992; 13 287-292

PubMed Search in Google Scholar
8 Greif R, Akça O, Horn E P, Kurz A, Sessler D I. Supplemental oxygen to reduce the incidence of surgical wound infection. N Engl J Med.. 2000; 342 161-167

Crossref PubMed Search in Google Scholar
9 Miles A A, Miles E M, Burke J. The value and duration of defense reactions of the skin to the primary lodgement of bacteria. Br J Exp Pathol. 1957; 38 79-97

PubMed Search in Google Scholar
10 Wenisch C, Narzt E, Sessler D I. et al . Mild intraoperative hypothermia reduces production of reactive intermediates by polymorphonuclear leucocytes. Anesth Analg. 1996; 82 810-816

PubMed Search in Google Scholar
11 Knighton D R, Halliday B, Hunt T K. Oxygen as an antibiotic. The effect of inspired oxygen on infection. Arch Surg. 1984; 119 199-204

PubMed Search in Google Scholar
12 Hopf H W, Hunt T K, West J M. et al . Wound tissue oxygen tension predicts the risk of wound infection in surgical patients. Arch Surg. 1997; 132 997-1005

Crossref PubMed Search in Google Scholar
13 Gottrup F. Physiology and measurement of tissue perfusion. Ann Chir Gynaecol. 1994; 83 183-189

PubMed Search in Google Scholar
14 Van Esbroeck G, Gys T, Hubens A. Evaluation of tissue oximetry in perioperative monitoring of colorectal surgery. Br J Surg. 1992; 79 584-587

PubMed Search in Google Scholar
15 Kabon B, Nagele A, Reddy D, Eagon C, Fleshman J W, Sessler D I, Kurz A. Obesity decreases perioperative tissue oxygenation. Anesthesiology. 2004; 100 274-280

Crossref PubMed Search in Google Scholar
16 Niinikoski J, Jussila P, Vihersaari T. Radical mastectomy wound as a model for studies of human wound embolism. Am J Surg. 1973; 126 53-58

PubMed Search in Google Scholar
17 Pryor K O, Fahey T J, Lien C A, Goldstein P A. Surgical site infection and the routine use of perioperative hyperoxia in a general surgical population: a randomized controlled trial. JAMA. 2004; 291 279-287

PubMed Search in Google Scholar
18 Hopf H W, Hunt T K, Rosen N. Supplemental oxygen and risk of surgical site infection. Letter to the Editor. JAMA. 2004; 291 1956

PubMed Search in Google Scholar
19 Akça O, Sessler D. Supplemental oxygen and risk of surgical site infection. Letter to the Editor. JAMA. 2004; 291 1956-1957

PubMed Search in Google Scholar
20 Greif R, Sessler D I. Supplemental oxygen and risk of surgical site infection. Letter to the Editor. JAMA. 2004; 291 1957

PubMed Search in Google Scholar
21 Harten J, Anderson K, Kinsella J. Supplemental oxygen and risk of surgical site infection. Letter to the Editor. JAMA. 2004; 291 1957

PubMed Search in Google Scholar
22 Lee J T. Supplemental oxygen and risk of surgical site infection. Letter to the Editor. JAMA. 2004; 291 1957-1958

PubMed Search in Google Scholar
23 O’Neill M J Jr. Supplemental oxygen and risk of surgical site infection. Letter to the Editor. JAMA. 2004; 291 1958

PubMed Search in Google Scholar
24 Fleureaux O, Estebe J P, Blery C, Douet N, Malledant Y. Effects of preoxygenation methods on the course of PaO₂ and PaCO₂ in anesthetic post-induction apnea. Cah Anesthesiol. 1995; 43 367-370

PubMed Search in Google Scholar
25 Edmark L, Kostova-Aherdan K, Enlund M, Hedenstierna G. Optimal oxygen concentration during induction of general anesthesia. Anesthesiology. 2003; 98 28-33

Crossref PubMed Search in Google Scholar
26 Farmery A D, Roe P G. A model to describe the rate of oxyhaemoglobin desaturation during apnea. Br J Anaesth. 1996; 76 284-291

PubMed Search in Google Scholar
27 Kemming G I, Meisner F G, Kleen M, Meier J M, Tillmanns J, Hutter J W, Wojtczyk C J, Packert K B, Bottino D, Habler O P. Hyperoxic ventilation at the critical haematocrit. Resuscitation. 2003; 56 289-297

Crossref PubMed Search in Google Scholar
28 Meier J, Kemming G, Kisch-Wedel H, Wölkhammer S, Habler O. Hyperoxic ventilation reduces 6-hour mortality at the critical hemoglobin concentration. Anesthesiology. 2004; 100 70-76

PubMed Search in Google Scholar
29 Van Bommel J, Trouwborst A, Schwarte L, Siegemund M, Ince C, Henny C. Intestinal and cerebral oxygenation during severe isovolemic hemodilution and subsequent hyperoxic ventilation in a pig model. Anesthesiology. 2002; 97 660-670

Crossref PubMed Search in Google Scholar
30 Spahn D R, van Brempt R, Theilmeier G, Reibold J P, Welte M, Heinzerling H, Birck K, Keipert P E, Messmer K,. the European Perflubron Emulsion Study Group . Perflubron emulsion delays blood transfusions in orthopedic surgery. Anesthesiology. 1999; 91 1195-1210

Crossref PubMed Search in Google Scholar
31 Macario A, Dexter F. What are the most important risk factors for a patient's developing intraoperative hypothermia?. Anesth Analg. 2002; 94 215-220

PubMed Search in Google Scholar
32 Wetchler B V. Postoperative nausea and vomiting in day-case surgery. Br J Anaesth. 1992; 69 S33-39

PubMed Search in Google Scholar
33 Greif R, Laciny S, Rapf B, Hickle R, Sessler D I. Supplemental oxygen reduces the incidence of postoperative nausea and vomiting. Anesthesiology. 1999; 91 1246-1252

PubMed Search in Google Scholar
34 Purhonen S, Niskanen M, Wüstefeld M, Mustonen P, Hynynen M. Supplemental oxygen for prevention of nausea and vomiting after breast surgery. Br J Anaesth. 2003; 91 284-287

Crossref PubMed Search in Google Scholar
35 Goll V, Akça O, Greif R. et al . Ondansetron is no more effective than supplemental intraoperative oxygen for prevention of postoperative nausea and vomiting. Anesth Analg. 2001; 92 112-117

PubMed Search in Google Scholar
36 Buerk D G, Osanai S, Mokashi A. et al . Dopamine, sensory discharge, and stimulus interaction with CO2 and O2 in cat carotid body. J Appl Physiol. 1998; 85 1719-1726

PubMed Search in Google Scholar
37 Shen W V, Baig M S, Sata L S. et al . Dopamine receptor supersensitvity and the chemoreceptor trigger zone. Biol Psychiatry. 1983; 18 917-921

PubMed Search in Google Scholar
38 Tramer M R, Reynolds D J, Moore R A. et al . Efficacy, dose-response, and safety of Ondansetron in treatment of postoperative nausea and vomiting: a quantitative systematic review of randomized placebo-controlled trials. Anesthesiology. 1997; 87 1277-1289

Crossref PubMed Search in Google Scholar
39 Kovac A, McKenzie R, O'Connor T. et al . Prophylactic intravenous Ondansetron in female outpatients undergoing gynaecological surgery: a multicentre dose-comparison study. Eur J Anaesthesiol. 1992; 9 37-47

PubMed Search in Google Scholar
40 Diebel L N, Dulchavsky S A, Wilson R F. Effect of increased intraabdominal pressure on mesenteric arterial and intestinal mucosal blood flow. J Trauma. 1992; 33 45-48

PubMed Search in Google Scholar
41 Marston A. Responses of the splanchnic circulation to ischaemia. J Clin Pathol Suppl. 1977; 11 59-67

PubMed Search in Google Scholar
42 Kotani N, Hashimoto H, Sessler D I, Muraoka M, Hashiba E, Kubota T, Matsuki A. Supplemental intraoperative oxygen augments antimicrobial and proinflammatory responses of alveolar macrophages. Anesthesiology. 2000; 93 15-25

PubMed Search in Google Scholar
43 Joyce C J, Baker A B. Effects of inspired gas composition during anaesthesia and respiratory insufficiency in the postoperative lung volumes. Br J Anaesth. 1993; 75 417-421

PubMed Search in Google Scholar
44 Rothen H U, Sporre B, Engberg G, Wegenius G, Hogman M, Hedenstierna G. Influence of gas composition on recurrence of atelectasis after a reexpansion maneuver during general anesthesia. Anesthesiology. 1995; 82 832-842

Crossref PubMed Search in Google Scholar
45 Rothen H U, Sporre B, Engberg G, Wegenius G, Hedenstierna G. Reexpansion of atelectasis during general anaesthesia may have a prolonged effect. Acta Anaesthesiol Scand. 1995; 39 118-125

PubMed Search in Google Scholar
46 Hedenstierna G. Atelectasis and its prevention during anaesthesia. Eur J Anaesthesiol. 1998; 15 387-390

Crossref PubMed Search in Google Scholar
47 Edmark L, Kostova-Aherdan K, Enlund M, Hedenstierna G. Optimal oxygen concentration during induction of general anaesthesia. Anesthesiology. 2003; 98 28-33

Crossref PubMed Search in Google Scholar
48 Shulkin D J, Kinosian B, Glick H, Glen-Puschett C, Daly J, Eisenberg J M. The economic impact of infections: an analysis of hospital costs and charges in surgical patients with cancer. Arch Surg. 1993; 128 449-452

PubMed Search in Google Scholar

Dr. med. Oliver Danzeisen,
Prof. Dr. med. Hans-Joachim Priebe

Anästhesiologische Universitätsklinik ·

Hugstetter Straße 55 · 79106 Freiburg

Email: priebe@ana1.ukl.uni-freiburg.de