Some students have asked me about the reason of using FiO2 80% in my clinical practice. I figure I will list my rationals for using high FiO2 80% during most of the GA cases I do. First of all, people may worry about absorption atelectasis with high inspired FiO2. Akca et al found that the incidence and severity of atelectasis,were comparable in patients given 30% and 80% perioperative oxygen. A few other studies have also substantiated these findings that administration of 80% oxygen in the perioperative doesn’t significantly worsen lung function .
In addition, higher concentrations of fraction of inspired oxygen (FIO2) have been shown associated with lower risk for surgical site infection and reducing PONV to some extent. Furthermore, it buys you some time in case your tube gets kinked, migrated out such as in prone position. Based on aforementioned reasons, I routinely use 80% FiO2 on most of the cases.
Please let me know what you do in your practice.
O Akça, A Podolsky, E Eisenhuber, O Panzer, H Hetz, K Lampl, F X Lackner, K Wittmann, F Grabenwoeger, A Kurz, A M Schultz, C Negishi, D I Sessler Comparable postoperative pulmonary atelectasis in patients given 30% or 80% oxygen during and 2 hours after colon resection. Anesthesiology: 1999, 91(4);991-8
Hovaguimian F1, Lysakowski C, Elia N, Tramèr MR. Effect of intraoperative high inspired oxygen fraction on surgical site infection, postoperative nausea and vomiting, and pulmonary function: systematic review and meta-analysis of randomized controlled trials. Anesthesiology. 2013 Aug;119(2):303-16. doi: 10.1097/ALN.0b013e31829aaff4.