Study: Risk of higher oxygen levels under general anesthesia

Editor's Note

An observational study, led by researchers at Vanderbilt University Medical Center (VUMC) and released on November 30 in The BMJ, the flagship journal of the British Medical Association, shows that higher levels of oxygen given to patients under general anesthesia can add risk of injury, VUMC reported on November 30, reports December 8 Healthcare Purchasing News.

The study comprised data from over 350,000 adult patients who underwent major surgery at 42 U.S. medical centers from January 2016 to November 2018.

“Supplemental oxygen is administered to patients during surgery to limit risk and improve outcomes, but this study highlights potential harm of excess oxygen administration,” said associate professor of Anesthesiology and Medicine and a leader of the study, adding that “A large, definitive clinical trial to detect small but clinically significant effects of different oxygen administration strategies would be a next step toward addressing this vital and nagging issue.”

The study suggests that there is a need to reconsider excessive use of oxygen during general anesthesia. Patients under general anesthesia are delivered air to the lungs with oxygen concentrations of 40-100%, exceeding the 21% of oxygen in room air.

The data shows that the patients in the 75^th percentile of oxygen exposure had greater risk of kidney, lung, and myocardial injury than those with less oxygen exposure. The study’s secondary outcomes suggest that patients with higher oxygen exposure also had higher risk of stroke and 30-day mortality.

The data for the study came from medical centers participating in the Multicenter Perioperative Outcomes Group, based at the University of Michigan in Ann Arbor.

VUMC release

The BMJ Study