![]() Oxygen-induced hypercapnia is particularly harmful in patients with COPD and obesity hypoventilation syndrome. For example, hyperoxemia may cause ventilation/perfusion (V/Q) mismatch and oxygen-induced hypercapnia by inhibiting hypoxic pulmonary vasoconstriction, thereby increasing blood flow to poorly ventilated alveoli (Rev Med Interne 2019 40:670-6 Thorax 2017 72:ii1-ii90). This recommendation remains somewhat contentious as several potential adverse effects are associated with hyperoxemia (defined as a PaO 2 >100 mmHg) (Rev Med Interne 2019 40:670-6). The World Health Organization recommends providing >80% FiO 2 during general anesthesia to decrease the incidence of surgical site infections (asamonitor.pub/43AYgSG). ![]() Even though oxygen delivery in the hospital setting is an important topic, guidance on a justifiable intraoperative fraction of inspired oxygen (FiO 2) is lacking. While oxygen is vital to life and an important element of patient care, many providers fail to recognize the harms of over-oxygenation, notwithstanding normal oxygen levels in most patients. ![]() This includes everything from preoxygenation, to providing adequate oxygenation during the case, to oxygen uptake and delivery to vital organs, to preventing hypoxemia to reduce mortality in scenarios such as traumatic brain injury, and finally to providing sufficient oxygenation to prevent postoperative respiratory insufficiency on emergence. In the OR, much of patient care revolves around oxygen. While once reserved to treat and support patients with various life-threatening lung diseases, it has increasingly been routinely employed to prevent hypoxemia, particularly in the perioperative setting. It is a crucial component of atmospheric air, comprising approximately 21%, and is vital to numerous bodily functions and processes. ![]() Oxygen is one of the most common and overused interventions in hospitals. ![]()
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