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The cardiovascular effects of inspired oxygen fraction in anaesthetized patients

Published online by Cambridge University Press:  02 June 2005

K. J. Anderson ,
J. M. Harten ,
M. G. Booth  and
J. Kinsella
K. J. Anderson
Affiliation:
Glasgow Royal Infirmary, University of Glasgow, Department of Anaesthesia, Glasgow, UK
J. M. Harten
Affiliation:
Glasgow Royal Infirmary, University of Glasgow, Department of Anaesthesia, Glasgow, UK
M. G. Booth
Affiliation:
Glasgow Royal Infirmary, University of Glasgow, Department of Anaesthesia, Glasgow, UK
J. Kinsella
Affiliation:
Glasgow Royal Infirmary, University of Glasgow, Department of Anaesthesia, Glasgow, UK
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Extract

Summary

Background and objective: Increased inspired oxygen fractions (FiO2) have significant haemodynamic effects in awake volunteers. We sought to establish whether these effects are also present in anaesthetized patients.

Methods: We prospectively studied 30 ASA I–II patients, 15 in each of a propofol and sevoflurane group. Their haemodynamic responses, awake and anaesthetized, when the FiO2 was changed between 0.3 and 1.0 were measured with a non-invasive transthoracic bio-impedance monitor.

Results: While preoxygenating awake patients in both groups the FiO2 was increased from 0.21 to 1.0. This reduced the mean cardiac index (3.38 ± 0.5 to 3.03 ± 0.5 L min−1 m−2; P < 0.001); reduced the heart rate (HR) (68.1 ± 10.4 to 62.8 ± 9.4 beats per minute (bpm); P < 0.001); and reduced the stroke index (50.4 ± 9.6 to 48.5 ± 8.6; P = 0.02). It increased the systemic vascular resistance index (2060 ± 319 to 2220 ± 382 dyn s−1 cm−5 m−2; P = 0.002); but did not change mean arterial pressure. In the anaesthetized patients, when decreasing the FiO2 from 1.0 to 0.3, mean cardiac index (L min−1 m−2) increased (3.06 ± 0.57 to 3.25 ± 0.56, P = 0.008 for sevoflurane; 2.76 ± 0.46 to 2.89 ± 0.42, P = 0.002 for propofol). The mean HR (bpm) increased (65.1 ± 7.8 to 69.1 ± 7.5, P < 0.001 for sevoflurane; 67.5 ± 11.8 to 72.7 ± 11.6, P = 0.001 for propofol). The mean systemic vascular resistance (dyn s−1 cm−5 m−2) decreased (1883 ± 329 to 1735 ± 388, P = 0.008 for sevoflurane; 2015 ± 369 to 1771 ± 259, P = 0.003 for propofol). Mean arterial pressure (mmHg) decreased (74.8 ± 8.7 to 71.4 ± 8.7, P < 0.001 for sevoflurane; 72.1 ± 8 to 66.5 ± 6.8, P = 0.002 for propofol).

Conclusion: O2 has haemodynamic effects in awake and anaesthetized patients. These effects were of overall similar magnitude for patients anaesthetized with propofol and sevoflurane.

Keywords

OXYGENHAEMODYNAMIC PHENOMENA, cardiac output, heart rate, vascular resistanceIMPEDANCE CARDIOGRAPHYPROPOFOLSEVOFLURANE
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 6 , June 2005 , pp. 420 - 425
Copyright
© 2005 European Society of Anaesthesiology

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