Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-26T05:16:23.106Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Thomson AJ, Webb DJ, Maxwell SR, Grant IS. Oxygen therapy in acute medical care. BMJ 2002; 324: 1406–1407.Google Scholar
Lodato RF. Decreased oxygen consumption and cardiac output during normobaric hyperoxia in conscious dogs. J Appl Physiol 1989; 67: 1551–1559.Google Scholar
Daly WJ, Bondurant S. The effects of oxygen breathing on heart rate, blood pressure, and cardiac index of normal men-resting, with reactive hyperaemia, and after atropine. J Clin Invest 1962; 41: 126–132.Google Scholar
Harten JM, Anderson KJ, Angerson WJ, Booth MG, Kinsella J. Normobaric hyperoxia reduces cardiac index in healthy awake volunteers. Anaesthesia 2003; 58: 885–888.Google Scholar
Haque WA, Boehmer J, Clemson BS, Leuenberger UA, Silber DH, Sinoway LI. Hemodynamic effects of supplemental oxygen administration in congestive heart. J Am Coll Cardiol 1996; 27: 353–357.Google Scholar
Claeys MA, Gepts E, Camu F. Haemodynamic changes during anaesthesia induced and maintained with propofol. Br J Anaesth 1983; 60: 3–9.Google Scholar
Malan TP, DiNardo JA, Isner RJ, et al. Cardiovascular effects of sevoflurane compared with those of isoflurane in volunteers. Anesthesiology 1995; 83: 918–928.Google Scholar
Ebert TJ, Muzi M, Lopatka CW. Neurocirculatory responses to sevoflurane in humans. A comparison to desflurane. Anesthesiology 1995; 83: 88–95.Google Scholar
Van Keer L, Van Aken H, Vandermeersch E. Propofol does not inhibit hypoxic pulmonary vasoconstriction in humans. J Clin Anesth 1989; 1: 284–288.Google Scholar
Beck DH, Doepfmer UR, Sinemus C, Bloch A, Schenk MR, Kox WJ. Effects of sevoflurane and propofol on pulmonary shunt fraction during one-lung ventilation for thoracic surgery. Br J Anaesth 2001; 86: 38–43.Google Scholar
Sageman WS, Riffenburgh RH, Spiess BD. Equivalence of bioimpedance and thermodilution in measuring cardiac index after cardiac surgery. J Cardiothorac Vasc Anesth 2002; 16: 8–14.Google Scholar
Akca O, Doufas AG, Morioka N, Iscoe S, Fisher J, Sessler DI. Hypercapnia improves tissue oxygenation. Anesthesiology 2002; 97: 801–806.Google Scholar
Raaijmakers E, Faes TJ, Scholten RJ, Goovaerts HG, Heethaar RM. A meta-analysis of three decades of validating thoracic impedance cardiography. Crit Care Med 1999; 27: 1203–1213.Google Scholar
Goll V, Akca O, Greif R, Sessler DI. Ondansetron is no more effective than supplemental intraoperative oxygen for prevention of postoperative nausea and vomiting. Anesth Analg 2001; 92: 112–117.Google Scholar
Greif R, Akca O, Horn EP, Kurz A, Sessler DI. Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection. New Engl J Med 2000; 342: 161–167.Google Scholar
Greif R, Laciny S, Rapf B, Hickle RS, Sessler DI. Supplemental oxygen reduces the incidence of postoperative nausea and vomiting. Anesthesiology 1999; 91: 1246–1252.Google Scholar
Pryor KO, Fahey III TJ, Lien CA, Goldstein PA. Surgical site infection and the routine use of perioperative hyperoxia in a general surgical population: a randomized controlled trial. JAMA 2004; 291: 79–87.Google Scholar