Subcutaneous oxygen pressure in spontaneously breathing lean and obese volunteers: a pilot study.
BACKGROUND
Oxidative killing is the primary defense against surgical pathogens; risk of infection is inversely related to tissue oxygenation. Subcutaneous tissue oxygenation in obese patients is significantly less than in lean patients during general anesthesia. However, it remains unknown whether reduced intraoperative tissue oxygenation in obese patients results from obesity per se or from a combination of anesthesia and surgery. In a pilot study, we tested the hypothesis that tissue oxygenation is reduced in spontaneously breathing, unanesthetized obese volunteers.


METHODS
Seven lean volunteers with a body mass index (BMI) of 22 +/- 2 kg/m(2) were compared to seven volunteers with a BMI of 46 +/- 4 kg/m(2). Volunteers were subjected to the following oxygen challenges: (1) room air; (2) 2 l/min oxygen via nasal prongs, (3) 6 l/min oxygen through a rebreathing face mask; (4) oxygen as needed to achieve an arterial oxygen pressure (arterial pO(2)) of 200 mmHg; and (5) oxygen as needed to achieve an arterial pO(2) of 300 mmHg. The oxygen challenges were randomized. Arterial pO(2) was measured with a continuous intraarterial blood gas analyzer (Paratrend 7); deltoid subcutaneous tissue oxygenation was measured with a polarographic microoxygen sensor (Licox).


RESULTS
Subcutaneous tissue oxygenation was similar in lean and obese volunteers: (1) room air, 52 +/- 10 vs 58 +/- 8 mmHg; (2) 2 l/min, 77 +/- 25 vs 79 +/- 24 mmHg; (3) 6 l/min, 125 +/- 43 vs 121 +/- 25 mmHg; (4) arterial pO(2) = 200 mmHg, 115 +/- 42 vs 144 +/- 23 mmHg; (5) arterial pO(2) = 300 mmHg, 145 +/- 41 vs 154 +/- 32 mmHg.


CONCLUSIONS
In this pilot study, we could not identify significant differences in deltoid subcutaneous tissue oxygen pressure between lean and morbidly obese volunteers.
Hiltebrand
Luzius B
LB
Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.
Kaiser
Heiko A
HA
Niedhart
Dagmar J
DJ
Pestel
Gunther
G
Kurz
Andrea
A
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000503:physiopathology*; D010100:Oxygen / Q000032:analysis*; D010865:Pilot Projects; D011312:Pressure; D040521:Subcutaneous Tissue / Q000737:chemistry*; D013851:Thinness; D014838:Volunteers
D010100:Oxygen