title: Rational use of oxygen in medical disease and anesthesia.
abstract: OBJECTIVE
  Supplemental oxygen is often administered during anesthesia and in critical illness to treat hypoxia, but high oxygen concentrations are also given for a number of other reasons such as prevention of surgical site infection (SSI). The decision to use supplemental oxygen is, however, controversial, because of large heterogeneity in the reported results and emerging reports of side-effects. The aim of this article is to review the recent findings regarding benefits and harms of oxygen therapy in anesthesia and acute medical conditions.
  
  
  RESULTS
  Large randomized trials have not found significant reductions in SSI with 80% oxygen during and after abdominal surgery and cesarean section. There is no documented benefit of hyperbaric oxygen treatment for acute ischemic stroke, and there is emerging data to suggest increased mortality with normobaric supplemental oxygen for myocardial infarction without heart failure. Survival and neurologic outcome seem to be adversely affected by hyperoxia in patients with return of spontaneous circulation after cardiac arrest.
  
  
  CONCLUSIONS
  The benefits of supplemental oxygen are not yet confirmed, and new findings suggest that potential side-effects should be considered if the inspired oxygen concentration is increased above what is needed to maintain normal arterial oxygen saturation.
authors.affiliation: Department of Anaesthesiology, Copenhagen University Hospital, Herlev, Denmark. christianmeyhoff@gmail.com
authors.forename: Christian S
authors.initials: CS
authors.lastname: Meyhoff
authors.forename: Anne K
authors.initials: AK
authors.lastname: Staehr
authors.forename: Lars S
authors.initials: LS
authors.lastname: Rasmussen
mesh_terms: D000758:Anesthesia / Q000379:methods*; D002318:Cardiovascular Diseases / Q000628:therapy; D016638:Critical Illness; D006801:Humans; D006931:Hyperbaric Oxygenation; D000860:Hypoxia / Q000628:therapy*; D010100:Oxygen / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010102:Oxygen Inhalation Therapy / Q000009:adverse effects; D011182:Postoperative Care; D020250:Postoperative Nausea and Vomiting / Q000628:therapy; D001261:Pulmonary Atelectasis / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D013530:Surgical Wound Infection / Q000628:therapy
chemical_list: D010100:Oxygen