title: Perioperative use of oxygen: variabilities across age.
abstract: Enormous interest has emerged in the perioperative use of high concentrations of inspired oxygen in an attempt to increase tissue oxygenation and thereby improve postoperative outcome. An extensive debate has arisen regarding the risk/benefit ratio of oxygen therapy, with some researchers advocating the benefits of perioperative hyperoxia, particularly with regard to surgical site infection, whereas others emphasize its detrimental consequences on multiple organs, particularly the lungs and the brain. As one aspect of this debate, there is increased awareness of effects of reactive oxygen metabolites, a feature that contributes to the complexity of achieving consensus regarding optimum oxygen concentration in the perioperative period. Many reviews have discussed the pros and cons in the use of perioperative oxygen supplementation, but the potential importance of age-related factors in hyperoxia has not been addressed. The present narrative review provides a comprehensive overview of the physiological mechanisms and clinical outcomes across the age range from neonates to the elderly. Risks greatly outweigh the benefits of hyperoxia both in the very young, where growth and development are the hallmarks, and in the elderly, where ageing increases sensitivity to oxidative stress. Conversely, in middle age, benefits of short-term administration of perioperative oxygen therapy exceed potential adverse change effects, and thus, oxygen supplementation can be considered an important therapy to improve anaesthesia management.
authors.affiliation: Geneva Children's Hospital, University Hospitals of Geneva, 6 rue Willy Donzé, CH-1205 Geneva, Switzerland Pathophysiological Experimental Platform, Department of Anaesthesiology, Pharmacology and Intensive Care, University of Geneva, 1 rue Michel Servet, CH-1205 Geneva, Switzerland walid.habre@hcuge.ch.
authors.forename: W
authors.initials: W
authors.lastname: Habre
authors.affiliation: Pathophysiological Experimental Platform, Department of Anaesthesiology, Pharmacology and Intensive Care, University of Geneva, 1 rue Michel Servet, CH-1205 Geneva, Switzerland Department of Medical Physics and Informatics, University of Szeged, 9 Koranyi fasor, H-6720 Szeged, Hungary.
authors.forename: F
authors.initials: F
authors.lastname: Peták
mesh_terms: D000367:Age Factors; D006801:Humans; D018496:Hyperoxia / Q000209:etiology / Q000503:physiopathology; D000860:Hypoxia / Q000517:prevention & control; D018384:Oxidative Stress / Q000502:physiology; D010102:Oxygen Inhalation Therapy / Q000009:adverse effects / Q000379:methods*; D019990:Perioperative Care / Q000379:methods*
keywords: atelectasis; hyperoxia; oxidative stress; oxygenases/toxicity surgical site infection