Journal ArticleDOI
The effects of general anaesthesia on oxygen consumption: A meta-analysis guiding future studies on perioperative oxygen transport
Julia Jakobsson,Julia Jakobsson,Sofia Vadman,Eva Hagel,Sigridur Kalman,Sigridur Kalman,Erzsébet Bartha,Erzsébet Bartha +7 more
TLDR
The effects of general anaesthesia on VO2 is investigated, which has been associated with poor outcome after surgery and is seldom monitored directly in routine care.Abstract:
Background Increased oxygen extraction, the ratio of consumption to delivery, has been associated with poor outcome after surgery Oxygen consumption (VO2) can change in several ways in the perioperative period, but is seldom monitored directly in routine care This study investigates the effects of general anaesthesia on VO2 Methods We searched PubMed, EMBASE, and Cochrane Library 1946-2018 for studies including VO2 measurements before and after anaesthesia induction Quality was assessed by Cochrane risk of bias tool and NIH Quality Assessment tool for before-and-after studies Changes in VO2 after anaesthesia induction were pooled in a random effects model meta-analysis with standardized mean differences transformed to absolute changes of VO2 Changes in VO2 after surgical incision and after recovery from anaesthesia were analysed as secondary outcomes in the included studies Results Twenty-four studies including 453 patients were analysed for VO2 changes induced by anaesthesia Studies were published during 1969-2000 and mean age of patients ranged 28-70 years VO2 decreased after anaesthesia induction by -65 (-75; -55, 95% CI) mL min-1 and indexed VO2 (VO2I) by -33 (-38; -28, 95% CI) mL min-1 m-2 After surgical incision and in the post-operative period VO2 increased again Heterogeneity was considerable among the studies and the overall quality of evidence was very low Conclusions General anaesthesia probably reduces oxygen consumption but the effect estimate is uncertain Given the limited generalizability and low quality of the available evidence, new studies in modern perioperative settings and in today's older high-risk surgical patient populations are neededread more
Citations
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Trends in the Use of the pulmonary artery catheter in the United states, 1993-2004. Commentary
Renda Soylemez Wiener,H. Gilbert Welch,Derek C. Angus,Gordon D. Rubenfeld,Elizabeth Mcnamara-Aslin,Lewis Rubinson +5 more
TL;DR: In this article, a time trend analysis on national estimates of PA catheterization utilization from 1993-2004 using data from all US states contributing to the Nationwide Inpatient Sample was performed.
Journal ArticleDOI
Effect of variable pre-oxygenation endpoints on safe apnoea time using high flow nasal oxygen for women in labour: a modelling investigation.
TL;DR: In this article, the authors used simulation suite to study the effect of varying FE′O2 (60, 70, 80, and 90%) on the duration of safe apnoea times using high flow nasal oxygen therapy (HFNO) and facemask techniques.
Journal ArticleDOI
Peri-operative oxygen consumption revisited: An observational study in elderly patients undergoing major abdominal surgery
TL;DR: General anaesthesia reduced VO2 by approximately a third in elderly patients undergoing major abdominal surgery and the relevance of these changes needs further assessment in relation to outcomes and haemodynamic interventions.
Journal ArticleDOI
Comparison of apnoeic oxygen techniques in term pregnant subjects: a computational modelling study.
TL;DR: Low-flow nasal oxygenation (LFNO) was used to extend safe apnoea time in pregnant women in and out of labour as mentioned in this paper , with a high-fidelity, computational, physiological model.
Journal ArticleDOI
Systemic Oxygen Delivery during One-Lung Ventilation: Comparison between Propofol and Sevoflurane Anaesthesia in a Randomised Controlled Trial.
TL;DR: DO2 did not significantly differ between sevoflurane and propofol anaesthesia, and may provide additional information on patient status, which may be especially important when patients show a low SaO2.
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