Skip to main content
Erschienen in: Die Anaesthesiologie 5/2023

21.04.2023 | Allgemeinanästhesie | Allgemeinanästhesie

Die perioperative Hyperoxie – mehr Schaden als Nutzen?

verfasst von: Dr. med. Johann Stuby, PD Dr. med. Alexander Kaserer, Dr. med. Sascha Ott, Prof. Dr. med. Kurt Ruetzler, Dr. med. Julian Rössler

Erschienen in: Die Anaesthesiologie | Ausgabe 5/2023

Einloggen, um Zugang zu erhalten

Zusammenfassung

Hintergrund

Die ideale Höhe der perioperativen Sauerstoffkonzentration ist kontrovers, und die bisherigen Studienresultate sind uneinheitlich.

Fragestellung

Heutiger Wissensstand über die potenziellen vor- und nachteiligen Effekte einer perioperativen Hyperoxie.

Material und Methode

Narrativer Review der aktuellen Literatur.

Ergebnisse

Die perioperative Hyperoxie führt wahrscheinlich nicht zu einem vermehrten Auftreten von Atelektasen, pulmonalen- bzw. kardiovaskulären Komplikationen oder einer Mortalitätszunahme. Vorteilhafte Effekte wie die Reduktion chirurgischer Wundinfekte oder postoperativer Übelkeit und Erbrechen sind kaum nachweisbar. Entsprechend dem heutigen Wissensstand ist es empfehlenswert, ausgenommen kritischer Phasen wie Notfallsituationen oder Ein- und Ausleitung einer Anästhesie, eine perioperative Hyperoxie zu vermeiden und stattdessen eine Normoxie anzustreben.
Literatur
1.
Zurück zum Zitat Allegranzi B, Zayed B, Bischoff P et al (2016) New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis 16:e288–e303PubMedCrossRef Allegranzi B, Zayed B, Bischoff P et al (2016) New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis 16:e288–e303PubMedCrossRef
2.
Zurück zum Zitat Allen DB, Maguire JJ, Mahdavian M et al (1997) Wound hypoxia and acidosis limit neutrophil bacterial killing mechanisms. Arch Surg 132:991–996PubMedCrossRef Allen DB, Maguire JJ, Mahdavian M et al (1997) Wound hypoxia and acidosis limit neutrophil bacterial killing mechanisms. Arch Surg 132:991–996PubMedCrossRef
3.
Zurück zum Zitat Anthony T, Murray BW, Sum-Ping JT et al (2011) Evaluating an evidence-based bundle for preventing surgical site infection: a randomized trial. Arch Surg 146:263–269PubMedCrossRef Anthony T, Murray BW, Sum-Ping JT et al (2011) Evaluating an evidence-based bundle for preventing surgical site infection: a randomized trial. Arch Surg 146:263–269PubMedCrossRef
4.
Zurück zum Zitat Apfelbaum JL, Hagberg CA, Connis RT et al (2022) 2022 American society of anesthesiologists practice guidelines for management of the difficult airway. Anesthesiology 136:31–81PubMedCrossRef Apfelbaum JL, Hagberg CA, Connis RT et al (2022) 2022 American society of anesthesiologists practice guidelines for management of the difficult airway. Anesthesiology 136:31–81PubMedCrossRef
5.
Zurück zum Zitat Asfar P, Schortgen F, Boisramé-Helms J et al (2017) Hyperoxia and hypertonic saline in patients with septic shock (HYPERS2S): a two-by-two factorial, multicentre, randomised, clinical trial. Lancet Respir Med 5:180–190PubMedCrossRef Asfar P, Schortgen F, Boisramé-Helms J et al (2017) Hyperoxia and hypertonic saline in patients with septic shock (HYPERS2S): a two-by-two factorial, multicentre, randomised, clinical trial. Lancet Respir Med 5:180–190PubMedCrossRef
7.
Zurück zum Zitat Barbateskovic M, Schjørring OL, Krauss SR et al (2021) Higher vs lower oxygenation strategies in acutely ill adults: a systematic review with meta-analysis and trial sequential analysis. Chest 159:154–173PubMedCrossRef Barbateskovic M, Schjørring OL, Krauss SR et al (2021) Higher vs lower oxygenation strategies in acutely ill adults: a systematic review with meta-analysis and trial sequential analysis. Chest 159:154–173PubMedCrossRef
8.
Zurück zum Zitat Benoît Z, Wicky S, Fischer J‑F et al (2002) The effect of increased FIO2 before tracheal extubation on postoperative atelectasis. Anesth Analg 95:1777–1781PubMedCrossRef Benoît Z, Wicky S, Fischer J‑F et al (2002) The effect of increased FIO2 before tracheal extubation on postoperative atelectasis. Anesth Analg 95:1777–1781PubMedCrossRef
9.
Zurück zum Zitat Berríos-Torres SI, Umscheid CA, Bratzler DW et al (2017) Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg 152:784–791PubMedCrossRef Berríos-Torres SI, Umscheid CA, Bratzler DW et al (2017) Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg 152:784–791PubMedCrossRef
10.
Zurück zum Zitat Chu DK, Kim LH, Young PJ et al (2018) Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis. Lancet 391:1693–1705PubMedCrossRef Chu DK, Kim LH, Young PJ et al (2018) Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis. Lancet 391:1693–1705PubMedCrossRef
11.
Zurück zum Zitat Cohen B, Ruetzler K, Kurz A et al (2019) Intra-operative high inspired oxygen fraction does not increase the risk of postoperative respiratory complications: alternating intervention clinical trial. Eur J Anaesthesiol 36:320–326PubMedCrossRef Cohen B, Ruetzler K, Kurz A et al (2019) Intra-operative high inspired oxygen fraction does not increase the risk of postoperative respiratory complications: alternating intervention clinical trial. Eur J Anaesthesiol 36:320–326PubMedCrossRef
12.
Zurück zum Zitat Cohen B, Schacham Y, Ruetzler K et al (2018) Effect of intraoperative hyperoxia on the incidence of surgical site infections: a meta-analysis. Br J Anaesth 120:1176–1186PubMedCrossRef Cohen B, Schacham Y, Ruetzler K et al (2018) Effect of intraoperative hyperoxia on the incidence of surgical site infections: a meta-analysis. Br J Anaesth 120:1176–1186PubMedCrossRef
13.
Zurück zum Zitat Court MW, Mcalister S, Pierce JMT et al (2021) Converting gas-driven ventilators from oxygen to air: environmental implications. Anaesthesia 76:285–286PubMedCrossRef Court MW, Mcalister S, Pierce JMT et al (2021) Converting gas-driven ventilators from oxygen to air: environmental implications. Anaesthesia 76:285–286PubMedCrossRef
14.
Zurück zum Zitat de Jonge S, Egger M, Latif A et al (2019) Effectiveness of 80 % vs 30–35 % fraction of inspired oxygen in patients undergoing surgery: an updated systematic review and meta-analysis. Br J Anaesth 122:325–334PubMedCrossRef de Jonge S, Egger M, Latif A et al (2019) Effectiveness of 80 % vs 30–35 % fraction of inspired oxygen in patients undergoing surgery: an updated systematic review and meta-analysis. Br J Anaesth 122:325–334PubMedCrossRef
15.
Zurück zum Zitat Duggan M, Kavanagh BP (2005) Pulmonary atelectasis: a pathogenic perioperative entity. Anesthesiology 102:838–854PubMedCrossRef Duggan M, Kavanagh BP (2005) Pulmonary atelectasis: a pathogenic perioperative entity. Anesthesiology 102:838–854PubMedCrossRef
16.
Zurück zum Zitat Edmark L, Kostova-Aherdan K, Enlund M et al (2003) Optimal oxygen concentration during induction of general anesthesia. Anesthesiology 98:28–33PubMedCrossRef Edmark L, Kostova-Aherdan K, Enlund M et al (2003) Optimal oxygen concentration during induction of general anesthesia. Anesthesiology 98:28–33PubMedCrossRef
17.
Zurück zum Zitat Espinosa-Diez C, Miguel V, Mennerich D et al (2015) Antioxidant responses and cellular adjustments to oxidative stress. Redox Biol 6:183–197PubMedPubMedCentralCrossRef Espinosa-Diez C, Miguel V, Mennerich D et al (2015) Antioxidant responses and cellular adjustments to oxidative stress. Redox Biol 6:183–197PubMedPubMedCentralCrossRef
18.
Zurück zum Zitat Ferrando C, Aldecoa C, Unzueta C et al (2020) Effects of oxygen on post-surgical infections during an individualised perioperative open-lung ventilatory strategy: a randomised controlled trial. Br J Anaesth 124:110–120PubMedCrossRef Ferrando C, Aldecoa C, Unzueta C et al (2020) Effects of oxygen on post-surgical infections during an individualised perioperative open-lung ventilatory strategy: a randomised controlled trial. Br J Anaesth 124:110–120PubMedCrossRef
19.
Zurück zum Zitat Fonnes S, Gögenur I, Søndergaard ES et al (2016) Perioperative hyperoxia—long-term impact on cardiovascular complications after abdominal surgery, a post hoc analysis of the PROXI trial. Int J Cardiol 215:238–243PubMedCrossRef Fonnes S, Gögenur I, Søndergaard ES et al (2016) Perioperative hyperoxia—long-term impact on cardiovascular complications after abdominal surgery, a post hoc analysis of the PROXI trial. Int J Cardiol 215:238–243PubMedCrossRef
20.
Zurück zum Zitat Goll V, Akça O, Greif R et al (2001) Ondansetron is no more effective than supplemental intraoperative oxygen for prevention of postoperative nausea and vomiting. Anesth Analg 92:112–117PubMedCrossRef Goll V, Akça O, Greif R et al (2001) Ondansetron is no more effective than supplemental intraoperative oxygen for prevention of postoperative nausea and vomiting. Anesth Analg 92:112–117PubMedCrossRef
21.
Zurück zum Zitat Greif R, Akça O, Horn E‑P et al (2000) Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection. N Engl J Med 342:161–167PubMedCrossRef Greif R, Akça O, Horn E‑P et al (2000) Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection. N Engl J Med 342:161–167PubMedCrossRef
22.
Zurück zum Zitat Hol L, Nijbroek SG, Schultz MJ (2020) Perioperative lung protection: clinical implications. Anesth Analg 131:1721–1729PubMedCrossRef Hol L, Nijbroek SG, Schultz MJ (2020) Perioperative lung protection: clinical implications. Anesth Analg 131:1721–1729PubMedCrossRef
23.
Zurück zum Zitat Holse C, Aasvang EK, Vester-Andersen M et al (2022) Hyperoxia and antioxidants for myocardial injury in noncardiac surgery: a 2× 2 factorial, blinded, randomized clinical trial. Anesthesiology 136:408–419PubMedCrossRef Holse C, Aasvang EK, Vester-Andersen M et al (2022) Hyperoxia and antioxidants for myocardial injury in noncardiac surgery: a 2× 2 factorial, blinded, randomized clinical trial. Anesthesiology 136:408–419PubMedCrossRef
24.
Zurück zum Zitat Holst JM, Klitholm MP, Henriksen J et al (2022) Intraoperative respiratory and hemodynamic strategies for reducing nausea, vomiting, and pain after surgery: Systematic review and meta-analysis. Acta Anaesthesiol Scand 66:1051–1060PubMedPubMedCentralCrossRef Holst JM, Klitholm MP, Henriksen J et al (2022) Intraoperative respiratory and hemodynamic strategies for reducing nausea, vomiting, and pain after surgery: Systematic review and meta-analysis. Acta Anaesthesiol Scand 66:1051–1060PubMedPubMedCentralCrossRef
25.
Zurück zum Zitat Hovaguimian F, Lysakowski C, Elia N et al (2013) Effect of intraoperative high inspired oxygen fraction on surgical site infection, postoperative nausea and vomiting, and pulmonary function: systematic review and meta-analysis of randomized controlled trials. Anesthesiology 119:303–316PubMedCrossRef Hovaguimian F, Lysakowski C, Elia N et al (2013) Effect of intraoperative high inspired oxygen fraction on surgical site infection, postoperative nausea and vomiting, and pulmonary function: systematic review and meta-analysis of randomized controlled trials. Anesthesiology 119:303–316PubMedCrossRef
26.
Zurück zum Zitat Høybye M, Lind PC, Holmberg MJ et al (2022) Fraction of inspired oxygen during general anesthesia for non-cardiac surgery: systematic review and meta-analysis. Acta Anaesthesiol Scand 66:923–933PubMedPubMedCentralCrossRef Høybye M, Lind PC, Holmberg MJ et al (2022) Fraction of inspired oxygen during general anesthesia for non-cardiac surgery: systematic review and meta-analysis. Acta Anaesthesiol Scand 66:923–933PubMedPubMedCentralCrossRef
28.
Zurück zum Zitat Kiers D, Gerretsen J, Janssen E et al (2015) Short-term hyperoxia does not exert immunologic effects during experimental murine and human endotoxemia. Sci Rep 5:1–11CrossRef Kiers D, Gerretsen J, Janssen E et al (2015) Short-term hyperoxia does not exert immunologic effects during experimental murine and human endotoxemia. Sci Rep 5:1–11CrossRef
29.
Zurück zum Zitat Kilgannon JH, Jones AE, Shapiro NI et al (2010) Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality. JAMA 303:2165–2171PubMedCrossRef Kilgannon JH, Jones AE, Shapiro NI et al (2010) Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality. JAMA 303:2165–2171PubMedCrossRef
30.
Zurück zum Zitat Kongebro EK, Jorgensen LN, Siersma VD et al (2019) Association between perioperative hyperoxia and cerebrovascular complications after laparotomy—a post-hoc follow-up study. Acta Anaesthesiol Scand 63:164–170PubMedCrossRef Kongebro EK, Jorgensen LN, Siersma VD et al (2019) Association between perioperative hyperoxia and cerebrovascular complications after laparotomy—a post-hoc follow-up study. Acta Anaesthesiol Scand 63:164–170PubMedCrossRef
31.
Zurück zum Zitat Kurz A, Fleischmann E, Sessler D et al (2015) Effects of supplemental oxygen and dexamethasone on surgical site infection: a factorial randomized trial. Br J Anaesth 115:434–443PubMedCrossRef Kurz A, Fleischmann E, Sessler D et al (2015) Effects of supplemental oxygen and dexamethasone on surgical site infection: a factorial randomized trial. Br J Anaesth 115:434–443PubMedCrossRef
32.
Zurück zum Zitat Kurz A, Kopyeva T, Suliman I et al (2018) Supplemental oxygen and surgical-site infections: an alternating intervention controlled trial. Br J Anaesth 120:117–126PubMedCrossRef Kurz A, Kopyeva T, Suliman I et al (2018) Supplemental oxygen and surgical-site infections: an alternating intervention controlled trial. Br J Anaesth 120:117–126PubMedCrossRef
33.
Zurück zum Zitat Lin X, Wang P, Liu D‑W et al (2021) Intraoperative oxygen concentration and postoperative delirium after laparoscopic gastric and colorectal malignancies surgery: a randomized, double-blind, controlled trial. Clin Interv Aging 16:1085PubMedPubMedCentralCrossRef Lin X, Wang P, Liu D‑W et al (2021) Intraoperative oxygen concentration and postoperative delirium after laparoscopic gastric and colorectal malignancies surgery: a randomized, double-blind, controlled trial. Clin Interv Aging 16:1085PubMedPubMedCentralCrossRef
34.
Zurück zum Zitat Mackle D, Bellomo R, Bailey M et al (2019) Conservative oxygen therapy during mechanical ventilation in the ICU. N Engl J Med 382:989–998PubMed Mackle D, Bellomo R, Bailey M et al (2019) Conservative oxygen therapy during mechanical ventilation in the ICU. N Engl J Med 382:989–998PubMed
36.
Zurück zum Zitat Mattishent K, Thavarajah M, Sinha A et al (2019) Safety of 80 % vs 30–35 % fraction of inspired oxygen in patients undergoing surgery: a systematic review and meta-analysis. Br J Anaesth 122:311–324PubMedCrossRef Mattishent K, Thavarajah M, Sinha A et al (2019) Safety of 80 % vs 30–35 % fraction of inspired oxygen in patients undergoing surgery: a systematic review and meta-analysis. Br J Anaesth 122:311–324PubMedCrossRef
37.
Zurück zum Zitat Mellin-Olsen J, Mcdougall RJ, Cheng D (2017) WHO guidelines to prevent surgical site infections. Lancet Infect Dis 17:260–261PubMedCrossRef Mellin-Olsen J, Mcdougall RJ, Cheng D (2017) WHO guidelines to prevent surgical site infections. Lancet Infect Dis 17:260–261PubMedCrossRef
38.
Zurück zum Zitat Meyhoff CS, Jorgensen LN, Wetterslev J et al (2012) Increased long-term mortality after a high perioperative inspiratory oxygen fraction during abdominal surgery: follow-up of a randomized clinical trial. Anesth Analg 115:849–854PubMedCrossRef Meyhoff CS, Jorgensen LN, Wetterslev J et al (2012) Increased long-term mortality after a high perioperative inspiratory oxygen fraction during abdominal surgery: follow-up of a randomized clinical trial. Anesth Analg 115:849–854PubMedCrossRef
39.
Zurück zum Zitat Meyhoff CS, Wetterslev J, Jorgensen LN et al (2009) Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery: the PROXI randomized clinical trial. JAMA 302:1543–1550PubMedCrossRef Meyhoff CS, Wetterslev J, Jorgensen LN et al (2009) Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery: the PROXI randomized clinical trial. JAMA 302:1543–1550PubMedCrossRef
40.
Zurück zum Zitat Myles P, Kurz A (2017) Supplemental oxygen and surgical site infection: getting to the truth. Oxford University Press, S 13–15 Myles P, Kurz A (2017) Supplemental oxygen and surgical site infection: getting to the truth. Oxford University Press, S 13–15
41.
Zurück zum Zitat O’driscoll B, Howard L, Earis J et al (2017) British thoracic society guideline for oxygen use in adults in healthcare and emergency settings. BMJ Open Resp Res 4:e170PubMedPubMedCentralCrossRef O’driscoll B, Howard L, Earis J et al (2017) British thoracic society guideline for oxygen use in adults in healthcare and emergency settings. BMJ Open Resp Res 4:e170PubMedPubMedCentralCrossRef
42.
Zurück zum Zitat Orhan-Sungur M, Kranke P, Sessler D et al (2008) Does supplemental oxygen reduce postoperative nausea and vomiting? A meta-analysis of randomized controlled trials. Anesth Analg 106:1733–1738PubMedCrossRef Orhan-Sungur M, Kranke P, Sessler D et al (2008) Does supplemental oxygen reduce postoperative nausea and vomiting? A meta-analysis of randomized controlled trials. Anesth Analg 106:1733–1738PubMedCrossRef
43.
Zurück zum Zitat Pedersen SS, Holse C, Mathar CE et al (2022) Intraoperative inspiratory oxygen fraction and myocardial injury after noncardiac surgery: results from an international observational study in relation to recent controlled trials. Anesth Analg 135(5):1021–1030PubMedCrossRef Pedersen SS, Holse C, Mathar CE et al (2022) Intraoperative inspiratory oxygen fraction and myocardial injury after noncardiac surgery: results from an international observational study in relation to recent controlled trials. Anesth Analg 135(5):1021–1030PubMedCrossRef
45.
Zurück zum Zitat Podolyak A, Sessler DI, Reiterer C et al (2016) Perioperative supplemental oxygen does not worsen long-term mortality of colorectal surgery patients. Anesth Analg 122:1907–1911PubMedCrossRef Podolyak A, Sessler DI, Reiterer C et al (2016) Perioperative supplemental oxygen does not worsen long-term mortality of colorectal surgery patients. Anesth Analg 122:1907–1911PubMedCrossRef
46.
Zurück zum Zitat Roberts BW, Kilgannon JH, Hunter BR et al (2018) Association between early hyperoxia exposure after resuscitation from cardiac arrest and neurological disability: prospective multicenter protocol-directed cohort study. Circulation 137:2114–2124PubMedPubMedCentralCrossRef Roberts BW, Kilgannon JH, Hunter BR et al (2018) Association between early hyperoxia exposure after resuscitation from cardiac arrest and neurological disability: prospective multicenter protocol-directed cohort study. Circulation 137:2114–2124PubMedPubMedCentralCrossRef
47.
Zurück zum Zitat Ruetzler K, Cohen B, Leung S et al (2020) Supplemental intraoperative oxygen does not promote acute kidney injury or cardiovascular complications after noncardiac surgery: subanalysis of an alternating intervention trial. Anesth Analg 130:933–940PubMedCrossRef Ruetzler K, Cohen B, Leung S et al (2020) Supplemental intraoperative oxygen does not promote acute kidney injury or cardiovascular complications after noncardiac surgery: subanalysis of an alternating intervention trial. Anesth Analg 130:933–940PubMedCrossRef
48.
Zurück zum Zitat Schmidt H, Kjaergaard J, Hassager C et al (2022) Oxygen targets in comatose survivors of cardiac arrest. N Engl J Med 387:1467–1476PubMedCrossRef Schmidt H, Kjaergaard J, Hassager C et al (2022) Oxygen targets in comatose survivors of cardiac arrest. N Engl J Med 387:1467–1476PubMedCrossRef
49.
Zurück zum Zitat Semler MW, Casey JD, Lloyd BD et al (2022) Oxygen-saturation targets for critically ill adults receiving mechanical ventilation. N Engl J Med 387:1759–1769PubMedPubMedCentralCrossRef Semler MW, Casey JD, Lloyd BD et al (2022) Oxygen-saturation targets for critically ill adults receiving mechanical ventilation. N Engl J Med 387:1759–1769PubMedPubMedCentralCrossRef
51.
Zurück zum Zitat Singer M, Young PJ, Laffey JG et al (2021) Dangers of hyperoxia. Crit Care 25:1–15CrossRef Singer M, Young PJ, Laffey JG et al (2021) Dangers of hyperoxia. Crit Care 25:1–15CrossRef
52.
Zurück zum Zitat Staehr-Rye A, Meyhoff C, Scheffenbichler F et al (2017) High intraoperative inspiratory oxygen fraction and risk of major respiratory complications. Br J Anaesth 119:140–149PubMedCrossRef Staehr-Rye A, Meyhoff C, Scheffenbichler F et al (2017) High intraoperative inspiratory oxygen fraction and risk of major respiratory complications. Br J Anaesth 119:140–149PubMedCrossRef
53.
Zurück zum Zitat Stub D, Smith K, Bernard S et al (2015) Air versus oxygen in ST-segment–elevation myocardial infarction. Circulation 131:2143–2150PubMedCrossRef Stub D, Smith K, Bernard S et al (2015) Air versus oxygen in ST-segment–elevation myocardial infarction. Circulation 131:2143–2150PubMedCrossRef
54.
Zurück zum Zitat Taniyama Y, Griendling KK (2003) Reactive oxygen species in the vasculature: molecular and cellular mechanisms. Hypertension 42:1075–1081PubMedCrossRef Taniyama Y, Griendling KK (2003) Reactive oxygen species in the vasculature: molecular and cellular mechanisms. Hypertension 42:1075–1081PubMedCrossRef
56.
Zurück zum Zitat Volk T, Peters J, Sessler D (2017) The WHO recommendation for 80 % perioperative oxygen is poorly justified. Springer, S 227–229 Volk T, Peters J, Sessler D (2017) The WHO recommendation for 80 % perioperative oxygen is poorly justified. Springer, S 227–229
59.
Zurück zum Zitat Young CC, Harris EM, Vacchiano C et al (2019) Lung-protective ventilation for the surgical patient: international expert panel-based consensus recommendations. Br J Anaesth 123:898–913PubMedCrossRef Young CC, Harris EM, Vacchiano C et al (2019) Lung-protective ventilation for the surgical patient: international expert panel-based consensus recommendations. Br J Anaesth 123:898–913PubMedCrossRef
Metadaten
Titel
Die perioperative Hyperoxie – mehr Schaden als Nutzen?
verfasst von
Dr. med. Johann Stuby
PD Dr. med. Alexander Kaserer
Dr. med. Sascha Ott
Prof. Dr. med. Kurt Ruetzler
Dr. med. Julian Rössler
Publikationsdatum
21.04.2023
Verlag
Springer Medizin
Erschienen in
Die Anaesthesiologie / Ausgabe 5/2023
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI
https://doi.org/10.1007/s00101-023-01274-4

Weitere Artikel der Ausgabe 5/2023

Die Anaesthesiologie 5/2023 Zur Ausgabe

Qualitätssicherung und Medizinökonomie

Kinder brauchen Nachhaltigkeit

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.