Abstract:
BACKGROUND:In 2016, the World Health Organization (WHO) strongly recommended the use of a high fraction of inspired oxygen (FiO2) in adult patients undergoing general anaesthesia to reduce the risk of surgical site infection (SSI). Since then, further trials have been published, trials included previously have come under scrutiny, and one article was retracted. We updated the systematic review on which the recommendation was based. METHODS:We performed a systematic literature search from January 1990 to April 2018 for RCTs comparing the effect of high (80%) vs standard (30-35%) FiO2 on the incidence of SSI. Studies retracted or under investigation were excluded. A random effects model was used for meta-analyses; the sources of heterogeneity were explored using meta-regression. RESULTS:Of 21 RCTs included, six were newly identified since the publication of the WHO guideline review; 17 could be included in the final analyses. Overall, no evidence for a reduction of SSI after the use of high FiO2 was found [relative risk (RR): 0.89; 95% confidence interval (CI): 0.73-1.07]. There was evidence that high FiO2 was beneficial in intubated patients [RR: 0.80 (95% CI: 0.64-0.99)], but not in non-intubated patients [RR: 1.20 (95% CI: 0.91-1.58); test of interaction; P=0.048]. CONCLUSIONS:The WHO updated analyses did not show definite beneficial effect of the use of high perioperative FiO2, overall, but there was evidence of effect of reducing the SSI risk in surgical patients under general anaesthesia with tracheal intubation. However, the evidence for this beneficial effect has become weaker and the strength of the recommendation needs to be reconsidered.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
de Jonge S,Egger M,Latif A,Loke YK,Berenholtz S,Boermeester M,Allegranzi B,Solomkin Jdoi
10.1016/j.bja.2018.11.024subject
Has Abstractpub_date
2019-03-01 00:00:00pages
325-334issue
3eissn
0007-0912issn
1471-6771pii
S0007-0912(18)31346-1journal_volume
122pub_type
meta分析abstract::Cytokine synthesis and release is an essential component of the innate immune system, but inappropriate, excessive production results in a generalized systemic inflammatory response which damages distant organs. Recent research has identified an immunomodulatory function of the vagus nerve whereby activation of the ef...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aep037
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Anaesthetic drugs act at sites within the brain that undergo profound changes during typical ageing. We postulated that anaesthesia-induced brain dynamics observed in the EEG change with age. METHODS:We analysed the EEG in 155 patients aged 18-90 yr who received propofol (n=60) or sevoflurane (n=95) as the ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aev213
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:There have been few studies comparing the response to asphyxia and the effectiveness of typical cardiopulmonary resuscitation (CPR) using exogenous epinephrine administration and manual closed-chest compression between total intravenous anaesthesia (TIVA) and inhalational anaesthesia. METHODS:Twenty pigs we...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeg259
更新日期:2003-12-01 00:00:00
abstract::We have compared bispectral index (BIS), 95% spectral edge frequency (SEF) and approximate entropy (ApEn) in 37 patients during induction and recovery from a short general anaesthetic. Heart rate variability (HRV) was also compared during induction only. These indices were noted at the start of induction, when a syrin...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/82.5.666
更新日期:1999-05-01 00:00:00
abstract::Arterial PO2 (PaO2) has been related to inspired oxygen concentration (FIO2 range 0.21-0.60) in 20 patients, breathing spontaneously, while recovering from a range of conditions treated in an intensive therapy unit. There was a highly significant linear trend (P < 0.001) for the mean venous admixture ("virtual shunt")...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/72.5.515
更新日期:1994-05-01 00:00:00
abstract::Carbon dioxide laser surgery in the airway presents the anaesthetist with new problems. The mode of action of carbon dioxide lasers and its effects on anaesthetic agents and equipment are described. Complications, especially of fire hazards in the airway, and methods of avoiding them are set out in detail. Various ana...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/59.12.1610
更新日期:1987-12-01 00:00:00
abstract::Blood concentrations of nitrous oxide were measured in anaesthetists, surgeons and theatre nurses. Comparison of anaesthetists and surgeons working in the same theatre showed that in ENT surgeons concentrations were greater (P < 0.01), while in general surgeons they were smaller (P < 0.003). Blood concentrations of ni...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.11.1143
更新日期:1980-11-01 00:00:00
abstract::Patients with Munchausen's syndrome often undergo multiple surgical operations under general anaesthesia. They tend to have multiple exposures to routinely used anaesthetic agents. A patient with Munchausen's syndrome who developed an anaphylactoid reaction to thiopentone is described and the importance of obtaining p...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.11.1472
更新日期:1987-11-01 00:00:00
abstract::Maternal and umbilical venous serum naloxone concentrations were measured after the i.v. (30 mothers) or i.m. (seven mothers) injection of naloxone 400 micrograms. Following i.v. naloxone there was rapid transfer to the fetus and therapeutic plasma concentrations could be expected in 1 or 2 min. However, following i.m...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.1.45
更新日期:1986-01-01 00:00:00
abstract::We tested the hypothesis that the solvent for etomidate was a factor in the incidence of pain and other side effects after injection, and that these were associated with histamine release. Nine of 10 volunteers who received etomidate in a propylene glycol formulation reported moderate to severe pain on injection; only...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/83.3.464
更新日期:1999-09-01 00:00:00
abstract::Thirty patients for elective lower segment Caesarean section were randomly divided into two groups. One group received 50 mulitre/kg of Althesin for induction of anaesthesia and the other, 100 mulitre/kg. The two maternal groups were similar. There was no significant difference in the clinical or biochemical status of...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/47.11.1213
更新日期:1975-11-01 00:00:00
abstract::NHS Blood and Transplant (NHSBT) was established in 2005 as a Special Health Authority when the National Blood Authority and UK Transplant merged. This helped to bring tissue banking and organ transplantation services under one umbrella organization. This merger means that ~!95% of all deceased donors (whether tissue,...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aer398
更新日期:2012-01-01 00:00:00
abstract::We have compared the effects of sevoflurane and halothane on the discharge frequencies of 19 slowly adapting and four rapidly adapting lung receptors in the rabbit by recording from single vagal fibres. Both agents reduced the discharge frequency of slowly adapting receptors during expiration (P < 0.0005), halothane h...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/80.2.257
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:The objective of the present study was to investigate the effects of increasing doses of norepinephrine (NE) with or without arginine-vasopressin (AVP) on intestinal oxygen supply and jejunal mucosal tissue oxygen tension in an acute endotoxic pig model. METHODS:In this prospective, randomized, experimental...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aep239
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Obstructive sleep apnoea (OSA) affects ~9-24% of the general population, and 90% remain undiagnosed. Those patients with undiagnosed moderate-to-severe OSA may be associated with an increased risk of perioperative complications. Our objective was to evaluate the proportion of surgical patients with undiagnos...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes465
更新日期:2013-04-01 00:00:00
abstract::Studies with an emulsion formulation of ICI 35 868 (2,6- diisopropylphenol ) indicate that this new formulation has anaesthetic properties in rats and mice, and haemodynamic effects in the mini-pig which are similar to those of the previously available Cremophor formulation. Administration of the emulsion formulation ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.6.617
更新日期:1984-06-01 00:00:00
abstract::We have studied the effect of clonidine, dexmedetomidine and morphine on gastric emptying and gastrointestinal transit in the rat. In one group, each agonist was injected i.p. in 6-12 male Wistar rats. In another group of rats, yohimbine, naloxone or saline was injected with an agonist. At 30 min, radiolabelled saline...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/78.3.301
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:The usefulness of the PFA-100 in assessing the risk of bleeding in non-cardiac surgery is not clear. This study aims to examine this by correlating preoperative PFA-100 measurement with perioperative bleeding in patients receiving cyclooxygenase (COX) inhibitors. METHODS:PFA-100 with adenosine-5'-diphosphat...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aep091
更新日期:2009-06-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.12.1257
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/50.8.815
更新日期:1978-08-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/86.4.545
更新日期:2001-04-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aev104
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Patient dissatisfaction has been previously associated with motor block in shoulder surgery patients receiving brachial plexus block. For elective minor wrist and hand surgery, we tested whether a regional block accelerating the early return of upper extremity motor function would improve patient satisfactio...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
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更新日期:2012-11-01 00:00:00
abstract::We have studied post-tetanic count (PTC) and single twitch height at the onset of reflex movement to carinal stimulation after administration of vecuronium with five different types of anaesthesia. Seventy-five adult patients were allocated randomly to five groups of 15 patients each, to receive one of the following a...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验,收录出版
doi:10.1093/bja/72.6.688
更新日期:1994-06-01 00:00:00
abstract::Five hundred and seventeen women in labour receiving extradural analgesia, using bupivacaine plain solution, were randomly allocated to one of three groups. Group A received 6-8ml of 0.5% solution, group B 10-14ml of 0.25% solution, and group C 6-8 ml of 0.25% solution. Spontaneous delivery occurred in 31.7% of patien...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/53.9.933
更新日期:1981-09-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/85.2.287
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Anaesthesia and surgery are associated with impairment of the immune system expressed as an excessive proinflammatory immune response and suppression of cell-mediated immunity that may affect the course of the postoperative period. Addition of anaesthetic agents capable of attenuating the alterations in peri...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aem218
更新日期:2007-10-01 00:00:00
abstract::I.V. fluid therapy plays a fundamental role in the management of hospitalized patients. While the correct use of i.v. fluids can be lifesaving, recent literature demonstrates that fluid therapy is not without risks. Indeed, the use of certain types and volumes of fluid can increase the risk of harm, and even death, in...
journal_title:British journal of anaesthesia
pub_type: 共识发展会议,杂志文章,评审
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更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:The therapeutic potential of cardiac μ-opioid receptors in ischaemia-reperfusion (I/R) injury during opioid-modulating diseases, such as heart failure, is unknown. We aimed to explore the changes of cardiac μ-opioid receptor expression during heart failure, and its role in opioid-induced cardioprotection. M...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2017.11.110
更新日期:2018-07-01 00:00:00
abstract::Spontaneous movements are sometimes observed of the arm into which rocuronium is administered. In order to assess a possible relationship between these movements and pain, we injected in 10 awake, ASA I patients, in a double-blind manner, both rocuronium 1 ml (10 mg) and 0.9% NaCI 1 ml (placebo), with a 30-s interval ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/79.3.382
更新日期:1997-09-01 00:00:00