Effect of Fractional Inspiratory Oxygen Concentration on Perioperative Liver Injury and Lung Imaging
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Research Article
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Effect of Fractional Inspiratory Oxygen Concentration on Perioperative Liver Injury and Lung Imaging

1. Erzincan Binali Yıldırım University Faculty of Medicine Department of Anesthesiology and Reanimation, Erzincan, Turkey
2. Erzincan Binali Yıldırım University Faculty of Medicine Department of Biostatistics and Health Informatics, Erzincan, Turkey
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Received Date: 07.09.2024
Accepted Date: 10.09.2024
Online Date: 13.09.2024
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Abstract

Objectives: To maintain gas exchange and avoid desaturation during anesthesia, oxygen supplementation is frequently used. Nonetheless, there is an ongoing discussion on the ideal fractional inspiratory oxygen concentrations (FiO2) concentration, with practices ranging from 30% in Europe to 100% in the US. While preventing hypoxia, high FiO2 levels can have unfavorable effects, including absorption atelectasis, which may affect liver function in the postoperative period. The purpose of this study was to investigate how perioperative liver injury is affected by varying FiO2.

Methods: A total of 159 patients aged 18-65 years who underwent procedures lasting more than an hour were included in the study. Three groups of patients - one for each intraoperative FiO2 concentration - were given 34%, 50%, and 70% of the total. Pre- and postoperative measures of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and international normalized ratio (INR) were used to evaluate liver function. In this prospective trial design, participants with a history of liver disease or other aggravating circumstances were not allowed to participate. Pre- and postoperative chest X-rays were compared.

Results: There were no statistically significant variations in the ALT and AST values of the groups according to the analysis. In contrast to the other groups, the group that received 70% FiO2 had much lower INR levels. This implies that increased FiO2 concentrations may have a protective effect against liver function, especially in individuals with impaired liver function. No significant pathological differences were detected between preoperative and postoperative chest X-ray findings.

Conclusion: According to the study findings, patients who require liver-protective medication or have poor liver function may benefit more from high FiO2 concentrations after surgery. Although there was no indication of liver damage caused by hyperoxia, more investigation using larger samples and longer follow-up is recommended to validate these results.