Oxygen administration is particularly relevant in patients undergoing surgery under general anesthesia and in those who suffer from acute or critical illness. Nevertheless, excess O2, or hyperoxia, is also known to be harmful. Toxicity arises from the enhanced formation of Reactive Oxygen Species (ROS) that, exceeding the antioxidant defense, may generate oxidative stress. Oxidative stress markers are used to quantify ROS toxicity in clinical and non-clinical settings and represent a promising tool to assess the optimal FiO2 in anesthesia and critical care setting. Despite controversial, the guidelines for the regulation of FiO2 in such settings suggest the adoption of high perioperative oxygen levels. However, hyperoxia has also been shown to be an independent mortality risk factor in critically ill patients. In this literature review, we discuss the biochemical mechanisms behind oxidative stress and the available biomarkers for assessing the pro-oxidant vs antioxidant status. Then, we summarize recent knowledge on the hyperoxia-related consequences in the most common anesthesia and critical care settings, such as traumatic brain injury or cardiac arrest. To this purpose, we searched the Pubmed database according to the following combination of key words: ("hyperoxia" OR "FiO2" OR "oxygen therapy") AND ("oxidative stress" OR "ROS" OR "RNS" OR "lipid peroxidation") AND ("anesthesia" OR "surgery" OR "intensive care"). We focused in the results from the past 20 years. Available evidence points toward a conservative monitoring and use of oxygen, unless there is solid proof of its efficacy.
Hyperoxia and oxidative stress in anesthesia and critical care medicine / S. Ottolenghi, G. Sabbatini, A. Brizzolari, M. Samaja, D. Chiumello. - In: MINERVA ANESTESIOLOGICA. - ISSN 1827-1596. - 86:1(2020 Jan), pp. 64-75.
|Titolo:||Hyperoxia and oxidative stress in anesthesia and critical care medicine|
OTTOLENGHI, SARA (Primo) (Corresponding)
SABBATINI, GIOVANNI (Secondo)
SAMAJA, MICHELE (Penultimo)
CHIUMELLO, DAVIDE ALBERTO (Ultimo)
|Parole Chiave:||Hyperoxia; Oxidative stress; Anesthesia; Critical care; Oxygen consumption;|
|Settore Scientifico Disciplinare:||Settore MED/41 - Anestesiologia|
Settore BIO/10 - Biochimica
|Data di pubblicazione:||gen-2020|
|Data ahead of print / Data di stampa:||28-ott-2019|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.23736/S0375-9393.19.13906-5|
|Appare nelle tipologie:||01 - Articolo su periodico|
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