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April 28, 2004

Supplemental Oxygen and Risk of Surgical Site Infection

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(16):1956. doi:10.1001/jama.291.16.1957-b

To the Editor: Dr Pryor and colleagues1 reported that hyperoxia increased the risk of surgical wound infection. In contrast, Greif et al2 reported that hyperoxia decreased the risk. One possible explanation for these discrepant results may relate to the rate of oxygen delivery to the wound itself. In healthy awake volunteers, as well as in anesthetized patients, cardiac output is reduced and systemic vascular resistance increased following the exposure to normobaric hyperoxia.3,4 Oxygen delivery is the product of cardiac index and arterial oxygen content. Increasing the fractional inspired oxygen (FIO2) from 30% to 80% causes a small (0.5%) increase in arterial oxygen saturation, and consequently higher arterial oxygen content; however this was more than counteracted by a decrease (6%) in cardiac index.3

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