Difference between revisions of "Low vs. High FiO2"

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(Created page with "* High FiO2 is pro-inflammatory (pro-cancer?), generates ROS, drives resorption atelectasis, worsens HPV, may not prevent SSI. * High FiO2 undeniably buys apnea time * Extubat...")
 
 
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* Extubation practices vary, but one common practice is to remove PEEP, and turn FiO2 to 100%.
 
* Extubation practices vary, but one common practice is to remove PEEP, and turn FiO2 to 100%.
 
* This practice is associated with worsened post-extubation atelectasis and end-expiratory lung volumes (EELV) according to a 2026 BJA paper from a team at BIDMC who used EIT to measure atelectasis and lung volumes. Conversely, using an FiO2 of 40% or 70% was shown to decrease atelectasis and increase EELV.
 
* This practice is associated with worsened post-extubation atelectasis and end-expiratory lung volumes (EELV) according to a 2026 BJA paper from a team at BIDMC who used EIT to measure atelectasis and lung volumes. Conversely, using an FiO2 of 40% or 70% was shown to decrease atelectasis and increase EELV.
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https://journals.lww.com/anesthesia-analgesia/fulltext/10.1213/ane.0000000000004374~when-less-is-more-why-extubation-with-less-than-routine-100
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https://journals.lww.com/anesthesiology/fulltext/10.1097/aln.0000000000004654~extubation-with-reduced-inspiratory-oxygen-concentration-or

Latest revision as of 20:55, 29 September 2026

  • High FiO2 is pro-inflammatory (pro-cancer?), generates ROS, drives resorption atelectasis, worsens HPV, may not prevent SSI.
  • High FiO2 undeniably buys apnea time
  • Extubation practices vary, but one common practice is to remove PEEP, and turn FiO2 to 100%.
  • This practice is associated with worsened post-extubation atelectasis and end-expiratory lung volumes (EELV) according to a 2026 BJA paper from a team at BIDMC who used EIT to measure atelectasis and lung volumes. Conversely, using an FiO2 of 40% or 70% was shown to decrease atelectasis and increase EELV.

https://journals.lww.com/anesthesia-analgesia/fulltext/10.1213/ane.0000000000004374~when-less-is-more-why-extubation-with-less-than-routine-100

https://journals.lww.com/anesthesiology/fulltext/10.1097/aln.0000000000004654~extubation-with-reduced-inspiratory-oxygen-concentration-or