Effects of different inspired oxygen fractions on lipid peroxidation during general anaesthesia for elective Caesarean section
During general anaesthesia (GA) for Caesarean section (CS), fetal oxygenation is increased by administering an inspired oxygen fraction (Fio2) of 1.0. However, it is unclear whether such high Fio2 will increase oxygen free radical activity. We randomized 39 ASA I–II parturients undergoing elective C...
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| Veröffentlicht in: | British journal of anaesthesia : BJA 2010-09, Vol.105 (3), p.355-360 |
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| creator | Khaw, K.S. Ngan Kee, W.D. Chu, C.Y. Ng, F.F. Tam, W.H. Critchley, L.A.H. Rogers, M.S. Wang, C.C. |
| description | During general anaesthesia (GA) for Caesarean section (CS), fetal oxygenation is increased by administering an inspired oxygen fraction (Fio2) of 1.0. However, it is unclear whether such high Fio2 will increase oxygen free radical activity.
We randomized 39 ASA I–II parturients undergoing elective CS under GA to receive 30% (Gp 30), 50% (Gp 50), or 100% (Gp 100) oxygen with nitrous oxide and sevoflurane adjusted to provide equivalent minimum alveolar concentration. Baseline maternal arterial blood before preoxygenation and maternal arterial, umbilical arterial and venous blood at delivery were sampled for assays of the by-product of lipid peroxidation, isoprostane, and for measurement of blood gases and oxygen content.
Maternal and umbilical isoprostane concentrations were similar among the three groups at delivery, despite significantly increased maternal and fetal oxygenation in Gp 100. However, paired comparisons of maternal delivery vs baseline concentration of isoprostane showed an increase at delivery for all groups [Gp 30: mean 342 (sd 210) vs 154 (65) pg ml−1, P=0.016; Gp 50: 284 (129) vs 156 (79) pg ml−1, P=0.009; Gp 100: 332 (126) vs 158 (68) pg ml−1, P |
| doi_str_mv | 10.1093/bja/aeq154 |
| format | Article |
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We randomized 39 ASA I–II parturients undergoing elective CS under GA to receive 30% (Gp 30), 50% (Gp 50), or 100% (Gp 100) oxygen with nitrous oxide and sevoflurane adjusted to provide equivalent minimum alveolar concentration. Baseline maternal arterial blood before preoxygenation and maternal arterial, umbilical arterial and venous blood at delivery were sampled for assays of the by-product of lipid peroxidation, isoprostane, and for measurement of blood gases and oxygen content.
Maternal and umbilical isoprostane concentrations were similar among the three groups at delivery, despite significantly increased maternal and fetal oxygenation in Gp 100. However, paired comparisons of maternal delivery vs baseline concentration of isoprostane showed an increase at delivery for all groups [Gp 30: mean 342 (sd 210) vs 154 (65) pg ml−1, P=0.016; Gp 50: 284 (129) vs 156 (79) pg ml−1, P=0.009; Gp 100: 332 (126) vs 158 (68) pg ml−1, P<0.001]. The magnitude of increase was similar in all three groups and independent of the Fio2 or duration after induction.
GA for CS is associated with a marked increase in free radical activity in the mother and baby. The mechanism is unclear but it is independent of the inspired oxygen in the anaesthetic mixture. Therefore, when 100% oxygen is administered with sevoflurane for GA, fetal oxygenation can be increased, without inducing an increase in lipid peroxidation.</description><identifier>ISSN: 0007-0912</identifier><identifier>EISSN: 1471-6771</identifier><identifier>DOI: 10.1093/bja/aeq154</identifier><identifier>PMID: 20576633</identifier><identifier>CODEN: BJANAD</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>Adult ; anaesthesia ; anaesthesia obstetric ; anaesthesia, general ; Anesthesia ; Anesthesia, Inhalation - methods ; Anesthesia, Obstetrical - methods ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Apgar scores ; Biological and medical sciences ; Caesarean section ; Cesarean Section ; Female ; Fetal Blood - metabolism ; fetus ; Humans ; hyperoxia ; Infant, Newborn ; inspired concentration ; Intraoperative Care - methods ; Isoprostanes - blood ; Lipid Peroxidation ; lung ; lung, hyperoxia ; Maternal-Fetal Exchange ; Medical sciences ; oxygen ; Oxygen - blood ; Oxygen Inhalation Therapy - methods ; oxygen, inspired concentration ; oxygen, partial pressure, saturation ; oxygen, toxicity ; Partial Pressure ; Pregnancy ; Pregnancy Outcome ; saturation ; surgery ; toxicity ; Young Adult</subject><ispartof>British journal of anaesthesia : BJA, 2010-09, Vol.105 (3), p.355-360</ispartof><rights>2010 The Author(s)</rights><rights>The Author [2010]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org 2010</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c465t-5e33ab7a1258338378ec4cf1fd40cd94552c2ded05e45b38b6bdb281c3d3d9d03</citedby><cites>FETCH-LOGICAL-c465t-5e33ab7a1258338378ec4cf1fd40cd94552c2ded05e45b38b6bdb281c3d3d9d03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23217251$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20576633$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Khaw, K.S.</creatorcontrib><creatorcontrib>Ngan Kee, W.D.</creatorcontrib><creatorcontrib>Chu, C.Y.</creatorcontrib><creatorcontrib>Ng, F.F.</creatorcontrib><creatorcontrib>Tam, W.H.</creatorcontrib><creatorcontrib>Critchley, L.A.H.</creatorcontrib><creatorcontrib>Rogers, M.S.</creatorcontrib><creatorcontrib>Wang, C.C.</creatorcontrib><title>Effects of different inspired oxygen fractions on lipid peroxidation during general anaesthesia for elective Caesarean section</title><title>British journal of anaesthesia : BJA</title><addtitle>Br J Anaesth</addtitle><addtitle>Br J Anaesth</addtitle><description>During general anaesthesia (GA) for Caesarean section (CS), fetal oxygenation is increased by administering an inspired oxygen fraction (Fio2) of 1.0. However, it is unclear whether such high Fio2 will increase oxygen free radical activity.
We randomized 39 ASA I–II parturients undergoing elective CS under GA to receive 30% (Gp 30), 50% (Gp 50), or 100% (Gp 100) oxygen with nitrous oxide and sevoflurane adjusted to provide equivalent minimum alveolar concentration. Baseline maternal arterial blood before preoxygenation and maternal arterial, umbilical arterial and venous blood at delivery were sampled for assays of the by-product of lipid peroxidation, isoprostane, and for measurement of blood gases and oxygen content.
Maternal and umbilical isoprostane concentrations were similar among the three groups at delivery, despite significantly increased maternal and fetal oxygenation in Gp 100. However, paired comparisons of maternal delivery vs baseline concentration of isoprostane showed an increase at delivery for all groups [Gp 30: mean 342 (sd 210) vs 154 (65) pg ml−1, P=0.016; Gp 50: 284 (129) vs 156 (79) pg ml−1, P=0.009; Gp 100: 332 (126) vs 158 (68) pg ml−1, P<0.001]. The magnitude of increase was similar in all three groups and independent of the Fio2 or duration after induction.
GA for CS is associated with a marked increase in free radical activity in the mother and baby. The mechanism is unclear but it is independent of the inspired oxygen in the anaesthetic mixture. Therefore, when 100% oxygen is administered with sevoflurane for GA, fetal oxygenation can be increased, without inducing an increase in lipid peroxidation.</description><subject>Adult</subject><subject>anaesthesia</subject><subject>anaesthesia obstetric</subject><subject>anaesthesia, general</subject><subject>Anesthesia</subject><subject>Anesthesia, Inhalation - methods</subject><subject>Anesthesia, Obstetrical - methods</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Apgar scores</subject><subject>Biological and medical sciences</subject><subject>Caesarean section</subject><subject>Cesarean Section</subject><subject>Female</subject><subject>Fetal Blood - metabolism</subject><subject>fetus</subject><subject>Humans</subject><subject>hyperoxia</subject><subject>Infant, Newborn</subject><subject>inspired concentration</subject><subject>Intraoperative Care - methods</subject><subject>Isoprostanes - blood</subject><subject>Lipid Peroxidation</subject><subject>lung</subject><subject>lung, hyperoxia</subject><subject>Maternal-Fetal Exchange</subject><subject>Medical sciences</subject><subject>oxygen</subject><subject>Oxygen - blood</subject><subject>Oxygen Inhalation Therapy - methods</subject><subject>oxygen, inspired concentration</subject><subject>oxygen, partial pressure, saturation</subject><subject>oxygen, toxicity</subject><subject>Partial Pressure</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>saturation</subject><subject>surgery</subject><subject>toxicity</subject><subject>Young Adult</subject><issn>0007-0912</issn><issn>1471-6771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90UFrFTEQB_AgFvusXvwAkosIwrbJJtnsHu2jtoUHXhTES8gmk5q6L9kmu-X14mdv2n22F_GUYfgxE_6D0DtKjinp2El_rU803FDBX6AV5ZJWjZT0JVoRQmRFOlofotc5XxNCZd2JV-iwJkI2DWMr9OfMOTBTxtFh60udIEzYhzz6BBbH3d0VBOySNpOPobCABz96i0dIceetfmhjOycfrnChkPSAddCQp1-QvcYuJgxDWeFvAa9LXyfQAWd4HPgGHTg9ZHi7f4_Q9y9n39YX1ebr-eX686YyvBFTJYAx3UtNa9Ey1jLZguHGUWc5MbbjQtSmtmCJAC561vZNb_u6pYZZZjtL2BH6uMwdU7yZy-fU1mcDw6ADxDkryduuIayjRX5apEkx5wROjclvdbpTlKiHuFWJWy1xF_x-P3but2Cf6N98C_iwBzobPZQcg_H52bG6nETQZxfn8f8Lq8X5PMHuSer0WzWSSaEufvxUghK2EaeNWhfPFw8l3FsPSWXjIRiw5bxmUjb6f625B4IquVc</recordid><startdate>20100901</startdate><enddate>20100901</enddate><creator>Khaw, K.S.</creator><creator>Ngan Kee, W.D.</creator><creator>Chu, C.Y.</creator><creator>Ng, F.F.</creator><creator>Tam, W.H.</creator><creator>Critchley, L.A.H.</creator><creator>Rogers, M.S.</creator><creator>Wang, C.C.</creator><general>Elsevier Ltd</general><general>Oxford University Press</general><scope>6I.</scope><scope>AAFTH</scope><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100901</creationdate><title>Effects of different inspired oxygen fractions on lipid peroxidation during general anaesthesia for elective Caesarean section</title><author>Khaw, K.S. ; Ngan Kee, W.D. ; Chu, C.Y. ; Ng, F.F. ; Tam, W.H. ; Critchley, L.A.H. ; Rogers, M.S. ; Wang, C.C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-5e33ab7a1258338378ec4cf1fd40cd94552c2ded05e45b38b6bdb281c3d3d9d03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>anaesthesia</topic><topic>anaesthesia obstetric</topic><topic>anaesthesia, general</topic><topic>Anesthesia</topic><topic>Anesthesia, Inhalation - methods</topic><topic>Anesthesia, Obstetrical - methods</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Apgar scores</topic><topic>Biological and medical sciences</topic><topic>Caesarean section</topic><topic>Cesarean Section</topic><topic>Female</topic><topic>Fetal Blood - metabolism</topic><topic>fetus</topic><topic>Humans</topic><topic>hyperoxia</topic><topic>Infant, Newborn</topic><topic>inspired concentration</topic><topic>Intraoperative Care - methods</topic><topic>Isoprostanes - blood</topic><topic>Lipid Peroxidation</topic><topic>lung</topic><topic>lung, hyperoxia</topic><topic>Maternal-Fetal Exchange</topic><topic>Medical sciences</topic><topic>oxygen</topic><topic>Oxygen - blood</topic><topic>Oxygen Inhalation Therapy - methods</topic><topic>oxygen, inspired concentration</topic><topic>oxygen, partial pressure, saturation</topic><topic>oxygen, toxicity</topic><topic>Partial Pressure</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>saturation</topic><topic>surgery</topic><topic>toxicity</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Khaw, K.S.</creatorcontrib><creatorcontrib>Ngan Kee, W.D.</creatorcontrib><creatorcontrib>Chu, C.Y.</creatorcontrib><creatorcontrib>Ng, F.F.</creatorcontrib><creatorcontrib>Tam, W.H.</creatorcontrib><creatorcontrib>Critchley, L.A.H.</creatorcontrib><creatorcontrib>Rogers, M.S.</creatorcontrib><creatorcontrib>Wang, C.C.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of anaesthesia : BJA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Khaw, K.S.</au><au>Ngan Kee, W.D.</au><au>Chu, C.Y.</au><au>Ng, F.F.</au><au>Tam, W.H.</au><au>Critchley, L.A.H.</au><au>Rogers, M.S.</au><au>Wang, C.C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of different inspired oxygen fractions on lipid peroxidation during general anaesthesia for elective Caesarean section</atitle><jtitle>British journal of anaesthesia : BJA</jtitle><stitle>Br J Anaesth</stitle><addtitle>Br J Anaesth</addtitle><date>2010-09-01</date><risdate>2010</risdate><volume>105</volume><issue>3</issue><spage>355</spage><epage>360</epage><pages>355-360</pages><issn>0007-0912</issn><eissn>1471-6771</eissn><coden>BJANAD</coden><abstract>During general anaesthesia (GA) for Caesarean section (CS), fetal oxygenation is increased by administering an inspired oxygen fraction (Fio2) of 1.0. However, it is unclear whether such high Fio2 will increase oxygen free radical activity.
We randomized 39 ASA I–II parturients undergoing elective CS under GA to receive 30% (Gp 30), 50% (Gp 50), or 100% (Gp 100) oxygen with nitrous oxide and sevoflurane adjusted to provide equivalent minimum alveolar concentration. Baseline maternal arterial blood before preoxygenation and maternal arterial, umbilical arterial and venous blood at delivery were sampled for assays of the by-product of lipid peroxidation, isoprostane, and for measurement of blood gases and oxygen content.
Maternal and umbilical isoprostane concentrations were similar among the three groups at delivery, despite significantly increased maternal and fetal oxygenation in Gp 100. However, paired comparisons of maternal delivery vs baseline concentration of isoprostane showed an increase at delivery for all groups [Gp 30: mean 342 (sd 210) vs 154 (65) pg ml−1, P=0.016; Gp 50: 284 (129) vs 156 (79) pg ml−1, P=0.009; Gp 100: 332 (126) vs 158 (68) pg ml−1, P<0.001]. The magnitude of increase was similar in all three groups and independent of the Fio2 or duration after induction.
GA for CS is associated with a marked increase in free radical activity in the mother and baby. The mechanism is unclear but it is independent of the inspired oxygen in the anaesthetic mixture. Therefore, when 100% oxygen is administered with sevoflurane for GA, fetal oxygenation can be increased, without inducing an increase in lipid peroxidation.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>20576633</pmid><doi>10.1093/bja/aeq154</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult anaesthesia anaesthesia obstetric anaesthesia, general Anesthesia Anesthesia, Inhalation - methods Anesthesia, Obstetrical - methods Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Apgar scores Biological and medical sciences Caesarean section Cesarean Section Female Fetal Blood - metabolism fetus Humans hyperoxia Infant, Newborn inspired concentration Intraoperative Care - methods Isoprostanes - blood Lipid Peroxidation lung lung, hyperoxia Maternal-Fetal Exchange Medical sciences oxygen Oxygen - blood Oxygen Inhalation Therapy - methods oxygen, inspired concentration oxygen, partial pressure, saturation oxygen, toxicity Partial Pressure Pregnancy Pregnancy Outcome saturation surgery toxicity Young Adult |
| title | Effects of different inspired oxygen fractions on lipid peroxidation during general anaesthesia for elective Caesarean section |
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