Subcutaneous oxygen pressure in spontaneously breathing lean and obese volunteers: A pilot study
Subcutaneous oxygen pressure in spontaneously breathing lean and obese volunteers: A pilot study
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DOI：
10.1007/s11695-007-9313-x
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发表时间：
2008-01-01
期刊：
影响因子：
2.9
通讯作者：
Kurz, Andrea
中科院分区：
文献类型：
--
作者：
Hiltebrand, Luzius B.;Kaiser, Heiko A.;Kurz, Andrea
背景氧化杀伤是外科病原体的主要防御手段;感染风险与组织氧合呈负相关。全身麻醉期间，肥胖患者的皮下组织氧合显著低于瘦型患者。然而，肥胖患者术中组织氧合减少是否由肥胖本身或麻醉和手术联合引起仍不清楚。在一项初步研究中，我们测试了自发呼吸、未麻醉的肥胖志愿者组织氧合减少的假设。方法将7名体重指数（BMI）为22 +/-2kg/m2的瘦志愿者与7名BMI为46 4kg/m2的志愿者进行比较。志愿者经受以下氧气挑战：（1）室内空气;（2）通过鼻叉的2升/分钟氧气，（3）通过再呼吸面罩的6升/分钟氧气;（4）达到200 mmHg的动脉氧压（动脉PO 2）所需的氧气;和（5）达到300 mmHg的动脉PO 2所需的氧气。氧气挑战是随机的。动脉血气分析仪测定动脉血氧分压结果瘦志愿者和肥胖志愿者的皮下组织氧合作用相似：（1）室内空气中，52 ± 10 vs 58 ± 8 mmHg;（2）2 l/min，77 ± 25 vs 79 ± 24 mmHg;（3）6 l/min，125 ± 43 vs 121 ± 25 mmHg;（4）动脉PO2=200 mmHg，115 ± 42 vs 144 ± 23 mmHg;（5）动脉PO 2 =300 mmHg，145 +/- 41 vs 154 +/- 32 mmHg.结论在本初步研究中，我们不能确定瘦和病态肥胖志愿者之间三角肌皮下组织氧分压的显著差异。
Background Oxidative killing is the primary defense against surgical pathogens; risk of infection is inversely related to tissue oxygenation. Subcutaneous tissue oxygenation in obese patients is significantly less than in lean patients during general anesthesia. However, it remains unknown whether reduced intraoperative tissue oxygenation in obese patients results from obesity per se or from a combination of anesthesia and surgery. In a pilot study, we tested the hypothesis that tissue oxygenation is reduced in spontaneously breathing, unanesthetized obese volunteers. Methods Seven lean volunteers with a body mass index (BMI) of 22 +/- 2 kg/m(2) were compared to seven volunteers with a BMI of 46 4 kg/m(2). Volunteers were subjected to the following oxygen challenges: (1) room air; (2) 2 l/min oxygen via nasal prongs, (3) 6 l/min oxygen through a rebreathing face mask; (4) oxygen as needed to achieve an arterial oxygen pressure (arterial PO2) of 200 mmHg; and (5) oxygen as needed to achieve an arterial PO2 Of 300 mmHg. The oxygen challenges were randomized. Arterial PO2 was measured with a continuous intraarterial blood gas analyzer (Paratrend 7); deltoid subcutaneous tissue oxygenation was measured with a polarographic microoxygen sensor (Licox).Results Subcutaneous tissue oxygenation was similar in lean and obese volunteers: (1) room air, 52 +/- 10 vs 58 +/- 8 mmHg; (2) 2 l/min, 77 +/- 25 vs 79 +/- 24 mmHg; (3) 6 l/min, 125 +/- 43 vs 121 +/- 25 mmHg; (4) arterial PO2=200 mmHg, 115 +/- 42 vs 144 +/- 23 mmHg; (5) arterial PO2=300 mmHg, 145 +/- 41 vs 154 +/- 32 mmHg.Conclusion In this pilot study, we could not identify significant differences in deltoid subcutaneous tissue oxygen pressure between lean and morbidly obese volunteers.