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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

Oxygen delivery may therefore be paradoxically decreased by increasing the FIO₂. Thus, it is possible that patients experiencing hyperoxia intraoperatively may have less oxygen delivered to . . . [Full Text of this Article]

Johann Harten, MbChB, MD, FFARCSI; Keith Anderson, MbChB, FRCA; John Kinsella, MBBS, FRCA
Department of Anaesthesia
University of Glasgow
Glasgow, Scotland

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