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In Reply: Dr Hopf and colleagues note that our protocol permitted management variability. Our "real world" design allowed us to evaluate the effect of oxygen as it would be used in practice—if the benefit of hyperoxia depends upon an unrealistically tight set of cofactors, then its usefulness as a routine intervention is questionable. We acknowledged the potential biases involved. However, given that the issue faced by anesthesiologists and surgeons was whether hyperoxia should become standard practice, the practical question of our study is whether any inequalities between the groups were so large as to have concealed a significantly beneficial effect of hyperoxia. We strongly doubt this to be true. In comparing our results with those of Greif et al,¹ it is imperative to note critical differences in the patients studied. For example, 30% of their patients were transfused with an average of 3 units of blood, compared with 3% receiving . . . [Full Text of this Article]

Kane O. Pryor, MD
kopryor@yahoo.com
Department of Anesthesiology

Thomas J. Fahey III, MD
Department of Surgery

Cynthia A. Lien, MD; Peter A. Goldstein, MD
Department of Anesthesiology
Weill Medical College of Cornell University
New York, NY

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