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To the Editor: Dr Belda and colleagues¹ found that patients receiving supplemental inspired oxygen at a fraction of inspired oxygen (FIO₂) of 80% had a reduced risk of surgical wound infection compared with those who received oxygen at FIO₂ of 30%. I have concerns regarding the method of oxygen administration that was used in these patients.

Oxygen delivery systems are generally classified as low-flow (or variable-performance) devices and high-flow (or fixed-performance) devices. Low-flow systems provide oxygen at flow rates lower than the patient's inspiratory demands; if the total minute ventilation exceeds the flow capacity of the oxygen reservoir, room air is entrained. The final FIO₂ that is delivered depends not only on the ventilatory demands of the patient but also on the size of the oxygen reservoir and the rate at which the reservoir is filled. In contrast, high-flow systems provide a constant FIO₂ by . . . [Full Text of this Article]

Ritesh Agarwal, MD, DM
riteshpgi@gmail.com
Department of Pulmonary Medicine
Postgraduate Institute of Medical Education and Research
Chandigarh, India

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The low-flow or high-flow oxygen delivery system and a low-flow or high-flow nonrebreather mask.
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