Therapeutic effects of hyperoxic ventilation during shock

SUMMARY Decreased availability of oxygen to metabolizing cells is a major feature of circulatory shock that leads to tissue damage and multiple organ dysfunctions. A wish to alleviate tissue hypoxia underlies the common clinical use of hyperoxic ventilation in shock. Yet, this straightforward approach is met by skepticism that is based on the potential pro‐inflammatory effects of hyperoxia and the acknowledged roles of reactive oxygen species and oxidative stress in tissue injury. A steadily growing body of experimental data indicates that hyperoxia exerts an extensive profile of physiologic and pharmacologic effects that improve tissue oxygenation, exert anti‐inflammatory and antibacterial effects, augment tissue repair mechanisms, and may also decrease oxidative stress during shock. The currently available preclinical information on the benefits of early use of safe regimens of hyperoxic ventilation alone or in combination with other commonly employed modalities sets the stage for renewal of careful clinical evaluation of oxygen therapy in resuscitation of circulatory shock.