me libree Components o f Hyperoxia The GoodClearly, increasing inspired oxygen concentration can have beneficial effects during the perioperative period, including improved oxygen delivery to tissues and decreased incidence of wound infections associated with specific surgical procedures.'The work by Dr. Kotani et al.2 published in this issue of ANESTHESIOLOGY shows that exposure to 100% oxygen during prolonged major procedures inhibits, but does not prevent, a decrease in antimicrobial function in alveolar macrophages (M0) after surgery.In this study, there did not appear to be long-term pulmonary problems resulting from this therapy in otherwise healthy patients.A greater increase in proinflammatory cytokines was observed in the group of patients administered 100% oxygen, compared with the group administered 30%.Increasing either tumor necrosis factor (TNF)-a or interferon (IFN)-y improves antimicrobial pulmonary host defense in a number of animal models challenged with pathogenic bacteria.TNF-a is needed for neutrophil influx after intratracheal gram-negative challenge.
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Knight et al. (2000) studied this question.