Hyperoxia following cardiac arrest

Ball, Jonathan; Ranzani, Otávio T.

doi:10.1007/s00134-015-3660-1

Cited by 11 publications

(8 citation statements)

References 17 publications

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“…Mechanically ventilated (MV) CA survivors admitted to the ICU are initially typically sedated, receive targeted therapeutic hypothermia or maintained in strict normothermic conditions and receive mandatory mechanical ventilation. [12][13][14][15] During MV, while hypoxaemia is carefully avoided, there are concerns over the harmful cerebral effects of hyperoxaemia. 9,12,[14][15][16] Given these competing risks, it is uncertain whether a conservative approach to oxygen therapy may be feasible and free of major adverse effects and whether it may reduce exposure to both hypoxaemia, and hyperoxaemia.…”

Section: Introductionmentioning

confidence: 99%

Conservative oxygen therapy in mechanically ventilated patients following cardiac arrest: A retrospective nested cohort study

et al. 2016

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Section: Introductionmentioning

confidence: 99%

Conservative oxygen therapy in mechanically ventilated patients following cardiac arrest: A retrospective nested cohort study

et al. 2016

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“…Hyperoxia never occurs during natural circumstances. Thus, while normal tissues and cells have extensive adaptive mechanisms to hypoxemia and hypoxia, they have limited protection from hyperoxia [24]. High concentration oxygen exposure results in increased ROS formation and oxidative stress, DNA damage, protein damage and lipid peroxidation [25].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Deleterious Effects of Short-term Hyperoxia on Cancer Progression—Is Brain-Derived Neurotrophic Factor an Important Mediator? An Experimental Study

Tiron

Ristescu

Postu

et al. 2020

Cancers

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Perioperative factors promoting cancer recurrence and metastasis are under scrutiny. While oxygen toxicity is documented in several acute circumstances, its implication in tumor evolution is poorly understood. We investigated hyperoxia long-term effects on cancer progression and some underlying mechanisms using both in vitro and in vivo models of triple negative breast cancer (TNBC). We hypothesized that high oxygen exposure, even of short duration, may have long-term effects on cancer growth. Considering that hyperoxic exposure results in reactive oxygen species (ROS) formation, increased oxidative stress and increased Brain-Derived Neurotrophic Factor (BDNF) expression, BDNF may mediate hyperoxia effects offering cancer cells a survival advantage by increased angiogenesis and epithelial mesenchymal transition (EMT). Human breast epithelial MCF10A, human MDA-MB-231 and murine 4T1 TNBC were investigated in 2D in vitro system. Cells were exposed to normoxia or hyperoxia (40%, 60%, 80% O 2 ) for 6 h. We evaluated ROS levels, cell viability and the expression of BDNF, HIF-1α, VEGF-R2, Vimentin and E-Cadherin by immunofluorescence. The in vivo model consisted of 4T1 inoculation in Balb/c mice and tumor resection 2 weeks after and 6 h exposure to normoxia or hyperoxia (40%, 80% O 2 ). We measured lung metastases and the same molecular markers, immediately and 4 weeks after surgery. The in vitro study showed that short-term hyperoxia exposure (80% O 2 ) of TNBC cells increases ROS, increases BDNF expression and that promotes EMT and angiogenesis. The in vivo data indicates that perioperative hyperoxia enhances metastatic disease and this effect could be BDNF mediated.Cancers 2020, 12, 688 2 of 18 but rather to local recurrence and metastasis. Cancer evolution after radical resection depends on many factors, mainly the stage of the disease, tumor biological features, initial therapy and immune function status [2]. During the perioperative period several events, such as surgical insult, systemic inflammation, anesthetic and analgesic drugs and blood transfusion, can favor cancer progression [3,4].Oxygen is the most common used drug in the perioperative period. General anesthesia invariably results in perioperative supplemental oxygen administration. Long-time considered as a definitely useful and harmless intervention, oxygen therapy is under scrutiny in recent years. The accumulation of data showing hyperoxia harmful effects during acute events (stroke, myocardial infarction, cardiac arrest) was followed by guidelines recommendation for oxygen use [5,6]. The optimal perioperative oxygen concentration is still poorly defined for specific circumstances. Clinical trials suggest that surgical oncological patients may have an increased risk of mortality and cancer progression when exposed to high oxygen concentration [7,8].The main mechanism of oxygen toxicity is mediated by free radical oxygen species (ROS). ROS production may be followed by increased expression of Brain-Derived Neurotrophic Factor (BDNF) [9][10][11]. BDNF ...

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“…However, recent evidence opposes this belief. [24][25][26] In a pooled analysis, the association of hyperoxia with a PaO 2 above 300 was statistically significant with a high mortality with an adjusted odds ratio of 1.42 (95% confidence interval [CI]: 1.04-1.92). 10 In a similar vein, patients are exposed to a similar risk of oxygen toxicity with reperfusion during cardiac surgery.…”

Section: Hyperoxia-evidence From Clinical Studiesmentioning

confidence: 99%

Too Much Oxygen: Hyperoxia and Oxygen Management in Mechanically Ventilated Patients

Pannu¹

2016

Semin Respir Crit Care Med

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Hyperoxia, or excess oxygen supplementation, prevails in the intensive care unit (ICU) without a beneficial effect and, in some instances, may cause harm. Recent interest and surge in clinical studies in mechanically ventilated critically ill patients has brought this to the attention of clinicians and researchers. Hyperoxia can cause alveolar injury, pulmonary edema, and subsequent systemic inflammatory response and is known to augment ventilator-associated lung injury. Liberal oxygenation practices are also associated with increased mortality in subsets of critically ill patients with post-cardiac arrest, stroke, and traumatic brain injury. Most clinicians agree that oxygen titration should be done and, with appropriate safeguards, lower oxygenation targets may be acceptable and possibly beneficial in many critically ill patients. However, this problem is often overlooked. The use of periodic reminders and decision support may facilitate implementation of more precise oxygen titration at the bedside of critically ill patients. For implementing practice change, studies involving education and guidance of all health care staff involved in oxygen management are critical.

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Hyperoxia following cardiac arrest

Cited by 11 publications

References 17 publications

Conservative oxygen therapy in mechanically ventilated patients following cardiac arrest: A retrospective nested cohort study

Conservative oxygen therapy in mechanically ventilated patients following cardiac arrest: A retrospective nested cohort study

Long-Term Deleterious Effects of Short-term Hyperoxia on Cancer Progression—Is Brain-Derived Neurotrophic Factor an Important Mediator? An Experimental Study

Too Much Oxygen: Hyperoxia and Oxygen Management in Mechanically Ventilated Patients

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