Early hypoxemia detection with minimal FiO₂: Putting routine hyperoxygenation in anesthesia practice to the test

2026-05-25

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Anna Shalman Merkin *

Michael Shalman

DOI：10.1016/j.jclinane.2026.112241

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• Low FiO₂ exposes early gas-exchange impairment hidden under routine hyperoxia. • Iso-shunt principles demonstrate why desaturation appears sooner at FiO₂ ≤0.3. • Reframing physiology in saturation units clarifies the mechanism behind this effect. • Low FiO₂ increases pulse-oximetry sensitivity using a simple, widely available tool. • This approach supports safer, physiology-guided intraoperative oxygen titration.

Keywords:

Isoshunt

Ventilation-perfusion mismatch

Pulmonary gas exchange

Endobronchial intubation

Hyperoxia

Oximetry

Early hypoxemia detection with minimal FiO₂: Putting routine hyperoxygenation in anesthesia practice to the test

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