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In anaesthetized horses, pronounced ventilation/perfusion mismatching often occurs. Several authors have investigated the effect of lower inspired oxygen fractions (FiO 2 ) to reduce formation of absorption atelectasis. This systematic review compared the effects of low (&lt;0.6) and high (&gt;0.8) FiO 2 on the arterial oxygen tension (PaO 2 ), the alveolar-to-arterial oxygen tension difference (P(A-a)O 2 ), and the PaO 2 /FiO 2 ratio in horses during inhalation anaesthesia. Using the Systematic Review Protocol for Animal Intervention Studies, four experimental and one clinical investigations were deemed suitable for inclusion. A meta-analysis was performed on the four experimental studies. The PaO 2 was significantly lower ( p = 0.0007, mean difference -23.54 kPa, 95% CI -37.18, -9.90) with a lower FiO 2 . However, the P(A-a)O 2 was also significantly lower ( p &lt; 0.00001, mean difference -20.80 kPa, 95% CI -26.28, -15.32) when using a low FiO 2 . For the PaO 2 /FiO 2 ratio, only one study fitted the inclusion criteria, so no meta-analysis was performed. It is concluded that, while only a limited number of studies are available, the use of a higher FiO 2 in horses during inhalation anaesthesia will result in higher levels of PaO 2 , but also a larger P(A-a)O 2 difference. Further studies are needed to increase the level of evidence on this subject.

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Evaluation of the Effect of the Inspired Oxygen Fraction on Blood Oxygenation during Inhalant Anaesthesia in Horses: A Systematic Review with Meta-Analysis