Literature DB >> 20680710

The incidence of hypoxemia during surgery: evidence from two institutions.

Jesse M Ehrenfeld1, Luke M Funk, Johan Van Schalkwyk, Alan F Merry, Warren S Sandberg, Atul Gawande.   

Abstract

PURPOSE: The incidence of hypoxemia in patients undergoing surgery is largely unknown and may have a clinical impact. The objective of this study was to determine the incidence of intraoperative hypoxemia in a large surgical population.
METHODS: We performed a retrospective study of electronically recorded pulse oximetry data obtained from two large academic medical centres. All adults (age ≥ 16 yr) undergoing non-cardiac surgery during a three-year period at the two hospitals were included in the analysis. Our main outcome measure was the percentage of patients with episodes of hypoxemia (SpO(2) < 90) or severe hypoxemia (SpO(2) ≤ 85) for two minutes or longer during the intraoperative period (induction of anesthesia, surgery, and emergence).
RESULTS: We evaluated 95,407 electronic anesthesia records at the two hospitals. During the intraoperative period, 6.8% of patients had a hypoxemic event, and 3.5% of patients had a severely hypoxemic event of two consecutive minutes or longer. Seventy percent of the hypoxemic episodes occurred during either induction or emergence- time periods that represent 21% of the total intraoperative time. From induction to emergence, one episode of hypoxemia occurred every 28.9 hr, and one episode of severe hypoxemia occurred every 55.7 hr of intraoperative time.
CONCLUSION: Despite advances in monitoring technology, hypoxemia continues to occur commonly in the operating room and may be a serious safety concern because of its potential impact on end organ function and long-term outcomes. Further studies are needed to improve our understanding of the clinical impact of intraoperative hypoxemia and the strategies that will be most useful in minimizing its occurrence.

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Year:  2010        PMID: 20680710      PMCID: PMC2991088          DOI: 10.1007/s12630-010-9366-5

Source DB:  PubMed          Journal:  Can J Anaesth        ISSN: 0832-610X            Impact factor:   5.063


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