Episodic Postoperative Oxygen Desaturation: The Value of Added Oxygen

Jones, J. G.; Jordan, Christopher; ScuddeR, ChaelES L.; Rocke, D. A.; Barrowcliffe, M. P.

doi:10.1177/014107688507801208

Cited by 38 publications

(19 citation statements)

References 8 publications

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“…Administration of oxygen reduces the number of episodes of marked desaturation, associated with apnoeic episodes and partial airway obstruction, to zero [10]. None of our patients had episodes of severe hypoxaemia during oxygen therapy.…”

Section: Resultsmentioning

confidence: 64%

Hypoxaemia after osteosynthesis of hip fractures

Krasheninnikoff

Ellitsgaard

Rude

et al. 1993

International Orthopaedics

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Hypoxaemia may cause postoperative confusion after operations for hip fractures in elderly patients'. Twenty-two consecutive patients, with a median age of 73 years, had fractures fixed with a sliding hip screw within 48 hours of admission. The incidence of hypoxaemia was investigated postoperatively using a pulse oximeter. We have demonstrated that this complication occurs frequently on the first day and severe hypoxaemia can be prevented by supplementary oxygen therapy. Our results support the hypothesis that postoperative confusion can be caused by hypoxaemia. R~sumC L'hypoxdmie peut entrafner une confusion postop6ratoire, situation souvent rencontr6e chez les patients ~g~s victimes d'une fracture de la hanche. Dans cette dtude nous analysons la fr6quence et la sdvdrit6 de l'hypox6mie consdcutive au traitement chirurgical de ces fractures. Vingt-deux patients, d" un g~ge moyen de 73 ans, ont dtd operas pour fracture de la hanche, dans les 48 heures suivant leur admission, par vis ~ compression (systkme AO). Ils ont ensuite dtd surveillds pendant la p6riode postop6ratoire it l'aide d'un oxymOtre. Tousles sujets prdsentaient une saturation pr~-opdratoire en oxygone d' au moins 90% et un bilan cardio-pulmonaire normal. Les observations effectu6es se poursuivirent pendant 24 heures dans notre service, apr~s la p6-riode passde en rdanimation. Sur les 22 patients examines, 21 pr~sentOrent une hypoxdmie aprOs 632 minutes (en moyenne), soit 43% du temps d'observation, avec une saturation en oxygOne entre 80 et 90%. Sur ces 21 patients, six avaient une saturation Reprint requests to: M. Krasheninni,koff, en oxygOne au dessous de 80% aprOs 6 minutes (en moyenne). Cette ddsaturation survenait essentiellement la nuit. Neuf patients pr6sentbrent une confusion post-op6ratoire et trois d'entre eux une ddsaturation concommitante s6vOre. Six patients atteints de confusion refurent un apport suppl6mentaire d' oxygone, qui entra~na un retour it la normale chez quatre d' entre eux. Nous en concluons que l'hypox6mie est frdquente au cours du premier jour suivant l'intervention chirurgicale, et qu'un apport suppldmentaire d'oxygbne peut prdvenir une hypoxdmie sdvOre. Nos rdsultats confirment l'hypothkse selon laquelle la confusion post-opdratoire pourrait ~tre due it une hypoxdmie.

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Section: Resultsmentioning

confidence: 64%

Hypoxaemia after osteosynthesis of hip fractures

Krasheninnikoff

Ellitsgaard

Rude

et al. 1993

International Orthopaedics

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“…Treatment of episodic hypoxaemia in the late postoperative period has not been fully evaluated. Although episodic oxygen desaturation to less than 80 % in the postanaesthetic recovery period may be eliminated by oxygen therapy (.Flo, = 28%) [21], episodic desaturation may still occur despite oxygen therapy for longer than the first day after operation [2].…”

Section: Discussionmentioning

confidence: 99%

Late Postoperative Episodic and Constant Hypoxaemia and Associated Ecg Abnormalities

Rosenberg

Rasmussen

Jessen

et al. 1990

British Journal of Anaesthesia

113

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Twenty-two patients without cardiopulmonary disease and undergoing elective major abdominal surgery were monitored continuously with a Holter tape recorder and a pulse oximeter on one night before operation and the first two nights after operation (23:00 to 07:00), without oxygen therapy. Mean heart rate increased 16 beat min-1 (P less than 0.001) and mean oxygen saturation (SaO2) decreased 2.6% (P less than 0.001) after operation. Episodic oxygen desaturation to less than 80% occurred in four patients before operation, but in 13 patients after operation (P less than 0.05). ECG abnormalities were observed in 10 patients before operation and in 16 patients after operation (ns). Individual maximum ST depression was more pronounced after than before operation (P less than 0.05). Episodic desaturation was related closely to tachycardia in six patients before operation and one patient after operation; before operation to atrioventricular block in one patient, and after operation to ST depression in two patients. Mean SaO2 on the second night after operation correlated with total dose of opioid for pain relief (rs = -0.48; P less than 0.05), and postoperative decrease in SaO2 correlated with postoperative increase in heart rate (rs = -0.43; P less than 0.05). No patient had postoperative cardiac complications indicating treatment.

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“…Previous studies of postoperative oxygen saturation have been conducted in patients who did not receive hypnotics the night before surgery or oxygen supplementation in the postoperative course. However, both therapies are used routinely in order to minimize preoperative anxiety and insomnia, and postoperative severe oxygen desaturation, respectively [10].…”

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confidence: 99%

Risk Factors for Oxygen Desaturation During Sleep, After Abdominal Surgery

Beydon¹,

Hassapopoulos²,

Quera³

et al. 1992

British Journal of Anaesthesia

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The postoperative period after major abdominal surgery is known to be a period of increased episodic oxygen desaturation. In order to assess the risk factors for episodic desaturation, we have studied 29 surgical patients using pulse oximetry during the preoperative night (Npre) when they received benzodiazepine premedication and breathed air, and also during the first three nights after operation when they received nasal oxygen supplementation. Modal oxygen saturation (SpO2) exceeded 95% during all nights studied. The time spent at less than 90% (t90) and 85% (t85) SpO2 and the average SpO2 nadir (SpO2, nadir) did not differ each night. Heart rate was greater (mean 90.1 (SD 16.6) vs 68.2 (12.0) beat min-1, P < 0.001) during the second night after operation (N2) than during Npre. Before operation, the number of desaturations, t90 and t85 correlated with pharyngeal hypertrophy (P = 0.003, P = 0.002, P = 0.001, respectively). At the same time, t90 and t85 correlated with body mass index (P = 0.02 and P = 0.05, respectively). During N2, t90 correlated with radiological lung consolidation (P = 0.05) and SpO2, nadir correlated with FEV1 (P = 0.03). We conclude that there are several mechanisms responsible for oxygen desaturation and that these mechanisms differ before and after surgery.

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Episodic Postoperative Oxygen Desaturation: The Value of Added Oxygen

Cited by 38 publications

References 8 publications

Hypoxaemia after osteosynthesis of hip fractures

Hypoxaemia after osteosynthesis of hip fractures

Late Postoperative Episodic and Constant Hypoxaemia and Associated Ecg Abnormalities

Risk Factors for Oxygen Desaturation During Sleep, After Abdominal Surgery

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