Incidence of hypoxemia in a post-anaesthesia care unit and relevant risk factors: a retrospective study of 14604 patients with general anaesthesia

Tang, Shuai; Zhang, Liangyan; Wang, Han; Xue, Yang; Tian, Yong‐Sheng; Xiu-hua, Zhang; Huang, Yuguang

doi:10.21203/rs.2.12878/v1

Cited by 2 publications

(3 citation statements)

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“…In the retrospective study by Tang et al (2019) on the incidence of hypoxemia in a PACU and relevant risk factors, the incidence of POH was estimated to be 21.83% (14). Based on H. Li's (2023) retrospective observational study, the incidence of hypoxemia in the PACU following general anesthesia in children was estimated to be 4.35% (32).…”

Section: Discussionmentioning

confidence: 99%

“…Even mild hypoxia might impair the central nervous system, and very severe hypoxia might result in an abrupt loss of consciousness. Anesthetists better identify hypoxemia and hypoxia-related episodes by monitoring SPO 2 , but overall hypoxemia incidence seems somewhat unchanged (14).…”

Section: Introductionmentioning

confidence: 99%

“…1.969-6.736). A retrospective study byTang et al (2019) on the incidence of hypoxemia in PACU and relevant risk factors stated that surgery type (thoracic surgeries) had a Prolonged anesthesia time (> 1 hour) is signi cantly associated with POH (p = 0.02) and AOR = 2.153(1.13-14.1). A cross-sectional study by Cifuentes et al (2018) on the incidence of early post-anesthesia hypoxemia and related factors in the PACU stated that there was a signi cant association between prolonged anesthesia time and POH (p = 0.001)(31).…”

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Incidence and Predictors of Post-operative Hypoxemia in Pediatric Patients Undergoing General Anesthesia: a Single-arm Prospective Multi-center Cohort Study 2023

Mengistu,

Mulugeta,

Destaw

et al. 2024

Preprint

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Background: Pediatrics use more oxygen than adults do, which has an impact on how quickly the body desaturates after an apnea. Depending on age and other physiological parameters, the clinically relevant hypoxemia in pediatric patients can drop to 40% in as little as 1.5 minutes, which makes the transfer to the Post-Anesthesia Care Unit (PACU) a risky phase. Postoperative hypoxemia (POH) happens critically postoperatively and various factors predict POH. The objective of the study is to determine the incidence and predictors of POH in pediatric patients undergoing general anesthesia (GA) at Hawassa University Comprehensive Specialized Hospital (HUCSH), Saint Peter Specialized Hospital, and Tikur Anbessa Specialized Hospital (TASH) Methodology: In 292 pediatric patients, a single-arm prospective multi-center cohort study using systematic random sampling was carried out. Data entry and analysis were performed using Statistical Package for Social Sciences (SPSS) version 25.00 software. For logistic regression, a Hosmer-Lemeshow goodness of fit test was used (variables with a p > 0.05 were considered fit). Binomial logistic regression and multivariable analysis were performed. Independent variables were examined for multicollinearity, and those exhibiting a variance inflation factor (VIF) > 10 were removed. Additionally, the association between the variables was determined using Pearson chi-square, and p < 0.05 indicated statistically significant variables. Results: The incidence of POH was 47.9%. Pediatric age (≤ 2 years), opioids, and above-abdominal surgeries are associated with POH (p = < 0.001) and AOR = 3.263 (1.686–6.314), 5.545 (2.983–10.307), and 3.642 (1.969–6.736), respectively. Additionally, the presence of at least one comorbidity, use of muscle relaxants, prolonged anesthesia, and surgery duration are associated with POH (p = 0.001, 0.003, 0.02, and 0.037) and AOR = 4.259 (1.788–10.145), 29.72 (3.262–270.778), 2.153 (1.131–4.1), and 2.560 (1.058–6.196), respectively. However, anesthesia type is insignificantly associated with POH (p = 0.096). Conclusion:The incidence of POH in pediatric patients undergoing GA is high, and the presence of at least one comorbidity, pediatric age (≤ 2 years), use of opioids and muscle relaxants, above-abdominal surgeries, prolonged anesthesia, and surgery durations are significantly associated with POH. We recommend taking precautions, following them and having oxygen therapy for these high-risk pediatric patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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Incidence and Predictors of Post-operative Hypoxemia in Pediatric Patients Undergoing General Anesthesia: a Single-arm Prospective Multi-center Cohort Study 2023

Mengistu,

Mulugeta,

Destaw

et al. 2024

Preprint

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Magnitude of early postoperative hypoxemia and its associated factors among adult patients who undergo emergency surgery under general anesthesia at Jimma Medical Center, Jimma, Southwest Ethiopia, 2021: a prospective observational study

et al. 2023

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Purpose Emergency surgical procedures involve considerable risks. Among these, early postoperative hypoxemia (EPH) is a frequent anesthetic complication in the post-anesthetic care unit (PACU). There is a great concern for EPH among health professionals, specifically, those providing emergency surgery during the nighttime. This raised anesthesia-ended time-related risk of EPH question. Thus, this study aimed to determine the magnitude of EPH and its associated factors among adult patients who undergo emergency surgery under general anesthesia. Methods A prospective observational study through a consecutive sampling technique was conducted. Binary logistic regression analysis was used to identify associated risk factors. All variables that were found statistically significant on bivariable analysis were entered into a multivariable logistic regression analysis. Result Of 352 patients who had undergone emergency surgery, 149 (42.3%) patients developed EPH. Factors significantly associated with EPH were anesthesia ended during nighttime (AOR = 1.76, 95%CI [1.01, 3.05], p = 0.045), ASA III (AOR = 12.35, 95%CI: [4.5, 34.02], p ≤ 0.001), age greater than 55 (AOR = 3.2, 95%CI: [1.7, 5.91], p ≤ 0.001), surgery duration greater than 2 h (AOR = 2.012, 95%CI: [1.2, 3.51], p = 0.014), hypotension (AOR = 10.3, 95%CI: [2.4, 44.16], p = 0.002), muscular strength score zero (AOR = 2.944, 95%CI: [1.8, 4.82], p ≤ 0.001), and preoperative oxygen saturation less than 95% (AOR = 2.371, 95%CI: [1.35,4.16], p = 0.003). Conclusion The magnitude of EPH among patients who have undergone emergency surgery was high and thus recommended that oxygen should be provided timely to decrease it. Identified risk factors were night-time ended anesthesia, ASA III, age greater than 55, surgery duration greater than 2 h, hypotension, muscular strength score zero, and preoperative oxygen saturation less than 95%. This study found anesthesia ended during early morning favors early morning early postoperative hypoxemia (EMEPH). To avert EMEPH, the anesthetist should avoid factors that favor the circadian rhythm of the lung-based early morning anesthesia augmented EPH.

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Incidence of hypoxemia in a post-anaesthesia care unit and relevant risk factors: a retrospective study of 14604 patients with general anaesthesia

Cited by 2 publications

References 8 publications

Incidence and Predictors of Post-operative Hypoxemia in Pediatric Patients Undergoing General Anesthesia: a Single-arm Prospective Multi-center Cohort Study 2023

Incidence and Predictors of Post-operative Hypoxemia in Pediatric Patients Undergoing General Anesthesia: a Single-arm Prospective Multi-center Cohort Study 2023

Magnitude of early postoperative hypoxemia and its associated factors among adult patients who undergo emergency surgery under general anesthesia at Jimma Medical Center, Jimma, Southwest Ethiopia, 2021: a prospective observational study

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