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Can J Anaesth. 2010 Oct;57(10):888-97. doi: 10.1007/s12630-010-9366-5. Epub 2010 Jul 31.

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

Author information

1
Department of Anesthesia, Critical Care, & Pain Medicine, Massachusetts General Hospital, 55 Fruit St, Jackson 458, Boston, MA 02114, USA. jehrenfe@post.harvard.edu

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.

PMID:
20680710
PMCID:
PMC2991088
DOI:
10.1007/s12630-010-9366-5
[Indexed for MEDLINE]
Free PMC Article
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