The Influence of Surgical Sites on Early Postoperative Hypoxemia in Adults Undergoing Elective Surgery

Xue, Fu Shan; Li, Bai W.; Zhang, Guo S.; Liao, Xu; Zhang, Yan M.; Liu, Jian H.; An, Gang; Luo, Lai K.

doi:10.1213/00000539-199901000-00040

Cited by 71 publications

(21 citation statements)

References 32 publications

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“…14,15 Overall, abdominal surgery can lead to postoperative pulmonary complications by al- tering diaphragmatic function and contractility, which causes reduced lung volumes and flows, which predisposes to lower-lobe atelectasis. [1][2][3][4]27 Among the surgical population, the role of HFNC in preventing deterioration in pulmonary function after surgery is poorly defined. In cardiac surgery, results of studies demonstrated that prophylactic HFNC postextubation did not lead to improvements in pulmonary function or postoperative oxygenation in subjects with a body mass index Ն 30 kg/m 2 .…”

Section: Discussionmentioning

confidence: 99%

High-Flow Nasal Cannula Versus Standard Oxygen Therapy After Extubation in Liver Transplantation: A Matched Controlled Study

et al. 2019

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BACKGROUND: High-flow nasal cannula (HFNC) is a key component of oxygen therapy and has largely been used in patients with acute respiratory failure. We conducted a matched controlled study with the aim to compare the preventive use of oxygen therapy delivered by HFNC versus via air-entrainment mask (standard O 2) after extubation in adult subjects with liver transplantation for reducing postextubation hypoxemia. METHODS: Twenty-nine subjects with liver transplantation who received HFNC after extubation (HFNC group) were matched 1:1 with 29 controls (standard O 2 group) chosen from an historical group of 90 subjects admitted to the ICU during the previous 36 months. The primary outcome of the study was the incidence of hypoxemia at 1 h and 24 h after extubation. Secondary outcomes were the rate of weaning failure, ICU length of stay, and 28-d mortality. RESULTS: The incidence of hypoxemia was not significantly different between the HFNC and standard O 2 groups at 1 h and 24 h after extubation. In the HFNC group, there was a trend toward a lower rate of weaning failure compared with the standard O 2 group. ICU length of stay and 28-d mortality were similar in both groups. CONCLUSIONS: Early application of HFNC in the subjects with liver transplantation did not reduce the incidence of hypoxemia after extubation compared with standard O 2 and did not modify the incidence of weaning failure, ICU length of stay, and 28-d mortality in this high-risk population of subjects. (ClinicalTrials.gov registration NCT03441854.

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Section: Discussionmentioning

confidence: 99%

High-Flow Nasal Cannula Versus Standard Oxygen Therapy After Extubation in Liver Transplantation: A Matched Controlled Study

et al. 2019

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“…In another study on patients undergoing general anesthesia, the severity of arterial desaturation and the incidence of hypoxemia in the early postoperative period were closely related to the surgical site location, such that these were greatest in cases of thoracoabdominal surgery, less for upper abdominal surgery and least for peripheral surgery. 3 Arozullah et al developed and validated a preoperative risk index for predicting postoperative respiratory failure. More than 180,000 patients were enrolled in two phases of the study and it was found that the highest risk of developing postoperative respiratory failure was related to the type of surgery.…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors for perioperative pulmonary events among patients undergoing upper abdominal surgery

et al. 2007

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“…At present, researchers are still debating the risk factors for hypoxemia. According to literature reports, potential risk factors include age, 6 obesity, 11 12 ASA classification, 10 12 OSAS, 13 14 operating time, 10 12 type of muscle relaxant, 15 16 and intraoperative position. 17 However, researchers reached different conclusions about these factors.…”

Section: Discussionmentioning

confidence: 99%

“…This study showed that thoracic surgery may be a probable risk factor which was consistent with literature reports. Xue 6 included 944 patients undergoing superficial plastic surgery, abdominal surgery, and thoracic surgery; the results showed that the incidence of postoperative hypoxemia was highest in patients undergoing thoracic surgery (52%; incidence of severe hypoxemia: 20%), followed by upper abdominal surgery (38%) and superficial surgery (approximately 7%; incidence of severe hypoxemia: 0.7%).The factors associated with hypoxemia may include direct compression of the lungs during operation, incomplete pulmonary re-expansion, postoperative painrelated weak chest wall and diaphragm movement, atelectasis, and increased pulmonary shunting. 18 The risk of hypoxemia varies a great deal with age.…”

Section: Previous Studies Have Reported the Relationship Between The mentioning

confidence: 99%

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

Tang

Zhang

Wang

et al. 2019

Preprint

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Background This article is aim to investigate the incidence and risk factors for postoperative hypoxemia in a post-anaesthesia care unit (PACU). Methods The retrospective cohort assessed 14604 postoperative patients who were admitted to PACU between January 2015 and December 2015. A pulse oximeter was used to monitor and record pulse oxygen saturation (SpO2) every 5 minutes.Clinical data were collected for all these patients, and the incidence of and risk factors for postoperative hypoxemia were analysed. Results The total incidence of hypoxemia was 21.83% (SpO2 ≤ 95%) and 2.79% (SpO2 ≤ 90%). Multiple regression analysis indicated that the risk factors were age ≥50-year old, body mass index (BMI) ≥25kg/m2, American Society of Anaesthesiologists (ASA) II and III, limb surgery, and thoracic surgery. Conclusions Therefore, hypoxemia was common in postoperative patients in the PACU. Age, BMI, ASA classification, and surgical site are associated with postoperative hypoxemia. More attention should be paid to these patients to prevent hypoxemia in the PACU.

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The Influence of Surgical Sites on Early Postoperative Hypoxemia in Adults Undergoing Elective Surgery

Cited by 71 publications

References 32 publications

High-Flow Nasal Cannula Versus Standard Oxygen Therapy After Extubation in Liver Transplantation: A Matched Controlled Study

High-Flow Nasal Cannula Versus Standard Oxygen Therapy After Extubation in Liver Transplantation: A Matched Controlled Study

Prognostic factors for perioperative pulmonary events among patients undergoing upper abdominal surgery

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

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