Perioperative desaturation: Incidence, causes, management and outcome

Abstract

Objective: To determine the incidence, causes, management and outcome of desaturation occurring in the perioperative peroids (induction, maintence, emergence and recovery room) at Siriraj Hospital from June 2001-December 2001. Method: Perioperative incident reports were collected and analyzed. Patients were catergorized as having desaturation if the SpO2 was below 90 per cent for more than 3 minutes. The incidence, causes, management, and outcomes of these patients were examined in detail. Results: 62 out of 16,716 cases (0.37%) experienced desaturation. Elective patients (0.41%) experienced desaturation more frequently than emergency patients (0.14%). The causes were airway obstruction, hypoventilation, endotracheal tube problems, aspiration, atelectasis, and pulmonary edema. These patients were treated with higher FiO2, airway management, and ventilatory support which led to unplanned ICU admission. 4 patients developed cardiac arrest with successful resuscitation although 2 patients had cerebral infarction. Conclusion: Perioperative desaturation is an important sign of respiratory complications that should be recognized and treated immediately to prevent mortality and serious morbidity.