Predictors of desaturation during patient transport to the postoperative anesthesia care unit: an observational study

The transport of postoperative patients to the postoperative anesthesia care unit (PACU) is a high-risk period for hypoxemia. The aim of this study was to determine risk factors for hypoxemia during transfers to the PACU.

An observational, prospective, monocentric, and noninterventional study was conducted in the University Hospital of Toulouse in 2015 during a 5-week period. All patients who were transferred to PACU were included. Twenty-eight variables related to patient, surgery, and anesthesia were recorded. Hypoxemia during transfer was defined as Spo₂ <90%.

Five hundred five patients were included. The incidence of hypoxemia during transfer was 13%. After logistic regression analysis, 3 risk factors for desaturation were identified: sedation score >2, Spo₂ <96% before exiting the operating room (OR), and body mass index >30 kg/m². The 72% of patients were transferred without oxygen. Most of the hypoxemia appears in these patients.

The development of hypoxemia during transfer from the OR to the PACU was greater in patients who were obese, were more sedated, or had lower oxygen saturations upon leaving the OR. The rates of hypoxemia were greater among patients in whom supplemental oxygen was not administered. Supplemental oxygen should be considered in higher risk patients.