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Arterial desaturation in healthy children during transfer to the recovery room
J Pullerits1, F A Burrows, W L Roy
1Department of Anaesthesia, Hospital for Sick Children, Toronto, Ontario.
Insights
Many pediatric patients experience significant oxygen desaturation after general anesthesia. Cyanosis is an unreliable indicator, suggesting supplemental oxygen use during recovery is crucial.
Area of Science:
- Anesthesiology
- Pediatric Critical Care
- Respiratory Physiology
Background:
- Postoperative oxygen desaturation is a concern in pediatric patients.
- Clinical signs like cyanosis may not reliably indicate hypoxemia.
Purpose of the Study:
- To assess the incidence of arterial desaturation in healthy pediatric patients during transfer from the operating room to the recovery room.
- To evaluate the clinical recognition of desaturation by cyanosis.
Main Methods:
- Continuous pulse oximetry monitoring in 71 healthy pediatric patients (3.5 months to 16.7 years).
- Patients breathed room air during transfer.
- Correlation of desaturation with age, anesthetic type, narcotics, and respiration type was analyzed.
Main Results:
- 28.1% of patients exhibited significant arterial desaturation (SpO2 ≤ 90%).
- Cyanosis was clinically recognized in only 45% of desaturated patients.
- No significant relationship was found between desaturation and patient/anesthetic factors.
Conclusions:
- A significant proportion of pediatric patients desaturate post-anesthesia.
- Supplemental oxygen during transfer should be considered to mitigate risks.
- Relying on cyanosis for hypoxemia detection is insufficient.
Abstract:
The oxygen saturation in 71 healthy paediatric patients (3.5 months to 16.7 years) was measured by pulse oximetry during transfer from the operating room to the recovery room. These measurements were recorded continuously while the patients breathed room air. Of the patients studied, 28.1 per cent exhibited significant arterial desaturation of less than or equal to 90 per cent. The corresponding PO2 for this saturation level is less than or equal to 58 mmHg. In only 45 per cent of these desaturated patients was the desaturation recognized clinically by the presence of cyanosis. Age, type of anaesthetic, the use or avoidance of narcotics, and the use of controlled or spontaneous respiration had no significant relationship to the incidence of desaturation. Since more than a one quarter of all patients studied desaturated significantly, and since cyanosis can be difficult to detect clinically during the transfer period, the use of supplemental oxygen during transfer should be considered by the anaesthetist at the end of every paediatric general anaesthetic.