Best Evidence Summary of Nursing Management for Perioperative Patients with Hypoxemia

To identify, evaluate, and synthesize the best available evidence regarding the perioperative management of hypoxemia, providing a comprehensive clinical reference for healthcare professionals.

Following the "6S" evidence-based resource pyramid model, a systematic search was performed across international and domestic databases and professional society websites. The search encompassed clinical decision support tools, guidelines, evidence summaries, systematic reviews, expert consensuses, and randomized controlled trials (RCTs) published from database inception through November 2025. Two researchers independently performed quality assessment and evidence extraction for the included literature.

Twenty articles were included, comprising 2 clinical decisions, 1 guideline, 1 expert consensus, 10 systematic reviews, and 6 RCTs. A total of 38 pieces of evidence were synthesized across eight key dimensions: initial assessment and management, oxygenation monitoring and target-directed management, risk assessment for high-risk populations, intraoperative etiology and ventilation management, selection of non-invasive respiratory support, perioperative high-flow nasal cannula (HFNC) therapy, nursing management in the PACU, and comprehensive interventions (including positioning and pharmacotherapy).

This study summarizes the best evidence for the nursing management of perioperative hypoxemia, covering the entire process from risk assessment and intraoperative intervention to PACU care. These findings provide a standardized, evidence-based framework for healthcare professionals. When implementing these strategies, clinical context and individual patient characteristics should be considered to standardize hypoxemia management, reduce the risk of perioperative complications, and optimize patient outcomes.