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Intra-operative gas exchange and post-operative hypoxaemia

P G Roe1, R Gadelrab, D Sapsford

  • 1University Department of Anaesthesia, Addenbrookes Hospital, Cambridge, UK.

European Journal of Anaesthesiology
|March 1, 1997
PubMed
Summary

Intra-operative gas exchange, measured by pulse oximetry (SpO2) and inspired oxygen partial pressure (PIO2), predicts post-operative oxygen levels. This can help identify patients at risk of hypoxemia after surgery.

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Area of Science:

  • Anesthesiology
  • Respiratory Physiology
  • Postoperative Care

Background:

  • Post-operative hypoxemia is a significant concern following upper abdominal surgery.
  • Assessing intra-operative gas exchange can potentially predict postoperative respiratory outcomes.

Purpose of the Study:

  • To investigate the relationship between intra-operative gas exchange and post-operative oxygen saturation (SpO2).
  • To determine if intra-operative measurements can identify patients at risk of post-operative hypoxemia.

Main Methods:

  • Pulse oximetry (SpO2) and inspired oxygen partial pressure (PIO2) were used during anesthesia for upper abdominal surgery.
  • The relationship between PIO2 and SpO2 was plotted to infer gas exchange, analyzing lateral and vertical displacements from a standard oxygen dissociation curve.

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  • Post-operative SpO2 was measured 30 hours after surgery in patients breathing air.

    • Main Results:

    • A correlation coefficient of 0.7 was found between lateral displacement and post-operative SpO2.
    • A correlation coefficient of 0.66 was observed between vertical displacement and post-operative SpO2.
    • Intra-operative SpO2 at a PIO2 of 21 kPa correlated with post-operative SpO2 with a coefficient of 0.69.

    Conclusions:

    • Gas exchange abnormalities during anesthesia, indicated by PIO2 vs. SpO2 curve displacement, correlate with SpO2 levels 30 hours post-operatively.
    • These findings suggest that intra-operative gas exchange assessment may aid in identifying patients susceptible to post-operative hypoxemia.