Does preoperative night pulse oximetry provide a reliable baseline?

Area of Science:

• Anesthesiology
• Critical Care Medicine
• Geriatric Medicine

Background:

• Postoperative hypoxemia is a concern, often monitored using pulse oximetry for arterial hemoglobin saturation (SpO2).
• Nocturnal SpO2 values recorded preoperatively are typically used as patient baseline references.
• This study investigated discrepancies in nocturnal SpO2 between home and hospital settings before surgery.

Purpose of the Study:

• To evaluate potential differences in nocturnal SpO2 values between a patient's home environment and the hospital prior to surgery.
• To determine the reliability of hospital-based preoperative nocturnal SpO2 as a baseline for elderly patients.

Main Methods:

• Twenty patients aged 60 and above underwent continuous SpO2 monitoring for one night at home and one night post-hospitalization before surgery.
• SpO2 data were collected every 10 seconds with alarms disabled and values hidden from staff.
• Analysis included median SpO2 and counts of values above 90%, 86-90%, and below 86%.

Main Results:

• A total of 2186 (home) and 2330 (hospital) valid SpO2 values were recorded.
• The median SpO2 was 96% in both settings.
• No statistically significant differences were found in SpO2 values between home and hospital at any analyzed level, with less than 0.36% of values below 91%.

Conclusions:

• Preoperative nocturnal SpO2 measurements in a hospital setting appear to be reliable baseline indicators for elderly patients.
• This supports the use of hospital-acquired SpO2 data for postoperative monitoring and management.