Predictors of hypoxemia after general anesthesia in the early postoperative period in a hospital in Ethiopia: An observational study

Background: Early postoperative hypoxemia is a common problem after general anesthesia. The identification of factors associated with an increased occurrence of it might help healthcare professionals to hypoxemia risk patients, therefore this study aims to assess the incidence and factors associated with early postoperative hypoxemia among surgical procedures.Methods: A prospective cohort study design was conducted from February 1, 2020 to June 30, 2020, on a total of 424 patients who underwent surgery under general anesthesia in Debre Tabor Comprehensive Specialized Hospital. The data was collected using a structured checklist. Bivariable and multivariable logistic regressions were used to check the association.Results: The incidence of early postoperative hypoxemia was 45.8%. Patients having a BMI of 25-29.9 kg/m2 and BMI of 30-39.9 kg/m2, patients having a chronic disease, current smokers, SPO2 reading before induction of less than 95%, emergency surgery, and the absence of oxygen therapy during the period of transfer and/or in the post anesthesia care unit were significantly associated with an increased risk of hypoxemia in the early postoperative period.Conclusions: The incidence of early postoperative hypoxemia was high in Debre Tabor Comprehensive Specialized Hospital. Obese patients, patients having a chronic disease, current smokers, and lower oxygen saturations before induction, emergency surgery, and the absence of oxygen therapy were the main predictors of an increased occurrence of early postoperative hypoxemia

Feasibility and Efficacy of Lung Ultrasound to Diagnose Postoperative Hypoxemia-A Prospective Study

Background Postoperative hypoxemia is associated with morbidity and mortality. We aim to evaluate the feasibility and efficacy of lung ultrasound (LUS) to diagnose pulmonary complications in patients suffering from hypoxemia after general anesthesia, and compare to thoracic computed tomography (CT).Methods Adult patients received general anesthesia and suffered from hypoxemia in the PACU, were analyzed. Hypoxemia was defined as a SPO2 less than 92% for greater than 30 seconds on room air. LUS was performed by a trained anesthesiologist once hypoxemia occurred. After LUS examination, each patient was transported to radiology department for thoracic CT scan within 1 hour before returning to the ward.Results From January 2019 to May 2019, 113 patients (61 men) undergoing abdominal surgery (45 patients, 39.8%), video-assisted thoracic surgery (31 patients, 27.4%), major orthopedics surgery (17 patients, 15.0%), neurosurgery (10 patients, 8.8%) and other surgery (10 patients, 8.8%) were included. CT diagnosed 327 of 1356 lung zones as atelectasis while LUS revealed atelectasis in 311 of the CT-confirmed zones. Pneumothorax was detected by CT scan in 75 quadrants, 72 of which were detected by LUS. Pleural effusion was diagnosed in 144 zones on CT scan and LUS detected 131 of these zones. LUS was reliable in diagnosing atelectasis (sensitivity 98.0%, specificity 96.7% and diagnostic accuracy 97.2%), pneumothorax (sensitivity 90.0%, specificity 98.9% and diagnostic accuracy 96.7%) and pleural effusion (sensitivity 92.9%, specificity 96.0% and diagnostic accuracy 95.1%).Conclusions Lung ultrasound is feasible, efficient and accurate in diagnosing different etiologies of postoperative hypoxia in the PACU.