The occurence rate of disease of low oxygen blood after oxygen is being filled beforehand when anaes_News

Incidence And Risk Factors Of Hypoxaemia After Preoxygenation At Induction Of Anaesthesia

Setting and purpose

The occurence rate that manages disease of relevant low oxygen blood with spirit way remains a problem that deserves attention. Our purpose is to be in certainly the in anaesthetic and revulsive process critical factor of disease of low oxygen blood after standardization fills oxygen beforehand.

Method

This research is a many center, before look up sex, observation experiments, evaluated the occurence rate of disease of low oxygen blood when grown patient anaesthesia is revulsive, main index terminus is the occurence rate of disease of blood of low blood oxygen, definition of disease of low oxygen blood is degree of saturation of arterial blood oxygen (SpO2) <95% .

Result

In considering to bring into 2398 patients in all originally, 158 (6.6% ) exemple patient appears disease of low oxygen blood. Decided the critical factor of the independence before 5 art: It is disease of lung of chronic block sex, hypertensive, difficult to anticipate face guard aerates and difficult and tracheal spile and emergency call operation. Still have 3 revulsive before independent critical factor: Fill oxygen difficulty beforehand, face guard aerates difficulty and tracheal spile difficulty. Before we discover art, critical factor aerates to face guard forecast a value difficultly to be 0.96 (0.95-0.96) , tracheal spile forecasts a value difficultly to be 0.95 (0.94-0.96) . Share 723 patients (30% ) fill oxygen difficulty beforehand (FeO2<90% ) , among them operation of pneumonia of sex of the male, chronic block, hypertensive, emergency call and predicted difficulty face guard aerates is a patient the critical factor that produces oxygen to add up to difficulty to become independent.

Conclusion

Difficult face guard aerates and difficult and tracheal spile is the critical factor of disease of blood of low blood oxygen when general anesthesia is revulsive, the patient of 30% appears to fill the case of oxygen beforehand hard, decide the critical factor that happens for disease of blood of low blood oxygen.

Original document summary

C. Baillard, m. Boubaya, e. Statescu;Incidence And Risk Factors Of Hypoxaemia After Preoxygenation At Induction Of Anaesthesia;British Journal Of Anaesthesia, xxx (xxx) : Xxx (xxxx);doi: 10.1016/j.bja.2018.11.022

Background:THe Incidence Of Hypoxaemia Related To Airway Management Is Still A Matter Of Concern. Our Aim Was To Determine The Factors That Contribute To Hypoxaemia During Induction Of Anaesthesia After A Standardised Preoxygenation Procedure.

Methods:THe Study Was A Multicentre And Prospective Observational Trial. It Evaluated The Incidence Of Hypoxaemia At Induction Of Anaesthesia In Adult Patients. The Primary Endpoint Was The Incidence Of Hypoxaemia Defined As Pulse Oximetry Of Arterial Oxyhaemoglobin Saturation (SpO2) <95% .

Results:OF 2398 Patients, hypoxaemia Was Observed In 158 (6.6%) . We Identified Five Preoperative Independent Risk Factors: Chronic Obstructive Pulmonary Disease, hypertension, anticipated Difficult Mask Ventilation And Difficult Tracheal Intubation, and Emergency Surgery. There Were Also Three Pre-induction Independent Risk Factors: Difficult Preoxygenation, difficult Mask Ventilation, and Difficult Tracheal Intubation. We Found A High Negative Predictive Value Of Preoperative Risk Factors For Difficult Mask Ventilation Of 0.96 (0.95-0.96) , and For Difficult Tracheal Intubation (0.95[0.94-0.96]) . A Total Of 723 Patients (30%) Experienced Difficult Preoxygenation (FeO2<90% At The End Of Preoxygenation) . Male Sex, chronic Obstructive Pulmonary Disease, hypertension, emergency Surgery, and Predictable Difficult Mask Ventilation Were Independent Patient Risk Factors For Difficult Preoxygenation.

Conclusions: Difficult Mask Ventilation And Difficult Tracheal Intubation Are Risk Factors For Hypoxaemia At Induction Of General Anaesthesia. Difficult Preoxygenation Was Observed In 30% Of Patients And Was Also Identified As A Risk Factor For Hypoxaemia. This Suggests That Techniques Improving Preoxygenation Should Be Implemented In Daily Practice.