Early Postoperative Desaturation and Discharge Outcome

A large retrospective study reviewed oxygen desaturation < 90% in the 10mins after extubation in non-cardiac surgery. It was associated with higher odds of being discharged to a nursing facility, a higher risk of respiratory, renal and cardiovascular complications, as well as increased duration of hospital stay, postoperative intensive care unit admission frequency, and cost. Associated risk factors included high intraoperative FiO2, low FiO2 before extubation, high Neostigmine dose, and higher intraoperative long-acting opioid administration.

The authors note: There was substantial provider variability between anaesthetists in the incidence of postoperative desaturation unexplained by patient‐ and procedure‐related factors. This highlights the difficulty in interpreting retrospective studies, but should at least prompt reflecting on extubation readiness criteria as well as the role of oxygen saturation.

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