Incidence and associated risk factors of intraoperative hypoxemia in pediatric patients underwent elective and emergency surgery Under General Anesthesia at Tikur Anbessa specialized hospital,Addis Ababa,Ethiopia,2023/2024.
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Date
2024-05
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Addis Ababa University
Abstract
Background: Intraoperative hypoxemia is a very common respiratory adverse event in
pediatric anesthesia. It causes hemodynamic instability like tachycardia, bradycardia, cardiac
arrest, and hypoxic brain insults, and it is associated with increased morbidity and mortality.
Even though it is common, there are a few studies’ that show the incidence of intraoperative
hypoxemia increases with younger ages.
Objective: The objective of this study is to determine the incidence of intraoperative
hypoxemia and its associated patient, surgical, and anesthesia related risk factors in elective and
emergency pediatric surgery at TASH.
Method: The study design was a single-center analytic prospective observational study at Tikur
Anbessa Specialized Hospital with a sample size of 208. Convenience consecutive sampling
technique was used to select the patient. The data was collected from pediatric patients who have
had non-cardiac surgery from induction to the emergence of general anesthesia by continuous
monitoring and observation of the pulse oximetry record from the monitor. The observed data
was documented in the prepared anonymous questionnaire. The data was entered, coded,
cleaned, and analyzed by SPSS 29 software. Logistic regression was used to assess the
association between the dependent and independent variable and p value< 0.05 at Confidence
interval of 95% was used for assessing the statistical significance.
Result: Among the 208 pediatric patients included in the study, 117 (56.2%) were experienced a drop in
saturation at or below 90%. Forty four (37.6%) of this study participants (117) had only a one minute
duration of desaturation, and 49 (41.8%) of the participants had one episode. From 117, 91 (77.7%) were
attributed to true hypoxemia, and the other 26 (22.2%) were artifacts. 34 (29%) occurred during
induction, and the remaining occurred during maintenance and emergence. From all true hypoxemia,
46(50.5%) were mild, and the remaining's were in the moderate to severe ranges. The study finding
showed that the urgency of the surgery, neonatal age, higher ASA class and the presence of comorbidity
were associated with hypoxemia by bivariate and multivariate logistic regression.
Conclusion: Since intraoperative hypoxemia is prevalent in pediatric patients, understanding and
addressing these risk factors may help to improve perioperative care and outcomes.
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Keywords
Intraoperative hypoxemia, Anesthesia