Intraoperative hypoxia

Description

With the decline in anesthesia-related mortality, focus has shifted to effects of exposure to anesthesia. One area of great uncertainty is the clinical impact of transient hypoxemia during surgery. Despite advances in monitoring technology, hypoxemia continues to occur commonly in the operating room and may be a serious safety concern. Anesthesiologist  strive to avoid hypoxemia because of the risk of irreversible damage to the myocardium, brain, and other end organs. Mild to moderate hypoxia is a common surgical complication, often under-diagnosed. Severe life-threatening hypoxia is fortunately rare but needs rapid action to prevent death. Mechanisms for hypoxemia include ventilation perfusion mismatch, hypoventilation, diffusion impairment, and physiologic or anatomic shunt not to forget the faults with oxygen delivery systems. A physiological approach guides rapid diagnosis of the pathophysiological cause of hypoxia and of support of oxygen delivery until a specific diagnosis of causative disease process can be made.