Pulse oximetry monitoring and late postoperative hypoxemia on the general care floor.

Abstract

Hypoxemia has long been recognized as a risk to patients in the operating room and postanesthesia care unit, and hemoglobin oxygen saturation (HbO2) monitoring with pulse oximetry has become a standard of care in these areas. There is growing evidence, however, suggesting that later postoperative hypoxemia also may play a role in organ dysfunction leading to morbidity and mortality. Economic pressures to move patients earlier from expensive postanesthesia recovery and intensive care areas to the general care floor -- where nurse-to-patient ratios are lower and lines of sight and sound may be impaired by walls and curtains -- may lead to inadequate surveillance of at-risk patients. These patient-management trends underscore the importance of improved monitoring of respiratory status on the general care floor. In this environment, telemetric pulse oximetry monitoring may represent a cost-effective approach to maximizing quality of care while enhancing risk management. This review discusses late postoperative hypoxemia and identifies areas for further investigation.