The Silent Threat: Unveiling the Mystery of Post Op Hypoxemia after Open Heart Surgery

ABSTRACT

Hypoxemia is a well-known postoperative complication following open heart surgery. There is minimal literature and a lack of consensus on postoperative hypoxemia as a complication following open heart surgery and its relation to adverse outcomes, risk factors, and population characteristics. This is especially more apparent in lower middle-income countries where there is a double burden of disease. We aimed to determine the predictive and risk factors for postoperative hypoxemia due to the high incidence of associated complications that include increased morbidity, mortality, and length of hospital stay.

This study was a retrospective analysis, evaluating first-time open-heart surgery patients over a period of one year from January to December 2020. Data was collected prospectively through the section of cardiothoracic surgery’s computerized database, using standardized data collection strategies and definitions.

The overall prevalence of hypoxemia was estimated to be 73 (11.8%). Morbidity and Mortality were significantly higher in the hypoxemic group. Male gender, diabetes, hypertension, low EF%, CBP time, increased preoperative PaCO2, were found to be independent risk factors for the development of hypoxemia.

From the results of this study, it could be concluded that the magnitude of hypoxemia is substantial after on-pump open heart surgery. High risk and independent factors identified from this study were cumulatively grouped and preventive use of BiPAP was found to be a possible option to prevent hypoxemia This study highlights the importance of one of the underestimated post op morbid factors that has cost, quality, and outcome implications.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Aga Khan University Ethics Committee, approved.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present work are contained in the manuscript

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