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Volume 14 Issue 3
May  2023
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DUAN Hanyu, ZHU Qianmei, Cirendeji, LI Yi, MIAO Xuhan, ZHANG Yuelun, LIU Zijia, Labaciren, SHEN Le, HUANG Yuguang. Risk Factors of Hypoxemia During Non-cardiothoracic Surgery for Populations at High Altitude in Tibet: A Prospective Cohort Study[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(3): 646-651. DOI: 10.12290/xhyxzz.2022-0610
Citation: DUAN Hanyu, ZHU Qianmei, Cirendeji, LI Yi, MIAO Xuhan, ZHANG Yuelun, LIU Zijia, Labaciren, SHEN Le, HUANG Yuguang. Risk Factors of Hypoxemia During Non-cardiothoracic Surgery for Populations at High Altitude in Tibet: A Prospective Cohort Study[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(3): 646-651. DOI: 10.12290/xhyxzz.2022-0610
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Risk Factors of Hypoxemia During Non-cardiothoracic Surgery for Populations at High Altitude in Tibet: A Prospective Cohort Study

  • 1.

    Department of Anesthesiology and Operating Room, Tibet Autonomous Region People's Hospital, Lhasa 850000, China

  • 2.

    Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • 3.

    Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

Funds: 

Tibet Natural Science Funding Committee Grant XZ2020ZR-ZY06 (z)

More Information
  • Corresponding author:

    LIU Zijia, E-mail: liu-zj02@126.com

    Labaciren, E-mail: lbcr010203@163.com

  • Received Date: October 21, 2022
  • Accepted Date: December 11, 2022
  • Issue Publish Date: May 29, 2023
    Graphical Abstract
    • Abstract
  •   Objective  To investigate the incidence and risk factors of intraoperative hypoxemia in non- cardiothoracic surgery under general anesthesia in high-altitude areas of Tibet, and briefly analyze the impact of intraoperative hypoxemia on the prognosis.
      Methods  The clinical data of patients undergoing non-cardiothoracic surgery under general anesthesia in Tibet Autonomous Region People's Hospital from June 1, 2021 to August 31, 2022 were collected prospectively, including basic preoperative data, surgery information and anesthesia management. The main outcome was intraoperative hypoxemia. Multivariate Logistic regression was used to analyze the risk factors of intraoperative hypoxemia. The perioperative prognosis of patients with or without intraoperative hypoxemia was compared.
      Results  A total of 161 patients having non-cardiothoracic surgery under general anesthesia who met the inclusion and exclusion criteria were included. Among them, 9 patients (5.6%) suffered intraoperative hypoxemia and 152 cases (94.4%) experienced non-intraoperative hypoxemia. Multivariate Logistic regression analysis showed that preoperative oxygen saturation ≤ 85%(OR=4.604, 95% CI: 1.064-19.916, P=0.041), preoperative hemoglobin ≥ 170 g/L (OR=5.396, 95% CI: 1.163-25.035, P=0.031), and preoperative pulmonary artery pressure ≥ 40 mm Hg (OR=11.744, 95% CI: 1.599-86.243, P=0.015) were independent risk factors for hypoxemia during non-cardiothoracic surgery under general anesthesia in people at high altitude in Tibet. The incidence of perioperative adverse cardiac events in patients with intraoperative hypoxemia was significantly higher than that in patients without intraoperative hypoxemia (55.6% vs. 15.1%, P=0.002).
      Conclusion  Preoperative low oxygen saturation, hyperhemoglobin and pulmonary hypertension are the risk factors of intraoperative hypoxemia in non-cardiothoracic surgery under general anesthesia in people at high altitude in Tibet, and intraoperative hypoxemia may have a negative impact on the prognosis of patients.
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    • References (20)
  • [1]
    邹远妩, 袁志敏, 刘小星, 等. 阿里极高海拔地区藏族居民血液学指标特点及慢性高原病现况[J]. 西安交通大学学报(医学版), 2022, 43: 895-900. DOI: 10.7652/jdyxb202206017
    [2]
    马宏伟, 周艳杰, 赵子军, 等. 4300米高海拔地区老年病人手术麻醉的探讨[J]. 西藏医药, 2018, 39: 137-139. https://www.cnki.com.cn/Article/CJFDTOTAL-XZYY201805067.htm
    [3]
    Durkin C, Romano K, Egan S, et al. Hypoxemia During One-Lung Ventilation: Does It Really Matter[J]. Curr Anesthesiol Rep, 2021, 11: 414-420. DOI: 10.1007/s40140-021-00470-5
    [4]
    Tefferi A, Vannucchi AM, Barbui T. Polycythemia vera: historical oversights, diagnostic details, and therapeutic views[J]. Leukemia, 2021, 35: 3339-3351. DOI: 10.1038/s41375-021-01401-3
    [5]
    冯信焰, 于广飞, 尹思念. 高原不同海拔地区成人血红蛋白水平变化的调查分析[J]. 西部医学, 2010, 22: 923-924. DOI: 10.3969/j.issn.1672-3511.2010.05.066
    [6]
    Ehrenfeld JM, Funk LM, Van Schalkwyk J, et al. The incidence of hypoxemia during surgery: evidence from two institutions[J]. Can J Anaesth, 2010, 57: 888-897. DOI: 10.1007/s12630-010-9366-5
    [7]
    Villafuerte FC, Simonson TS, Bermudez D, et al. High-Altitude Erythrocytosis: Mechanisms of Adaptive and Maladap-tive Responses[J]. Physiology (Bethesda), 2022. doi: 10.1152/physiol.00029.2021.
    [8]
    Corante N, Anza-Ramírez C, Figueroa-Mujíca R, et al. Excessive Erythrocytosis and Cardiovascular Risk in Andean Highlanders[J]. High Alt Med Biol, 2018, 19: 221-231. DOI: 10.1089/ham.2017.0123
    [9]
    De Ferrari A, Miranda JJ, Gilman RH, et al. Prevalence, clinical profile, iron status, and subject-specific traits for excessive erythrocytosis in andean adults living permanently at 3, 825 meters above sea level[J]. Chest, 2014, 146: 1327-1336. DOI: 10.1378/chest.14-0298
    [10]
    León-Velarde F, Maggiorini M, Reeves JT, et al. Consensus statement on chronic and subacute high altitude diseases[J]. High Alt Med Biol, 2005, 6: 147-157. DOI: 10.1089/ham.2005.6.147
    [11]
    何斯, 严辰媛, 刚乔健, 等. 高原地区难愈合创面病理变化和特点[J]. 医学综述, 2022, 28: 2746-2750. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZS202214008.htm
    [12]
    Hirota K. Hypoxia-dependent signaling in perioperative and critical care medicine[J]. J Anesth, 2021, 35: 741-756. DOI: 10.1007/s00540-021-02940-w
    [13]
    Sydykov A, Mamazhakypov A, Maripov A, et al. Pulmonary Hypertension in Acute and Chronic High Altitude Maladaptation Disorders[J]. Int J Environ Res Public Health, 2021, 18: 1692. DOI: 10.3390/ijerph18041692
    [14]
    Miele CH, Schwartz AR, Gilman RH, et al. Increased Cardiometabolic Risk and Worsening Hypoxemia at High Altitude[J]. High Alt Med Biol, 2016, 17: 93-100. DOI: 10.1089/ham.2015.0084
    [15]
    全军麻醉与复苏学专业委员会, 中华医学会麻醉学分会. 高原环境战创伤麻醉共识(2019)[J]. 麻醉安全与质控, 2019, 3: 311-315.
    [16]
    Cutuli SL, Grieco DL, Menga LS, et al. Noninvasive ventilation and high-flow oxygen therapy for severe community-acquired pneumonia[J]. Curr Opin Infect Dis, 2021, 34: 142-150. DOI: 10.1097/QCO.0000000000000715
    [17]
    Schreiber A, DI Marco F, Braido F, et al. High flow nasal cannula oxygen therapy, work in progress in respiratory critical care[J]. Minerva Med, 2016, 107: 14-20. http://doc.paperpass.com/foreign/rgArti20166315392.html
    [18]
    Liu K, Scott JB, Jing G, et al. Management of Postoperative Hypoxemia[J]. Respir Care, 2021, 66: 1136-1149. DOI: 10.4187/respcare.08929
    [19]
    Liu Q, Zhu C, Lan C, et al. High-flow nasal cannula versus conventional oxygen therapy in patients with dyspnea and hypoxemia before hospitalization[J]. Expert Rev Respir Med, 2020, 14: 425-433. http://www.ncbi.nlm.nih.gov/pubmed/31985296
    [20]
    张玉飞, 格桑平措, 邱海兵, 等. 西藏阿里地区西部区域藏族人群慢性病及影响因素的相关性研究[J]. 现代预防医学, 2022, 49: 4246-4252, 4258. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202223004.htm
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