Sarah Jane Ramsay, BSc, MBBS
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Ramsay S.; Postoperative Pulmonary Complications. Ann Intern Med. 2002;137:550-551. doi: 10.7326/0003-4819-137-6-200209170-00032
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Published: Ann Intern Med. 2002;137(6):550-551.
TO THE EDITOR:
Arozullah and colleagues (1) describe the development of a multifactorial risk index for the prediction of postoperative pneumonia. The accompanying editorial by Lawrence (2) discusses the authors' decision to use a homogeneous outcome variable (postoperative pneumonia), in contrast to previous studies that used less clearly defined postoperative pulmonary complications as outcome measures. I take issue with the description of hypoxemia as a postoperative complication of “little clinical significance.”
Eichhorn (3) has reviewed the importance of late desaturation and hypoxemia. There are two recognized patterns: persistent hypoxemia, which is related to preoperative respiratory function, and episodic nocturnal hypoxemia, which is closely related to episodic sleep apnea and is aggravated by postoperative physiologic disturbances. The latter form of hypoxemia has in particular been linked with possible organ dysfunction and subsequent morbidity and possibly mortality. Episodic nocturnal hypoxemia has been associated with episodes of cardiac ischemia and may contribute to the increased frequency of unexpected postoperative deaths noted at night.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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