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Master Thesis

Oxygénothérapie en salle de surveillance post-interventionnelle : évaluation des pratiques professionnelles et mise en application de recommandations : étude SSPI-02

Abstract : Context: Using oxygen therapy is common in the Post Anesthesia Care Unit (PACU). However, systematic administration of oxygen exposes the patient to potential adverse effects. In 2018 and 2019, recommendations were published and objectives of SpO2 to start (SpO2 < 92%) or stop (SpO2 > 95%) oxygen therapy are proposed. Routine practices regarding oxygen therapy remain very heterogeneous and the application of these recommendations uncertain. The aim of this study was to investigate how oxygen therapy in PACU is routinely applied. Methods: A prospective, multicenter, regional, observational study was performed in 6 university and general hospitals in Auvergne area in France. Reported data were part of the usual management in the PACU. All adult patients who underwent a general anesthesia with invasive mechanical ventilation or sedation with spontaneous ventilation requiring monitoring in the PACU were included. Major outcome was the SpO2 at admission in the PACU or after extubation if performed in the PACU (T0). Main secondary outcomes were the number of patients receiving oxygen therapy and corresponding SpO2 at different predefined monitoring times in the PACU, the length of stay in the PACU including the length of stay with oxygen support, and the occurrence of oxygen weaning in the PACU. Results: Between 6 consecutive weeks in May and June 2021, 627 patients were included. Mean SpO2 at T0 was 96% with an oxygen support for 33% of them and a mean oxygen flow of 4,5L/min. SpO2 was in the ranges proposed by the BMJ for 74% of patients at this time. All along the monitoring in the PACU, 52% of patients kept a SpO2 in the ranges defined by the guidelines. 22% of patients presented at least one episode of desaturation during their surveillance. At the discharge of the PACU, 19% of patients had still an oxygen support with a mean flow of 2L/min. Median length of stay in the PACU was 75 minutes, and 45 minutes with oxygen support. For 18% of patients a target of SpO2 was prescribed. Conclusion: In this multicentric prospective observational study about postoperative oxygen management, we reported that the mean postoperative SpO2 was 96%. 52% of our population kept a SpO2 in the ranges fixed by the recommendations all along the surveillance in the PACU. Incidence of desaturation was 22%. This evaluation of the routine practice allows a better knowledge of how the oxygen is administered in the PACU and will help us to improve and personalize early postoperative care. Perspective: This study is a situational analysis of oxygen use in PACU and it will be a base to perform a training to healthcare team in guidelines. Then we will conduct a second prospective evaluation with the same modalities than the presented one, to measure the impact of the training on adequation with recommendations and improvement of postoperative oxygen management.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03585693
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Submitted on : Wednesday, February 23, 2022 - 12:18:33 PM
Last modification on : Friday, February 25, 2022 - 3:34:07 AM
Long-term archiving on: : Tuesday, May 24, 2022 - 6:34:57 PM

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Lucile Pouly. Oxygénothérapie en salle de surveillance post-interventionnelle : évaluation des pratiques professionnelles et mise en application de recommandations : étude SSPI-02. Human health and pathology. 2021. ⟨dumas-03585693⟩

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