Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry
| dc.contributor.advisor | Hofmeyr, Ross | |
| dc.contributor.advisor | du Toit, Leon | |
| dc.contributor.advisor | Dyer, Robert A | |
| dc.contributor.author | Smit, Maretha Isabel | |
| dc.date.accessioned | 2022-03-15T05:31:24Z | |
| dc.date.available | 2022-03-15T05:31:24Z | |
| dc.date.issued | 2021 | |
| dc.date.updated | 2022-03-15T05:30:49Z | |
| dc.description.abstract | Background In South Africa, hypertensive disorders of pregnancy are the leading cause of maternal mortality. More than 50% of anaesthesia-related deaths are attributed to complications of airway management. We compared the prevalence and risk factors for hypoxaemia (SpO2<90%) during induction of general anaesthesia in parturients with and without hypertensive disorders of pregnancy. We hypothesised that hypertensive disorders of pregnancy are associated with desaturation during tracheal intubation. Methods Data from 402 cases in a multicentre obstetric airway management registry were analysed. The prevalence of peri-induction hypoxaemia (SpO2<90%) was compared in patients with and without hypertensive disorders of pregnancy. Quantile regression of SpO2 nadir was performed to identify confounding variables associated with, and mediators of hypoxaemia.Results In the cohort of 402 cases, hypoxaemia occurred in 19% with and 9% without hypertension (estimated risk difference, 10%; 95% CI 2% to 17%; P=0.005). Quantile regression demonstrated a lower SpO2 nadir associated with hypertensive disorders of pregnancy as body mass index increased. Room-air oxygen saturation, Mallampati grade, and number of intubation attempts were associated with the relationship. Conclusions Clinically significant oxygen desaturation during airway management occurred twice as often in patients with hypertensive disorders of pregnancy, compounded by increasing body mass index. Intermediary factors in the pathway from hypertension to hypoxaemia were also identified. | |
| dc.identifier.apacitation | Smit, M. I. (2021). <i>Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry</i>. (). ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine. Retrieved from http://hdl.handle.net/11427/36076 | en_ZA |
| dc.identifier.chicagocitation | Smit, Maretha Isabel. <i>"Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry."</i> ., ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine, 2021. http://hdl.handle.net/11427/36076 | en_ZA |
| dc.identifier.citation | Smit, M.I. 2021. Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry. . ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine. http://hdl.handle.net/11427/36076 | en_ZA |
| dc.identifier.ris | TY - Master Thesis AU - Smit, Maretha Isabel AB - Background In South Africa, hypertensive disorders of pregnancy are the leading cause of maternal mortality. More than 50% of anaesthesia-related deaths are attributed to complications of airway management. We compared the prevalence and risk factors for hypoxaemia (SpO2<90%) during induction of general anaesthesia in parturients with and without hypertensive disorders of pregnancy. We hypothesised that hypertensive disorders of pregnancy are associated with desaturation during tracheal intubation. Methods Data from 402 cases in a multicentre obstetric airway management registry were analysed. The prevalence of peri-induction hypoxaemia (SpO2<90%) was compared in patients with and without hypertensive disorders of pregnancy. Quantile regression of SpO2 nadir was performed to identify confounding variables associated with, and mediators of hypoxaemia.Results In the cohort of 402 cases, hypoxaemia occurred in 19% with and 9% without hypertension (estimated risk difference, 10%; 95% CI 2% to 17%; P=0.005). Quantile regression demonstrated a lower SpO2 nadir associated with hypertensive disorders of pregnancy as body mass index increased. Room-air oxygen saturation, Mallampati grade, and number of intubation attempts were associated with the relationship. Conclusions Clinically significant oxygen desaturation during airway management occurred twice as often in patients with hypertensive disorders of pregnancy, compounded by increasing body mass index. Intermediary factors in the pathway from hypertension to hypoxaemia were also identified. DA - 2021 DB - OpenUCT DP - University of Cape Town KW - Airway management KW - body mass index (BMI) KW - gestational hypertension KW - hypertensive disorders KW - hypoxaemia KW - preeclampsia KW - pregnancy LK - https://open.uct.ac.za PY - 2021 T1 - Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry TI - Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry UR - http://hdl.handle.net/11427/36076 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/36076 | |
| dc.identifier.vancouvercitation | Smit MI. Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry. []. ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine, 2021 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/36076 | en_ZA |
| dc.language.rfc3066 | eng | |
| dc.publisher.department | Department of Anaesthesia and Perioperative Medicine | |
| dc.publisher.faculty | Faculty of Health Sciences | |
| dc.subject | Airway management | |
| dc.subject | body mass index (BMI) | |
| dc.subject | gestational hypertension | |
| dc.subject | hypertensive disorders | |
| dc.subject | hypoxaemia | |
| dc.subject | preeclampsia | |
| dc.subject | pregnancy | |
| dc.title | Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry | |
| dc.type | Master Thesis | |
| dc.type.qualificationlevel | Masters | |
| dc.type.qualificationlevel | MMed |