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Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry
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 gen...
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| Format: | Thesis |
| Language: | English |
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Department of Anaesthesia and Perioperative Medicine
2022
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| _version_ | 1867614282015834112 |
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| access_status_str | Open Access |
| author | Smit, Maretha Isabel |
| author2 | Hofmeyr, Ross |
| author_browse | Hofmeyr, Ross Smit, Maretha Isabel |
| author_facet | Hofmeyr, Ross Smit, Maretha Isabel |
| author_sort | Smit, Maretha Isabel |
| collection | Thesis |
| description | 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. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/36076 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:49:33.712Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Department of Anaesthesia and Perioperative Medicine |
| publisherStr | Department of Anaesthesia and Perioperative Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/36076 Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry Smit, Maretha Isabel Hofmeyr, Ross du Toit, Leon Dyer, Robert A Airway management body mass index (BMI) gestational hypertension hypertensive disorders hypoxaemia preeclampsia pregnancy 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. 2022-03-15T05:31:24Z 2022-03-15T05:31:24Z 2021 2022-03-15T05:30:49Z Master Thesis Masters MMed http://hdl.handle.net/11427/36076 eng application/pdf Department of Anaesthesia and Perioperative Medicine Faculty of Health Sciences |
| spellingShingle | Airway management body mass index (BMI) gestational hypertension hypertensive disorders hypoxaemia preeclampsia pregnancy Smit, Maretha Isabel Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry |
| thesis_degree_str | Master's |
| title | Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry |
| title_full | Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry |
| title_fullStr | Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry |
| title_full_unstemmed | Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry |
| title_short | Hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy: analysis of data from an obstetric airway management registry |
| title_sort | hypoxaemia during tracheal intubation in patients with hypertensive disorders of pregnancy analysis of data from an obstetric airway management registry |
| topic | Airway management body mass index (BMI) gestational hypertension hypertensive disorders hypoxaemia preeclampsia pregnancy |
| url | http://hdl.handle.net/11427/36076 |
| work_keys_str_mv | AT smitmarethaisabel hypoxaemiaduringtrachealintubationinpatientswithhypertensivedisordersofpregnancyanalysisofdatafromanobstetricairwaymanagementregistry |