The Silent Threat: Unveiling the Mystery of Post Op Hypoxemia after Open Heart Surgery

Introduction: Hypoxemia is a well-known postoperative complication following open heart surgery. There is minimal literature and a lack of consensus on postoperative hypoxemia as a complication following open heart surgery and its relation to adverse outcomes, risk factors, and population characteristics. This is especially more apparent in lower middle-income countries where there is a double burden of disease. We aimed to determine the predictive and risk factors for postoperative hypoxemia due to the high incidence of associated complications that include increased morbidity, mortality, and length of hospital stay. Methods: This study was a retrospective analysis, evaluating first-time open-heart surgery patients over a period of one year from January to December 2020. Data was collected prospectively through the section of cardiothoracic surgery computerized database, using standardized data collection strategies and definitions. Results: The overall prevalence of hypoxemia was estimated to be 73 (11.8%). Morbidity and Mortality were significantly higher in the hypoxemic group. Male gender, diabetes, hypertension, low EF%, CBP time, increased preoperative PaCO2, were found to be independent risk factors for the development of hypoxemia. Conclusion: From the results of this study, it could be concluded that the magnitude of hypoxemia is substantial after on-pump open heart surgery. High-risk and independent factors identified from this study were cumulatively grouped and preventive use of BiPAP was found to be a possible option to prevent hypoxemia This study highlights the importance of one of the underestimated post-op morbid factors with cost, quality, and outcome implications.