[Late postoperative hypoxemia]

Abstract

Arterial hypoxaemia may be observed several days after an uncomplicated major surgical operation and may be of constant or episodic nature. Late postoperative constant hypoxaemia is mainly due to reduced pulmonary volume on account of reduced diaphragmatic function. The cause of late postoperative episodic hypoxaemia is probably opioid-induced alterations in regulation of respiration and alterations in sleep on account of pain and stress which cause intermittent hypoventilation and central and/or obstructive apnoea. The clinical significance of late postoperative hypoxaemia is not yet fully elucidated. The data available suggest, however, that it may be a contributory factor in the development of cardiac, cerebral and wound complications. The pathogenesis should, therefore, be elucidated and rational therapeutic principles against late postoperative hypoxaemia should receive higher priority.