Continuous surveillance of oxygen saturation and respirations after bariatric surgery

Background: Continuous, post-operative patient monitoring can provide healthcare workers with earlier warning signs of patient deterioration. The Masimo Pulse CO-Oximeter (Masimo Corporation, Irvine, CA) has acoustic monitoring technology which measures respiratory rate (RR) by analyzing acoustic signals generated across the upper airway while breathing. We continuously monitored for 19-24 hours (hrs) post-surgery RR and oxygen saturation (SpO2) in obese patients who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) for bariatric surgery weight loss. The objective was to assess incidence of decreased RR ( 30, between 30 and 10, and < 10 breaths per minute). The percentage of time that the patient spent in each range was calculated. Median values were calculated for each category. Results: During the extended monitoring period, the median percentage of time spent with SpO2 below 90% was 5.4%. The median percentage of time that a subject had a RR of less than 10 respirations/min was 0%. There was no correlation between SpO2 and respiratory rate. Fourteen patients in our study population were on continuous positive airway pressure (CPAP) and reported VAS scores between 3 and 6. This may have prevented them from being deeply sedated. There were no apnea periods longer than 30 seconds. Conclusions: In this small group of obese patients, a low RR was not encountered during an extended post-operative period. These patients did not experience desaturation, apnea, or significant reductions of RR.