Objective:

To investigate the incidence, independent risk factors, and postoperative outcomes of intraoperative desaturation during mechanical ventilation in pediatric patients at 3,650 m altitude, focusing on physical development indicators.

Approach:

Key Findings:

• Overall incidence of intraoperative desaturation was 3.5% (63/1,793).
• Independent risk factors included younger age (adjusted OR 0.80, 95% CI: 0.72–0.90), severe underweight (adjusted OR 4.57, 95% CI: 2.18–9.58), lower preoperative hemoglobin (adjusted OR 0.85, 95% CI: 0.74–0.98), prolonged mechanical ventilation (adjusted OR 1.46, 95% CI: 1.24–1.73), and female sex (adjusted OR 1.76, 95% CI: 1.01–3.04).
• A non-linear L-shaped relationship was found between absolute body weight and desaturation risk, with an exploratory safety threshold at 26.95 kg.

Interpretation:

The identified risk factors and the non-linear relationship between body weight and desaturation risk provide insights for preoperative risk stratification in high-altitude pediatric anesthesia.

Limitations:

• The study was conducted in a single center, which may limit generalizability.
• Retrospective design may introduce biases in data collection and analysis.

Conclusion:

Intraoperative desaturation in pediatric patients at extreme high altitude is influenced by several independent risk factors.

Source

Based on findings from:

Intraoperative desaturation in pediatric patients at high altitude: incidence, risk factors, and a non-linear body weight safety threshold

Dawa Puzhen, Yiwen Yang, Xiaoyan Li, Laba Ciren, Yi Feng, Qi Yan. Frontiers In Pediatrics, 2026.

https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2026.1871256/full

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