major desaturation events (oxygen saturation measured by pulse oximetry Յ 85% for 30 s or longer) in 67 children with a higher incidence by a factor of 2 in those whose anesthesiologist did not have the oximeter data available. These studies suggested that the oximeter allowed early recognition and intervention, thus preventing a minor desaturation event from progressing to a major desaturation event. 3,4 We also found a higher incidence of these major desaturation events in children younger

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... n 2 yr. I do not know whether it is possible for Wilder et al. to go back and examine the anesthesia records from the 144 children in their cohort who had two or more anesthetic exposures to determine whether hypoxic events were recorded, but it might be a useful endeavor. I suggest that we need to look at other issues beyond simple exposure to anesthetic agents as possible contributory factors and look forward to more wonderful work from the Mayo group.