Posted in
Clinical Adult, Literature Updates
Posted:
January 30, 2018
Authors: Pien GW, Ye L, Keenan BT, Maislin G, Björnsdóttir E, Arnardottir ES, Benediktsdottir B, Gislason T, Pack AI
Contributors: Yamini Subramani
Published: Sleep. 2018 Jan 2
Distinct clinical phenotypes of obstructive sleep apnea (OSA) have been identified: Disturbed Sleep, Minimally Symptomatic, and Sleepy phenotypes. This study examined relationships between changes in symptoms and PAP adherence. It proved that OSA treatment response patterns differed by initial clinical phenotype and PAP adherence. Individuals with insomnia-related symptoms may require additional targeted therapy for these complaints, emphasizing the need for a personalized approach to management.
https://www.ncbi.nlm.nih.gov/pubmed/29301021
Posted in
Clinical Adult, Literature Updates
Posted:
January 30, 2018
Authors: Nagappa M, Ho G, Patra J, Wong J, Singh M, Kaw R, Cheng D, Chung F
Contributors: Yamini Subramani
Published: Anesth Analg. 2017 Dec;125(6):2030-2037
Obstructive sleep apnea (OSA) is a common comorbidity in patients undergoing cardiac surgery and may predispose patients to postoperative complications. This meta-analysis determines the evidence of postoperative complications associated with OSA patients undergoing cardiac surgery and demonstrates that after cardiac surgery, major adverse cardiac or cerebrovascular events and newly documented postoperative atrial fibrillation had 33.3% and 18.1% higher odds in OSA versus non-OSA patients, respectively.
https://www.ncbi.nlm.nih.gov/pubmed/29049073
Posted in
Clinical Adult, Literature Updates
Posted:
January 30, 2018
Authors: Liao P, Wong J, Singh M, Wong DT, Islam S, Andrawes M, Shapiro CM, White DP, Chung F
Contributors: Yamini Subramani
Published: Chest. 2017 Mar;151(3):597-611
Postoperative supplemental oxygen is commonly used, but it may contribute to respiratory depression in patients with OSA receiving opioids. This randomized controlled trial investigated the effect of postoperative supplemental oxygen on arterial oxygen saturation (Sao2), sleep respiratory events, and CO2 level in patients with untreated OSA. Postoperative supplemental oxygen was found to improve oxygenation and decrease the AHI without increasing the duration of apnea-hypopnea event or PtcCO2 level. A small number of patients had significant CO2 retention while receiving supplemental oxygen.
https://www.ncbi.nlm.nih.gov/pubmed/28007620
Posted in
Clinical Adult, Literature Updates
Posted:
January 30, 2018
Authors: Lam T, Nagappa M, Wong J, Singh M, Wong D, Chung F
Contributors: Yamini Subramani
Published: Anesth Analg. 2017 Dec;125(6):2019-2029
The American Patient Safety Foundation has called for continuous electronic monitoring for all patients receiving opioids in the postoperative period. This study evaluated the effectiveness of continuous capnography monitoring, pulse oximetry and intermittent nursing checks for detecting postoperative respiratory depression (PORD) and preventing postoperative adverse events in the surgical ward. The use of continuous pulse oximetry on the surgical ward is associated with significant improvement in the detection of oxygen desaturation versus intermittent nursing spot-checks. The results also pointed out that capnography provides an early warning of PORD before oxygen desaturation, especially when supplemental oxygen is administered.
https://www.ncbi.nlm.nih.gov/pubmed/29064874
Posted in
Clinical Adult, Literature Updates
Posted:
January 30, 2018
Authors: Truong KK, De Jardin R, Massoudi N, Hashemzadeh M, Jafari B
Contributors: Crispiana Cozowicz
Published: J Clin Sleep Med. 2018
Retrospective analysis of 345 OSA patients hospitalized at a Veterans Affairs hospital showed that the all cause 30-day readmission rate was significantly higher in patient’s non-adherent to CPAP with adjusted odds of 3.52 (CI 2.04-6.08). Moreover, 30-day cardiovascular cause readmission rate was significantly higher in the CPAP non-adherent group, with adjusted odds of 2.31 (CI 1.11-4.78). Nonadherence to CPAP is associated with increased risk for hospital readmission in patients with OSA.
https://www.ncbi.nlm.nih.gov/pubmed/29351826
Posted in
Clinical Adult, Literature Updates
Posted:
January 30, 2018
Authors: Wong J, Lam D, Choi S, Singh M, Siddiqui N, Sockalingam S, Chung F
Contributors: Crispiana Cozowicz
Published: BMC Anesthesiol. 2018 Jan
Multicenter randomized controlled trial will enroll 634 elderly patients undergoing elective lower joint replacement surgery. Patients identified with OSA will be randomized to Auto-titrating continuous airway pressure (APAP) applied during sleep for 72h postoperatively or to control group without APAP. Delirium will be evaluated by using the Confusion assessment method in all patients for 72 hours postoperatively. Since delirium is associated with increased morbidity and mortality, findings could potentially inform best practices to improve surgical outcome and increase safety in the elderly patients with OSA.
https://www.ncbi.nlm.nih.gov/pubmed/29298664
Posted in
Clinical Adult, Literature Updates
Posted:
January 30, 2018
Authors: Wong JK, Mariano ER, Doufas AG, Olejniczak MJ, Kushida CA
Contributors: Crispiana Cozowicz
Published: J Cardiothorac Vasc Anesth. 2017 Aug
Retrospective analysis of 192 OSA undergoing cardiac surgery with cardiopulmonary bypass, showed that 54% of the study cohort were adherent to PAP therapy. Preoperative PAP use was associated with a decreased rate of postoperative atrial fibrillation in cardiac surgery.
https://www.ncbi.nlm.nih.gov/pubmed/28111105
Posted in
Clinical Adult, Literature Updates
Posted:
January 30, 2018
Authors: Truong KK, De Jardin R, Massoudi N, Hashemzadeh M, Jafari B
Contributors: Crispiana Cozowicz
Published: J Clin Sleep Med. 2018
Retrospective analysis of 345 OSA patients hospitalized at a Veterans Affairs hospital showed that the all cause 30-day readmission rate was significantly higher in patient’s non-adherent to CPAP with adjusted odds of 3.52 (CI 2.04-6.08). Moreover, 30-day cardiovascular cause readmission rate was significantly higher in the CPAP non-adherent group, with adjusted odds of 2.31 (CI 1.11-4.78). Nonadherence to CPAP is associated with increased risk for hospital readmission in patients with OSA.
https://www.ncbi.nlm.nih.gov/pubmed/29351826
Posted in
Clinical Adult, Literature Updates
Posted:
January 30, 2018
Authors: Ibrahim Sadek, Edwin Seet, Jit Biswas, Bessam Abdulrazak, Mounir Mokhtari
Contributors: Edwin Seet
Published: IEEE Access 2018 Jan
“Current approaches for sleep-disordered breathing detection are intrusive and can affect the patient’s sleep quality. Ten patients scheduled for drug-induced sleep endoscopy were recruited to determine the utility of a novel unobtrusive microbend fiber optic sensor mattress (cardioballistography technology) to monitor heart rate, respiratory rate, apnea and hypopnea episodes. Pearson correlation coefficient between the proposed sensor and the reference device was 0.96 and 0.78 for heart rate and respiration, respectively. The proposed sensor provided a low sensitivity (24.24±12.81%) and high specificity (85.88±6.01%) for sleep apnea detection. It is expected that this preliminary research will pave the way toward unobtrusive detection of vital signs in real time.”
DOI: 10.1109/ACCESS.2017.2783939
Posted in
Clinical Adult, Literature Updates
Posted:
January 30, 2018
Authors: Nagappa M, Ho G, Patra J, Wong J, Singh M, Kaw R, Cheng D, Chung F
Contributors: Eric Deflandre
Published: Anesth Analg. 2017 Dec;125(6):2030-2037
This meta-analysis was related to adverse events in cardiac surgery. The authors demonstrate that major cardiac events and newly documented atrial fibrillation exhibit higher odds ratio in OSA versus non-OSA patients.
https://www.ncbi.nlm.nih.gov/pubmed/29049073
