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Clinical Adult, Literature Updates
Posted:
May 1, 2012
Authors: Khalid I, Roehrs TA, Hudgel DW, Roth T
Contributors: Nabil Elkassabany, Stavros Memtsoudis, Tajender Vasu, Susana Vacas, Frances Chung
Published: Sleep 2011; 34(12):1687–91.
This study is to evaluate effects of CPAP on pain sensitivity in severe OSA patients. Apnea-hypopnea index (AHI) decreased from 50.9 ± 14.5 to 1.4 ± 1.0 with CPAP, and sleep continuity improved. CPAP treatment reduces pain sensitivity in OSA patients.
http://www.ncbi.nlm.nih.gov/pubmed/22131606
Posted in
Clinical Adult, Literature Updates
Posted:
May 1, 2012
Authors: Fleetham J, Ayas N, Bradley D, Fitzpatrick M, Oliver TK, Morrison D, Ryan F, Series F, Skomro R, Tsai W; Canadian Thoracic Society Sleep Disordered Breathing Committee
Contributors: Nabil Elkassabany, Stavros Memtsoudis, Tajender Vasu, Susana Vacas, Frances Chung
Published: Can Respir J 2011; Jan-Feb;18(1):25–47.
The CTS Sleep Disordered Breathing Committee posed specific questions for 8 areas. The recommendations regarding maximum assessment wait times, portable monitoring, treatment of asymptomatic adult OSA patients, treatment with conventional CPAP compared with automatic CPAP, and treatment of central sleep apnea syndrome in heart failure patients replace the recommendations in the 2006⁄2007 guidelines. The recommendations on bariatric surgery, complex sleep apnea and optimum positive airway pressure technologies are new topics, which were not covered in the 2006⁄2007 guidelines.
http://www.ncbi.nlm.nih.gov/pubmed/21369547
Posted in
Clinical Adult, Literature Updates
Posted:
May 1, 2012
Authors: Dorman RB, Miller CJ, Leslie DB, Serrot FJ, Slusarek B, Buchwald H, Connett JE, Ikramuddin S
Contributors: Nabil Elkassabany, Stavros Memtsoudis, Tajender Vasu, Susana Vacas, Frances Chung
Published: PLoS One. 2012;7(3):e32506. Epub 2012.
This is a prospective observational study of 24,662 patients undergoing primary RYGB and 26,002 patients undergoing primary AGB at 249 and 317 Bariatric Surgery Centers of Excellence, for three years. The readmission rate was 5.8% for RYGB and 1.2% for AGB patients 30 days after discharge. Readmission rates are low and mortality is very rare following bariatric surgery, but risk for both is significantly higher after RYGB. Predictors of readmission were disparate for the two procedures. Results do not support excluding patients with certain comorbidities since any reductions in overall readmission rates would be very small on the absolute risk scale.
http://www.ncbi.nlm.nih.gov/pubmed/22412881
Posted in
Clinical Adult, Literature Updates
Posted:
May 1, 2012
Authors: Isono S
Contributors: Nabil Elkassabany, Stavros Memtsoudis, Tajender Vasu, Susana Vacas, Frances Chung
Published: Respirology. 2012 Jan;17(1):32–42.
In the pharyngeal airway region, excessive soft tissue for a given maxillomandibular enclosure size (upper airway anatomical imbalance) can increase tissue pressure surrounding the pharyngeal airway, thereby narrowing the airway. Lung volume reduction due to excessive central fat deposition may decrease longitudinal tracheal traction forces and pharyngeal wall tension, changing the ‘tube law’ in the pharyngeal airway (lung volume dependence of the upper airway). The lung volume dependence of pharyngeal airway patency appears to contribute more significantly to the development of OSA in morbidly obese, apnoeic patients.
http://www.ncbi.nlm.nih.gov/pubmed/22023094
Posted in
Clinical Adult, Literature Updates
Posted:
May 1, 2012
Authors: Al-Nasser B
Contributors: Nabil Elkassabany, Stavros Memtsoudis, Tajender Vasu, Susana Vacas, Frances Chung
Published: Acta Anaesthesiol Taiwan. 2012 Mar;50(1):29–34. Epub 2012 Mar 25.
The ongoing debate on the relevance of obesity, for example in terms of OSA syndrome, obesity hypoventilation syndrome, and other related respiratory disturbances, in relation to the choice of analgesic techniques, especially interscalene block, patient-controlled intravenous analgesia and patient monitoring, demands large-scale, well-designed studies to resolve it. Nevertheless, obesity per se should not dissuade patients from undergoing shoulder surgery under interscalene block.
http://www.ncbi.nlm.nih.gov/pubmed/22500911
Posted in
Clinical Adult, Literature Updates
Posted:
May 1, 2012
Authors: Chung F, Subramanyam R, Liao P, Sasaki E, Shapiro C, Sun Y
Contributors: Nabil Elkassabany, Stavros Memtsoudis, Tajender Vasu, Susana Vacas, Frances Chung
Published: Br J Anaesth. 2012 May;108(5):768–75. Epub 2012 Mar 8.
The STOP-Bang questionnaire is used to screen patients for OSA. This study evaluated the association between STOP-Bang scores and the probability of OSA. In the surgical population, a STOP-Bang score of 5–8 identified patients with high probability of moderate/severe OSA. The STOP-Bang score can help the healthcare team to stratify patients for unrecognized OSA, practice perioperative precautions, or triage patients for diagnosis and treatment.
http://www.ncbi.nlm.nih.gov/pubmed/22401881
Posted in
Clinical Adult, Literature Updates
Posted:
May 1, 2012
Authors: Kim GH, Lee JJ, Choi SJ, Shin BS, Lee AR, Lee SH, Kim MH
Contributors: Nabil Elkassabany, Stavros Memtsoudis, Tajender Vasu, Susana Vacas, Frances Chung
Published: Anaesthesia. 2012 Apr 16.
This study assessed the relationship between the occurrence of apnoea-hypopnoea during propofol sedation for spinal anaesthesia and two different predictive tests of sleep apnoea: the STOP-Bang score and the OSA score. Both assessment tools have some predictive value for the occurrence of apnoea-hypopnoea during propofol sedation in patients undergoing spinal anaesthesia.
http://www.ncbi.nlm.nih.gov/pubmed/22506571
Posted in
Clinical Adult, Literature Updates
Posted:
May 1, 2012
Authors: Berry RB, Kushida CA, Kryger MH, Soto-Calderon H, Staley B, Kuna ST
Contributors: Nabil Elkassabany, Stavros Memtsoudis, Tajender Vasu, Susana Vacas, Frances Chung
Published: Sleep 2012; 35(3): 361–7.
The purpose of this study was to compare the AED (Automatic Event Detection) algorithm used in PAP device with manually scored events on PSG. The AHI, AI, and HI by the two methods were highly correlated. An AHI < 10 events/hr by AED is likely to indicate efficacious treatment. However, high AHI values by AED may represent inadequate treatment especially if the reported events are apneas.
http://www.ncbi.nlm.nih.gov/pubmed/22379242
Posted in
Clinical Adult, Literature Updates
Posted:
May 1, 2012
Authors: Vasu TS, Grewal R, Doghramji K
Contributors: Nabil Elkassabany, Stavros Memtsoudis, Tajender Vasu, Susana Vacas, Frances Chung
Published: J Clin Sleep Med 2012; 8(2): 199–207.
In this systematic review, the authors describe the epidemiology and pathophysiology of an association between OSAS and perioperative complications. They also discuss the perioperative strategy to identify and manage these patients.
http://www.ncbi.nlm.nih.gov/pubmed/22505868
Posted in
Clinical Adult, Literature Updates
Posted:
May 1, 2012
Authors: Borel JC, Tamisier R, Gonzalez-Bermejo J, Baguet JP, Monneret D, Arnol N, Roux-Lombard P, Wuyam B, Levy P, Pépin JL
Contributors: Nabil Elkassabany, Stavros Memtsoudis, Tajender Vasu, Susana Vacas, Frances Chung
Published: Chest 2012; 141(3): 692–702.
In this RCT, the authors evaluated the impact of one month NIV (Non-Invasive Ventilation) on mild OHS (Obesity Hypoventilation Syndrome) compared with lifestyle change. NIV treatment significantly reduced daytime PaCO2 and apnea-hypopnea index. However, the use of NIV did not lead to significant improvement in daytime sleepiness, or inflammatory, cytokine, or metabolic markers.
http://www.ncbi.nlm.nih.gov/pubmed/21885724