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David J Plevak - One of the best experts on this subject based on the ideXlab platform.

  • identification of patients at risk for postoperative respiratory complications using a preoperative obstructive sleep apnea screening tool and postanesthesia care assessment
    Anesthesiology, 2009
    Co-Authors: Bhargavi Gali, Francis X Whalen, Darrell R Schroeder, David J Plevak
    Abstract:

    Background: Patients with obstructive sleep apnea are at risk for perioperative morbidity. The authors used a screening prediction model for obstructive sleep apnea to generate a sleep apnea clinical score (SACS) that identified patients at high or low risk for obstructive sleep apnea. This was combined with postanesthesia care unit (PACU) monitoring with the aim of identifying patients at high risk of postoperative oxygen Desaturation and respiratory complications. Methods: In this prospective cohort study, surgical patients with a hospital stay longer than 48 h who consented were enrolled. The SACS (high or low risk) was calculated; all patients were monitored in the PACU for recurrent episodes of bradypnea, apnea, Desaturations, and pain‐sedation mismatch. All patients underwent pulse oximetry postoperatively; complications were documented. Chi-square, two-sample t test, and logistic regression were used for analysis. The oxygen Desaturation index (number of Desaturations per hour) was calculated. Oxygen Desaturation index and incidence of postoperative cardiorespiratory complications were primary endpoints. Results: Six hundred ninety-three patients were enrolled. From multivariable logistic regression analysis, the likelihood of a postoperative oxygen Desaturation index greater than 10 was increased with a high SACS (odds ratio 1.9, P < 0.001) and recurrent PACU events (odds ratio 1.5, P 0.036). Postoperative respiratory events were also associated with a high SACS (odds ratio 3.5, P < 0.001) and recurrent PACU events (odds ratio 21.0, P < 0.001). Conclusions: Combination of an obstructive sleep apnea screening tool preoperatively (SACS) and recurrent PACU respiratory events was associated with a higher oxygen Desaturation index and postoperative respiratory complications. A two-phase process to identify patients at higher risk for perioperative respiratory Desaturations and complications may be useful to stratify and manage surgical patients postoperatively. PATIENTS with obstructive sleep apnea (OSA) are at risk for perioperative morbidity, and many patients who present for surgical procedures may have undiagnosed OSA. 1–5 In 1993, approximately 4% of men and 2% of

  • identification of patients at risk for postoperative respiratory complications using a preoperative obstructive sleep apnea screening tool and postanesthesia care assessment
    Anesthesiology, 2009
    Co-Authors: Bhargavi Gali, Francis X Whalen, Darrell R Schroeder, David J Plevak
    Abstract:

    Background: Patients with obstructive sleep apnea are at risk for perioperative morbidity. The authors used a screening prediction model for obstructive sleep apnea to generate a sleep apnea clinical score (SACS) that identified patients at high or low risk for obstructive sleep apnea. This was combined with postanesthesia care unit (PACU) monitoring with the aim of identifying patients at high risk of postoperative oxygen Desaturation and respiratory complications. Methods: In this prospective cohort study, surgical patients with a hospital stay longer than 48 h who consented were enrolled. The SACS (high or low risk) was calculated; all patients were monitored in the PACU for recurrent episodes of bradypnea, apnea, Desaturations, and pain‐sedation mismatch. All patients underwent pulse oximetry postoperatively; complications were documented. Chi-square, two-sample t test, and logistic regression were used for analysis. The oxygen Desaturation index (number of Desaturations per hour) was calculated. Oxygen Desaturation index and incidence of postoperative cardiorespiratory complications were primary endpoints. Results: Six hundred ninety-three patients were enrolled. From multivariable logistic regression analysis, the likelihood of a postoperative oxygen Desaturation index greater than 10 was increased with a high SACS (odds ratio 1.9, P < 0.001) and recurrent PACU events (odds ratio 1.5, P 0.036). Postoperative respiratory events were also associated with a high SACS (odds ratio 3.5, P < 0.001) and recurrent PACU events (odds ratio 21.0, P < 0.001). Conclusions: Combination of an obstructive sleep apnea screening tool preoperatively (SACS) and recurrent PACU respiratory events was associated with a higher oxygen Desaturation index and postoperative respiratory complications. A two-phase process to identify patients at higher risk for perioperative respiratory Desaturations and complications may be useful to stratify and manage surgical patients postoperatively. PATIENTS with obstructive sleep apnea (OSA) are at risk for perioperative morbidity, and many patients who present for surgical procedures may have undiagnosed OSA. 1–5 In 1993, approximately 4% of men and 2% of

Bhargavi Gali - One of the best experts on this subject based on the ideXlab platform.

  • identification of patients at risk for postoperative respiratory complications using a preoperative obstructive sleep apnea screening tool and postanesthesia care assessment
    Anesthesiology, 2009
    Co-Authors: Bhargavi Gali, Francis X Whalen, Darrell R Schroeder, David J Plevak
    Abstract:

    Background: Patients with obstructive sleep apnea are at risk for perioperative morbidity. The authors used a screening prediction model for obstructive sleep apnea to generate a sleep apnea clinical score (SACS) that identified patients at high or low risk for obstructive sleep apnea. This was combined with postanesthesia care unit (PACU) monitoring with the aim of identifying patients at high risk of postoperative oxygen Desaturation and respiratory complications. Methods: In this prospective cohort study, surgical patients with a hospital stay longer than 48 h who consented were enrolled. The SACS (high or low risk) was calculated; all patients were monitored in the PACU for recurrent episodes of bradypnea, apnea, Desaturations, and pain‐sedation mismatch. All patients underwent pulse oximetry postoperatively; complications were documented. Chi-square, two-sample t test, and logistic regression were used for analysis. The oxygen Desaturation index (number of Desaturations per hour) was calculated. Oxygen Desaturation index and incidence of postoperative cardiorespiratory complications were primary endpoints. Results: Six hundred ninety-three patients were enrolled. From multivariable logistic regression analysis, the likelihood of a postoperative oxygen Desaturation index greater than 10 was increased with a high SACS (odds ratio 1.9, P < 0.001) and recurrent PACU events (odds ratio 1.5, P 0.036). Postoperative respiratory events were also associated with a high SACS (odds ratio 3.5, P < 0.001) and recurrent PACU events (odds ratio 21.0, P < 0.001). Conclusions: Combination of an obstructive sleep apnea screening tool preoperatively (SACS) and recurrent PACU respiratory events was associated with a higher oxygen Desaturation index and postoperative respiratory complications. A two-phase process to identify patients at higher risk for perioperative respiratory Desaturations and complications may be useful to stratify and manage surgical patients postoperatively. PATIENTS with obstructive sleep apnea (OSA) are at risk for perioperative morbidity, and many patients who present for surgical procedures may have undiagnosed OSA. 1–5 In 1993, approximately 4% of men and 2% of

  • identification of patients at risk for postoperative respiratory complications using a preoperative obstructive sleep apnea screening tool and postanesthesia care assessment
    Anesthesiology, 2009
    Co-Authors: Bhargavi Gali, Francis X Whalen, Darrell R Schroeder, David J Plevak
    Abstract:

    Background: Patients with obstructive sleep apnea are at risk for perioperative morbidity. The authors used a screening prediction model for obstructive sleep apnea to generate a sleep apnea clinical score (SACS) that identified patients at high or low risk for obstructive sleep apnea. This was combined with postanesthesia care unit (PACU) monitoring with the aim of identifying patients at high risk of postoperative oxygen Desaturation and respiratory complications. Methods: In this prospective cohort study, surgical patients with a hospital stay longer than 48 h who consented were enrolled. The SACS (high or low risk) was calculated; all patients were monitored in the PACU for recurrent episodes of bradypnea, apnea, Desaturations, and pain‐sedation mismatch. All patients underwent pulse oximetry postoperatively; complications were documented. Chi-square, two-sample t test, and logistic regression were used for analysis. The oxygen Desaturation index (number of Desaturations per hour) was calculated. Oxygen Desaturation index and incidence of postoperative cardiorespiratory complications were primary endpoints. Results: Six hundred ninety-three patients were enrolled. From multivariable logistic regression analysis, the likelihood of a postoperative oxygen Desaturation index greater than 10 was increased with a high SACS (odds ratio 1.9, P < 0.001) and recurrent PACU events (odds ratio 1.5, P 0.036). Postoperative respiratory events were also associated with a high SACS (odds ratio 3.5, P < 0.001) and recurrent PACU events (odds ratio 21.0, P < 0.001). Conclusions: Combination of an obstructive sleep apnea screening tool preoperatively (SACS) and recurrent PACU respiratory events was associated with a higher oxygen Desaturation index and postoperative respiratory complications. A two-phase process to identify patients at higher risk for perioperative respiratory Desaturations and complications may be useful to stratify and manage surgical patients postoperatively. PATIENTS with obstructive sleep apnea (OSA) are at risk for perioperative morbidity, and many patients who present for surgical procedures may have undiagnosed OSA. 1–5 In 1993, approximately 4% of men and 2% of

Alistair J Gunn - One of the best experts on this subject based on the ideXlab platform.

  • randomized controlled trial of a car safety seat insert to reduce hypoxia in term infants
    Pediatrics, 2013
    Co-Authors: Christine G Mcintosh, Shirley L Tonkin, Alistair J Gunn
    Abstract:

    OBJECTIVE: To test the hypothesis that a foam plastic insert that allows the infant head to rest in a neutral position in sleep may prevent obstruction of the upper airway and thus reduce episodes of reduced oxygenation in term infants in car seats. METHODS: Healthy full-term babies were randomized to be studied during sleep while restrained in an infant car safety seat either with or without the insert, with continuous polysomnographic recordings with sleep video. RESULTS: Seventy-eight infants (39 in each group) had polysomnogram recordings at a mean of 8 days of age. Both groups showed a small fall in mean hemoglobin oxygen saturation (SpO2) over the first hour of sleep. There was no difference between insert and no insert in the rate of moderate Desaturations (a fall in SpO2 ≥4% lasting for ≥10 seconds, mean ± SEM, 17.0 ± 1.5 vs 17.2 ± 1.5/hour), or mean SpO2 during sleep. The insert was associated with a significant reduction in the rate of obstructive apnea (0.3 ± 0.1 vs 0.9 ± 1.5/hour, P < .03), the severity of Desaturation events (minimum SpO2 82% ± 1% vs 74% ± 2%, P < .001), and time with SpO2 <85% (0.6% ± 0.3% vs 1.8% ± 1.4%, P = .03). CONCLUSIONS: In full-term newborn infants, a car seat insert that helps the head to lie in a neutral position was associated with reduced severity of Desaturation events but not the overall rate of moderate Desaturations. * Abbreviations: SpO2 — : hemoglobin oxygen saturation

  • Randomized Controlled Trial of a Car Safety Seat Insert to Reduce Hypoxia in Term Infants
    Pediatrics, 2013
    Co-Authors: Christine G Mcintosh, Shirley L Tonkin, Alistair J Gunn
    Abstract:

    OBJECTIVE: To test the hypothesis that a foam plastic insert that allows the infant head to rest in a neutral position in sleep may prevent obstruction of the upper airway and thus reduce episodes of reduced oxygenation in term infants in car seats. METHODS: Healthy full-term babies were randomized to be studied during sleep while restrained in an infant car safety seat either with or without the insert, with continuous polysomnographic recordings with sleep video. RESULTS: Seventy-eight infants (39 in each group) had polysomnogram recordings at a mean of 8 days of age. Both groups showed a small fall in mean hemoglobin oxygen saturation (SpO2) over the first hour of sleep. There was no difference between insert and no insert in the rate of moderate Desaturations (a fall in SpO2 ≥4% lasting for ≥10 seconds, mean ± SEM, 17.0 ± 1.5 vs 17.2 ± 1.5/hour), or mean SpO2 during sleep. The insert was associated with a significant reduction in the rate of obstructive apnea (0.3 ± 0.1 vs 0.9 ± 1.5/hour, P < .03), the severity of Desaturation events (minimum SpO2 82% ± 1% vs 74% ± 2%, P < .001), and time with SpO2

Darrell R Schroeder - One of the best experts on this subject based on the ideXlab platform.

  • identification of patients at risk for postoperative respiratory complications using a preoperative obstructive sleep apnea screening tool and postanesthesia care assessment
    Anesthesiology, 2009
    Co-Authors: Bhargavi Gali, Francis X Whalen, Darrell R Schroeder, David J Plevak
    Abstract:

    Background: Patients with obstructive sleep apnea are at risk for perioperative morbidity. The authors used a screening prediction model for obstructive sleep apnea to generate a sleep apnea clinical score (SACS) that identified patients at high or low risk for obstructive sleep apnea. This was combined with postanesthesia care unit (PACU) monitoring with the aim of identifying patients at high risk of postoperative oxygen Desaturation and respiratory complications. Methods: In this prospective cohort study, surgical patients with a hospital stay longer than 48 h who consented were enrolled. The SACS (high or low risk) was calculated; all patients were monitored in the PACU for recurrent episodes of bradypnea, apnea, Desaturations, and pain‐sedation mismatch. All patients underwent pulse oximetry postoperatively; complications were documented. Chi-square, two-sample t test, and logistic regression were used for analysis. The oxygen Desaturation index (number of Desaturations per hour) was calculated. Oxygen Desaturation index and incidence of postoperative cardiorespiratory complications were primary endpoints. Results: Six hundred ninety-three patients were enrolled. From multivariable logistic regression analysis, the likelihood of a postoperative oxygen Desaturation index greater than 10 was increased with a high SACS (odds ratio 1.9, P < 0.001) and recurrent PACU events (odds ratio 1.5, P 0.036). Postoperative respiratory events were also associated with a high SACS (odds ratio 3.5, P < 0.001) and recurrent PACU events (odds ratio 21.0, P < 0.001). Conclusions: Combination of an obstructive sleep apnea screening tool preoperatively (SACS) and recurrent PACU respiratory events was associated with a higher oxygen Desaturation index and postoperative respiratory complications. A two-phase process to identify patients at higher risk for perioperative respiratory Desaturations and complications may be useful to stratify and manage surgical patients postoperatively. PATIENTS with obstructive sleep apnea (OSA) are at risk for perioperative morbidity, and many patients who present for surgical procedures may have undiagnosed OSA. 1–5 In 1993, approximately 4% of men and 2% of

  • identification of patients at risk for postoperative respiratory complications using a preoperative obstructive sleep apnea screening tool and postanesthesia care assessment
    Anesthesiology, 2009
    Co-Authors: Bhargavi Gali, Francis X Whalen, Darrell R Schroeder, David J Plevak
    Abstract:

    Background: Patients with obstructive sleep apnea are at risk for perioperative morbidity. The authors used a screening prediction model for obstructive sleep apnea to generate a sleep apnea clinical score (SACS) that identified patients at high or low risk for obstructive sleep apnea. This was combined with postanesthesia care unit (PACU) monitoring with the aim of identifying patients at high risk of postoperative oxygen Desaturation and respiratory complications. Methods: In this prospective cohort study, surgical patients with a hospital stay longer than 48 h who consented were enrolled. The SACS (high or low risk) was calculated; all patients were monitored in the PACU for recurrent episodes of bradypnea, apnea, Desaturations, and pain‐sedation mismatch. All patients underwent pulse oximetry postoperatively; complications were documented. Chi-square, two-sample t test, and logistic regression were used for analysis. The oxygen Desaturation index (number of Desaturations per hour) was calculated. Oxygen Desaturation index and incidence of postoperative cardiorespiratory complications were primary endpoints. Results: Six hundred ninety-three patients were enrolled. From multivariable logistic regression analysis, the likelihood of a postoperative oxygen Desaturation index greater than 10 was increased with a high SACS (odds ratio 1.9, P < 0.001) and recurrent PACU events (odds ratio 1.5, P 0.036). Postoperative respiratory events were also associated with a high SACS (odds ratio 3.5, P < 0.001) and recurrent PACU events (odds ratio 21.0, P < 0.001). Conclusions: Combination of an obstructive sleep apnea screening tool preoperatively (SACS) and recurrent PACU respiratory events was associated with a higher oxygen Desaturation index and postoperative respiratory complications. A two-phase process to identify patients at higher risk for perioperative respiratory Desaturations and complications may be useful to stratify and manage surgical patients postoperatively. PATIENTS with obstructive sleep apnea (OSA) are at risk for perioperative morbidity, and many patients who present for surgical procedures may have undiagnosed OSA. 1–5 In 1993, approximately 4% of men and 2% of

Francis X Whalen - One of the best experts on this subject based on the ideXlab platform.

  • identification of patients at risk for postoperative respiratory complications using a preoperative obstructive sleep apnea screening tool and postanesthesia care assessment
    Anesthesiology, 2009
    Co-Authors: Bhargavi Gali, Francis X Whalen, Darrell R Schroeder, David J Plevak
    Abstract:

    Background: Patients with obstructive sleep apnea are at risk for perioperative morbidity. The authors used a screening prediction model for obstructive sleep apnea to generate a sleep apnea clinical score (SACS) that identified patients at high or low risk for obstructive sleep apnea. This was combined with postanesthesia care unit (PACU) monitoring with the aim of identifying patients at high risk of postoperative oxygen Desaturation and respiratory complications. Methods: In this prospective cohort study, surgical patients with a hospital stay longer than 48 h who consented were enrolled. The SACS (high or low risk) was calculated; all patients were monitored in the PACU for recurrent episodes of bradypnea, apnea, Desaturations, and pain‐sedation mismatch. All patients underwent pulse oximetry postoperatively; complications were documented. Chi-square, two-sample t test, and logistic regression were used for analysis. The oxygen Desaturation index (number of Desaturations per hour) was calculated. Oxygen Desaturation index and incidence of postoperative cardiorespiratory complications were primary endpoints. Results: Six hundred ninety-three patients were enrolled. From multivariable logistic regression analysis, the likelihood of a postoperative oxygen Desaturation index greater than 10 was increased with a high SACS (odds ratio 1.9, P < 0.001) and recurrent PACU events (odds ratio 1.5, P 0.036). Postoperative respiratory events were also associated with a high SACS (odds ratio 3.5, P < 0.001) and recurrent PACU events (odds ratio 21.0, P < 0.001). Conclusions: Combination of an obstructive sleep apnea screening tool preoperatively (SACS) and recurrent PACU respiratory events was associated with a higher oxygen Desaturation index and postoperative respiratory complications. A two-phase process to identify patients at higher risk for perioperative respiratory Desaturations and complications may be useful to stratify and manage surgical patients postoperatively. PATIENTS with obstructive sleep apnea (OSA) are at risk for perioperative morbidity, and many patients who present for surgical procedures may have undiagnosed OSA. 1–5 In 1993, approximately 4% of men and 2% of

  • identification of patients at risk for postoperative respiratory complications using a preoperative obstructive sleep apnea screening tool and postanesthesia care assessment
    Anesthesiology, 2009
    Co-Authors: Bhargavi Gali, Francis X Whalen, Darrell R Schroeder, David J Plevak
    Abstract:

    Background: Patients with obstructive sleep apnea are at risk for perioperative morbidity. The authors used a screening prediction model for obstructive sleep apnea to generate a sleep apnea clinical score (SACS) that identified patients at high or low risk for obstructive sleep apnea. This was combined with postanesthesia care unit (PACU) monitoring with the aim of identifying patients at high risk of postoperative oxygen Desaturation and respiratory complications. Methods: In this prospective cohort study, surgical patients with a hospital stay longer than 48 h who consented were enrolled. The SACS (high or low risk) was calculated; all patients were monitored in the PACU for recurrent episodes of bradypnea, apnea, Desaturations, and pain‐sedation mismatch. All patients underwent pulse oximetry postoperatively; complications were documented. Chi-square, two-sample t test, and logistic regression were used for analysis. The oxygen Desaturation index (number of Desaturations per hour) was calculated. Oxygen Desaturation index and incidence of postoperative cardiorespiratory complications were primary endpoints. Results: Six hundred ninety-three patients were enrolled. From multivariable logistic regression analysis, the likelihood of a postoperative oxygen Desaturation index greater than 10 was increased with a high SACS (odds ratio 1.9, P < 0.001) and recurrent PACU events (odds ratio 1.5, P 0.036). Postoperative respiratory events were also associated with a high SACS (odds ratio 3.5, P < 0.001) and recurrent PACU events (odds ratio 21.0, P < 0.001). Conclusions: Combination of an obstructive sleep apnea screening tool preoperatively (SACS) and recurrent PACU respiratory events was associated with a higher oxygen Desaturation index and postoperative respiratory complications. A two-phase process to identify patients at higher risk for perioperative respiratory Desaturations and complications may be useful to stratify and manage surgical patients postoperatively. PATIENTS with obstructive sleep apnea (OSA) are at risk for perioperative morbidity, and many patients who present for surgical procedures may have undiagnosed OSA. 1–5 In 1993, approximately 4% of men and 2% of