Nasal Continuous Positive Airway Pressure in the Perioperative Management of Patients With Obstructive Sleep Apnea Submitted to Surgery

Rennotte, Marie-Thérèse; Baele, Philippe; Aubert, Geneviève; Rodenstein, Daniel

doi:10.1378/chest.107.2.367

Cited by 193 publications

(93 citation statements)

References 24 publications

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“…Opioid-free anaesthesia with a preference of regional anaesthesia (using local anaesthetics) and the use of minimally invasive procedures is recommended. Prophylactic nasal BiPAP/NIV for 24-48 h postoperatively has been shown to reduce risk of respiratory complications [227]. At least, prophylactic initiation of BiPAP in sitting/semi-sitting position along with intensive monitoring for first 24 h is recommended in these patients.…”

Section: B) Obese Patients With Osamentioning

confidence: 99%

Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

et al. 2016

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Background During the last two decades, an increasing number of bariatric surgical procedures have been performed worldwide. There is no consensus regarding optimal perioperative care in bariatric surgery. This review aims to present such a consensus and to provide graded recommendations for elements in an evidence-based ''enhanced'' perioperative protocol. Methods The English-language literature between January 1966 and January 2015 was searched, with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohort studies. Selected studies were examined, reviewed and graded. After critical appraisal of these studies, the group of authors reached a consensus recommendation. Results Although for some elements, recommendations are extrapolated from non-bariatric settings (mainly colorectal), most recommendations are based on good-quality trials or meta-analyses of good-quality trials. Conclusions A comprehensive evidence-based consensus was reached and is presented in this review by the enhanced recovery after surgery (ERAS) Society. The guidelines were endorsed by the International Association for Surgical Metabolism and Nutrition (IASMEN) and based on the evidence available in the literature for each of the elements of the multimodal perioperative care pathway for patients undergoing bariatric surgery.

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Section: B) Obese Patients With Osamentioning

confidence: 99%

Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

et al. 2016

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“…With early case reports documenting deaths in OSA patients following surgery [5,120], and the legal literature describing this as well [121], it has been assumed that, through the mechanisms discussed above, OSA would be associated with increased postoperative mortality. However, more recent research suggests this remains an unsettled issue.…”

Section: Mortalitymentioning

confidence: 99%

“…Recently, more acute clinical consequences related to OSA have garnered interest, particularly regarding the impact of OSA on outcomes in individuals subjected to the surgical environment, where a multitude of perioperative factors, including anesthetics and opioids, can affect breathing. Initially, case series in the 1990s [5,6] described postoperative respiratory complications in patients with OSA. Subsequently, a number of controlled studies have found a range of perioperative complications to be associated with a diagnosis of OSA, though the strength of the associations and the quality of data vary considerably.…”

Section: Introductionmentioning

confidence: 99%

Perioperative Complications in Obstructive Sleep Apnea Patients

Auckley

2016

Curr Sleep Medicine Rep

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Obstructive sleep apnea (OSA) is growing in prevalence though it still remains significantly underdiagnosed. Preoperative screening for OSA is taking place in many institutions, with a substantial number of patients being identified as having a high probability for OSA just prior to undergoing surgery. Emerging data increasingly demonstrates that patients with a high probability of having OSA as well as those with a known diagnosis of OSA may be at increased risk for developing complications in the perioperative setting. Postoperative cardiac and pulmonary adverse events appear to occur more frequently in these patients though the impact OSA has on postoperative mortality is controversial. In addition, determining which patients are at greatest risk remains an area of uncertainty. This chapter will review the current state of the knowledge regarding OSA as a risk factor for perioperative complications.

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“…While Ramachandran et al found that 83% of home CPAP users brought their machines into hospital [48], Liao et al found that only 49% actually received CPAP postoperatively [46]. Drummond et al have questioned the utility of 'routine' postoperative CPAP on the grounds that pre-operative CPAP settings may not be adequate in the postoperative setting, and respiratory therapists may be needed to titrate the appropriate CPAP level [51,52]. Importantly, though, Rennotte et al reported a reduction in postoperative complications in patients who used CPAP therapy preoperatively, upon extubation, and continuously 24-48 h after surgery [52].…”

Section: Hypoxaemia During Recovery From Anaesthesiamentioning

confidence: 99%

Hypoxia: developments in basic science, physiology and clinical studies

2011

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SummaryAirway management is primarily designed to avoid hypoxia, yet hypoxia remains the main ultimate cause of anaesthetic‐related death and morbidity. Understanding some of the physiology of hypoxia is therefore essential as part of a ‘holistic’ approach to airway management. Furthermore, it is strategically important that national specialist societies dedicated to airway management do not only focus upon the technical aspects of airway management, but also embrace some of the relevant scientific questions. There has been a great deal of research into causation of hypoxia and the body’s natural protective mechanisms and responses to it. This enables us to think of ways in which we might manipulate the cellular and molecular responses to confer greater protection against hypoxia‐induced tissue injury. This article reviews some of those aspects.

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Nasal Continuous Positive Airway Pressure in the Perioperative Management of Patients With Obstructive Sleep Apnea Submitted to Surgery

Cited by 193 publications

References 24 publications

Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

Perioperative Complications in Obstructive Sleep Apnea Patients

Hypoxia: developments in basic science, physiology and clinical studies

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