Sleep Study and Oximetry Parameters for Predicting Postoperative Complications in Patients With OSA

Abstract

In the surgical setting, OSA is associated with an increased risk of postoperative complications. At present, risk stratification using OSA-associated parameters derived from polysomnography

Digital oximetry biomarkers for assessing respiratory function: standards of measurement, physiological interpretation, and clinical use

“…arterial hypertension, atrial fibrillation, increased insulin resistance, higher incidence of lung cancer, and worst prognosis after myocardial infarction, as well as higher risk of post-surgery complications in OSA patients 17 . However, it remains very unclear which oximetric biomarkers (or combinations of biomarkers) are most predictive of clinical endpoints, such as metabolic and cardiovascular diseases.…”

Preoperative identification of children at high risk of obstructive sleep apnea

“…Commonly used indices to measure nocturnal hypoxemia include the oxygen desaturation index (ODI), mean oxygen saturation (mean SpO 2 ), lowest value of oxygen saturation (SpO 2 nadir), and proportion of time spent with oxygen saturation <90% (T90). In contrast to the adult population, there is only limited evidence in pediatric populations on the association between postoperative complications and mean nocturnal SpO 2 or T90 …”

“…There has been a recent interest in ODI and its value in management of OSA . ODI is defined as the number of events where the SpO 2 decreases by 3% (ODI3) or 4% (ODI4) from baseline level per hour.…”

Pulse-ox paradox: potential versus pitfalls of pulse oximetry monitoring in surgical patients with obstructive sleep apnea

“…Currently, much of the evidence linking OSA to perioperative complications is in relation to nocturnal hypoxemia. 11 In a recent prospective cohort study of 1,218 patients undergoing elective non-cardiac surgery, severe undiagnosed OSA was associated with a two-fold increased risk of cardiovascular complications (adjusted hazard ratio, 2.23) and longer duration of hypoxemia. 5 As well, the mean cumulative duration of SpO 2 \ 80% during the first three postoperative nights for patients with cardiovascular complications was increased compared with patients with no cardiovascular complications (23.1 [95% confidence interval (CI), 15.5 to 27.7] min vs 10.2 [95% CI, 7.8 to 10.9] min).…”

“…À l'heure actuelle, la plupart des données probantes associant l'AOS à des complications périopératoires sont liées à l'hypoxémie nocturne. 11 Dans une étude de cohorte prospective récente portant sur 1218 patients subissant une chirurgie non cardiaque et non urgente, une AOS grave non diagnostiquée était associée à un risque doublé de complications cardiovasculaires (rapport de risque ajusté, 2,23) et une durée prolongée de l'hypoxémie. 5 En outre, la durée moyenne cumulée de SpO 2 \ 80 % pendant les trois premières nuits postopératoires chez les patients souffrant de complications cardiovasculaires était plus importante que celle des patients n'ayant pas subi de complications cardiovasculaires (23,1 [intervalle de confiance (IC) 95 %, 15,5 à 27,7] min vs 10,2 [IC 95 %, 7,8 à 10,9] min).…”