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risk of surgery in patients with obstructive sleep apnea

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https://www.readbyqxmd.com/read/29753541/24-hour-ambulatory-blood-pressure-after-adenotonsillectomy-in-childhood-sleep-apnea
#1
Wei-Chung Hsu, Kun-Tai Kang, Shuenn-Nan Chiu, Wen-Chin Weng, Pei-Lin Lee, Che-Yi Lin
OBJECTIVE: To assess the effects of adenotonsillectomy (T&A) on ambulatory blood pressure (ABP) in childhood obstructive sleep apnea (OSA). STUDY DESIGN: From 2012 to 2017, children aged 4-16 years with symptoms and polysomnography-diagnosed OSA (apnea-hypopnea index [AHI] >1) underwent T&A. PSG studies and 24-hour ABP monitoring were performed before and at 3 months after surgery. RESULTS: In total, 159 children were enrolled (mean age, 7...
May 9, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29749570/validation-of-a-photoplethysmography-device-for-detection-of-obstructive-sleep-apnea-in-the-perioperative-setting
#2
Philipp Faßbender, Ali Haddad, Silja Bürgener, Jürgen Peters
Obstructive sleep apnea (OSA) is a risk factor for perioperative complications, but many OSA patients present undiagnosed. While polysomnography (PSG) is the "gold standard" for diagnosis, its application is technology-intense, time-consuming, expensive, and requires specialists, often delaying surgery. Thus, miniaturized devices were developed for OSA screening aimed at ruling out major OSA while measuring a lesser number of biological signals. We evaluated the accuracy of a photoplethysmography (PPG)-based device for OSA detection...
May 10, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29709333/gender-differences-in-morphological-and-functional-outcomes-after-mandibular-setback-surgery
#3
Khaled Dahy, Katsu Takahashi, Kazuyuki Saito, Honoka Kiso, Ibrahim Rezk, Toru Oga, Ryuji Uozumi, Kazuo Chin, Kazuhisa Bessho
PURPOSE: The aim of this study was to examine and compare morphological and functional outcomes after either isolated mandibular setback or bimaxillary surgery in males and females. MATERIALS AND METHODS: A retrospective study was done on 52 patients, in whom surgical correction for mandibular prognathism was performed either by isolated mandibular setback (30 cases) or by bimaxillary surgery (22 cases). Morphological changes were studied using cephalograms and functional changes studied using impulse oscillometry (IOS) taken before surgery (T0), 3 months (T1) and 1 year after surgery (T2)...
April 11, 2018: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29703506/safety-and-short-term-outcomes-of-laparoscopic-sleeve-gastrectomy-for-patients-over-65-years-old-with-severe-obesity
#4
Panagiotis Lainas, Carmelisa Dammaro, Martin Gaillard, Gianfranco Donatelli, Hadrien Tranchart, Ibrahim Dagher
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is a widely accepted, stand-alone bariatric operation. Data on elderly patients undergoing LSG are scarce. OBJECTIVES: The aim of this study was to demonstrate that LSG is safe and effective for patients>65 years old with severe obesity. SETTING: Department of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, AP-HP, Paris-Saclay University, France. METHODS: Prospectively collected data from consecutive patients undergoing LSG were retrospectively analyzed...
March 8, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29701869/obstructive-sleep-apnea-and-the-impact-on-surgical-outcomes-in-gynecology
#5
Erin E Medlin, Laurel W Rice, Ahmed Al-Niaimi
Importance: Obstructive sleep apnea syndrome (OSAS) is a common medical condition in the United States and affects gynecologic surgical outcomes. Objective: The aim of this review was to improve perioperative diagnosis and management of OSAS in patients presenting for gynecologic surgery and ultimately improve perioperative outcomes. The role of preoperative evaluation and screening is also addressed. Evidence Acquisition: Medical databases were queried for publications pertaining to OSAS complications, risk factors, screening, and perioperative management...
April 2018: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/29688821/risk-of-postoperative-complications-in-patients-with-obstructive-sleep-apnea-following-skull-base-surgery
#6
Phillip Huyett, Ryan J Soose, Amy E Schell, Juan C Fernandez-Miranda, Paul A Gardner, Carl H Snyderman, Eric W Wang
Objectives Obstructive sleep apnea (OSA) presents several challenges in skull base surgery, including increased intracranial pressure, worsened OSA with nasal packing, and avoidance of positive airway pressure (PAP) therapy postoperatively. The objective of this study was to examine the risk of postoperative complications in a skull base population with OSA in which PAP therapy is withheld. Study Design Retrospective cohort study. Setting Tertiary care hospital. Subjects and Methods Medical records of 414 adult patients undergoing anterior skull base procedures between January 1, 2014, and January 7, 2017, were retrospectively reviewed...
April 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29680418/uvulopalatopharyngoplasty-reduces-the-incidence-of-cardiovascular-complications-caused-by-obstructive-sleep-apnea-results-from-the-national-insurance-service-survey-2007-2014
#7
Heung Man Lee, Hyo Yeol Kim, Jeffrey D Suh, Kyung-Do Han, Jin Kook Kim, Young Chang Lim, Seok-Chan Hong, Jae Hoon Cho
OBJECTIVE: Untreated obstructive sleep apnea (OSA) is a risk factor for cardiovascular disease including myocardial infarction (MI), congestive heart failure (CHF), and atrial fibrillation (AF). Continuous positive airway pressure (CPAP) is an effective treatment for OSA; however, compliance with CPAP can be challenging for some patients. The objective of this study was to investigate whether uvulopalatopharyngoplasty (UPPP) reduced the risk of cardiovascular complications for patients with OSA...
May 2018: Sleep Medicine
https://www.readbyqxmd.com/read/29616468/prevalence-and-prediction-of-obstructive-sleep-apnea-prior-to-bariatric-surgery-gender-specific-performance-of-four-sleep-questionnaires
#8
Christian M Horvath, Juri Jossen, Dino Kröll, Philipp C Nett, Florent Baty, Anne-Kathrin Brill, Sebastian R Ott
PURPOSE: Bariatric surgery (BS) is a treatment option for morbid obesity leading to substantial and sustained weight loss in adults. As obstructive sleep apnea (OSA) is highly prevalent in obese subjects and may increase the perioperative risk, screening for OSA is recommended prior to BS. In clinical routine, BS is performed more frequently in women. Therefore, we sought to assess the gender-specific performance of four sleep questionnaires (Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), STOPBang, and NoSAS) to predict moderate to severe OSA in the morbidly obese population...
April 4, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29616465/incidence-indications-and-predictive-factors-for-icu-admission-in-elderly-high-risk-patients-undergoing-laparoscopic-sleeve-gastrectomy
#9
Nesreen Khidir, Moamena El-Matbouly, Mohammed Al Kuwari, Michel Gagner, Moataz Bashah
BACKGROUND: Obesity affects the elderly, leading to increased prevalence of age- and obesity-associated comorbidities. There are no guidelines for indications and risk assessment for the elderly undergoing bariatric surgery. OBJECTIVES: To determine the incidence, indications, and outcomes of planned ICU admission in elderly, high-risk patients after laparoscopic sleeve gastrectomy (LSG) and to assess if preoperative risk factors for planned postoperative ICU admission in elderly patients undergoing LSG could be predicted preoperatively...
April 3, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29609909/-why-is-the-morbidly-obese-patient-at-high-risk-of-anesthetic-complications
#10
Audrey De Jong, Daniel Verzilli, Marie Geniez, Gérald Chanques, David Nocca, Samir Jaber
Obesity is often associated with obstructive sleep apnea (OSA), which increases the risk of intraoperative and postoperative complications. The role of preoperative screening of OSA is crucial, with adequate management based on continuous positive pressure before, during and after surgery. The obese patient is at risk of postoperative complications: difficult airway management, acute respiratory failure following extubation due to atelectasis and airway obstruction, added to morphine overdosing. Optimal management of difficult mask ventilation and intubation, protective ventilation, combined to the reduction of sedatives and analgesics and the sitting position as soon as possible with a postoperative monitoring should decrease the occurrence of complications...
March 30, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29598850/evaluation-of-risk-factors-for-complications-after-bariatric-surgery
#11
D Quilliot, M-A Sirveaux, C Nomine-Criqui, T Fouquet, N Reibel, L Brunaud
The decision to perform a bariatric surgical procedure, the conclusion of a clinical pathway in which management is individually adapted to each patient, is taken after multidisciplinary consultation. Paradoxically, the patients who would most benefit from surgery are also those who have the highest operative risk. In practice, predictive factors of mortality and severe postoperative complications (Clavien-Dindo>III) must be used to evaluate the benefit/risk ratio most objectively. The main risk factors are age, male gender, body mass index, obstructive sleep apnea syndrome, insulin resistance and diabetes, tobacco abuse, cardiovascular disease, ability to lose weight before surgery, hypoalbuminemia and functional disability...
March 26, 2018: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29533258/patients-at-high-risk-for-obstructive-sleep-apnea-are-at-increased-risk-for-atrial-fibrillation-after-cardiac-surgery-a-cohort-analysis
#12
Nika Karimi, Marta Kelava, Perin Kothari, Nicole M Zimmerman, A Marc Gillinov, Andra E Duncan
BACKGROUND: Patients with obstructive sleep apnea (OSA) experience intermittent hypoxia, hypercarbia, and sympathetic activation during sleep, which increases risk for paroxysmal atrial fibrillation and other cardiac arrhythmias. Whether patients with OSA experience increased episodes of atrial fibrillation after cardiac surgery is unclear. We examined whether patients at increased risk for OSA, assessed by the STOP-BANG (snoring, tired during the day, observed stop breathing during sleep, high blood pressure, body mass index more than 35 kg/m, age more than 50 years, neck circumference more than 40 cm, and male gender) questionnaire, had a higher incidence of new-onset postoperative atrial fibrillation after cardiac surgery...
March 12, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29518206/the-science-of-obesity-management-an-endocrine-society-scientific-statement
#13
George A Bray, William E Heisel, Ashkan Afshin, Michael D Jensen, William H Dietz, Michael Long, Robert F Kushner, Stephen R Daniels, Thomas A Wadden, Adam G Tsai, Frank B Hu, John M Jakicic, Donna H Ryan, Bruce M Wolfe, Thomas H Inge
The prevalence of obesity, measured by body mass index, has risen to unacceptable levels in both men and women in the United States and worldwide with resultant hazardous health implications. Genetic, environmental, and behavioral factors influence the development of obesity, and both the general public and health professionals stigmatize those who suffer from the disease. Obesity is associated with and contributes to a shortened life span, type 2 diabetes mellitus, cardiovascular disease, some cancers, kidney disease, obstructive sleep apnea, gout, osteoarthritis, and hepatobiliary disease, among others...
April 1, 2018: Endocrine Reviews
https://www.readbyqxmd.com/read/29492464/a-retrospective-analysis-on-patients-at-high-risk-for-obstructive-sleep-apnea-undergoing-ear-nose-and-throat-surgeries
#14
Karina Woodling, Juan Fiorda-Diaz, Bradley A Otto, Christie A Barnes, Alberto A Uribe, Sergio D Bergese, Vedat Yildiz, Nicoleta Stoicea, Michael G Guertin
Background: Obstructive sleep apnea (OSA) may be related to episodes of oxygen de-saturation, hypercapnia, cardiovascular dysfunction, cor-pulmonale, and pulmonary hypertension. STOP-BANG is an acronym for eight specific questions used to assess the likelihood of OSA. If the individual exhibits three or more of these indicators, he/she should be considered to be at high risk for OSA complications. Therefore, the decision of proceeding with inpatient versus outpatient ENT surgery still remains controversial...
February 2018: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29460195/high-risk-for-obstructive-sleep-apnea-hypopnea-syndrome-predicts-new-onset-atrial-fibrillation-after-cardiac-surgery-a-retrospective-analysis
#15
Samir V Patel, Harmeet Gill, Diwas Shahi, Ajai Rajabalan, Palak Patel, Rajesh Sonani, Parth Bhatt, Rafael David Rodriguez, Manuel Bautista, Abhishek Deshmukh, Juan Viles Gonzalez, Sanjay Patel
PURPOSE: Obstructive sleep apnea hypopnea syndrome (OSAHS) is highly prevalent in patients undergoing coronary artery bypass surgery (CABG). OSAHS is a risk factor for the development of atrial fibrillation (AF), but the risk of AF in patients who are high risk for OSAHS is unclear. METHODS: A retrospective study was conducted on consecutive patients undergoing CABG from 2013 to 2015 without AF pre-operatively. Patients were categorized as low risk for OSAHS, high risk for OSAHS, or diagnosed OSAHS based on medical records review...
February 19, 2018: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29458741/sleep-disordered-breathing-is-associated-with-disturbed-cardiac-repolarization-in-patients-with-a-coronary-artery-bypass-graft-surgery
#16
Christina Schmidleitner, Michael Arzt, Maria Tafelmeier, Sarah Ripfel, Miriam Fauser, Teresa Weizenegger, Bernhard Flörchinger, Daniele Camboni, Sigrid Wittmann, Florian Zeman, Christof Schmid, Lars S Maier, Stefan Wagner, Christoph Fisser
BACKGROUND: The development of malignant ventricular arrhythmias due to abnormal cardiac repolarization is a major complication after coronary artery bypass graft surgery (CABG). Sleep-disordered breathing (SDB) is linked to prolonged cardiac repolarization in non-surgical patients. This study evaluates cardiac repolarization in patients with and without SDB who underwent CABG. METHODS: 100 patients who had received CABG (84% men, age 68 ± 10 years, body-mass-index [BMI] 28...
February 2018: Sleep Medicine
https://www.readbyqxmd.com/read/29409812/effects-of-obesity-therapies-on-sleep-disorders
#17
Melissa S Xanthopoulos, Robert I Berkowitz, Ignacio E Tapia
Obesity is a significant risk factor for obstructive sleep apnea syndrome (OSAS), and has also been linked to reductions in sleep quality and quantity. Weight loss has been shown to be an effective treatment for improving OSAS; however, there is a high degree of variability in improvements of OSAS in response to weight loss. There are three modalities of obesity therapies: 1) lifestyle modification, which includes changes in dietary intake and physical activity, along with behavioral interventions; 2) pharmacologic agents; and 3) bariatric surgery...
February 1, 2018: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/29397339/sleep-snoring-and-surgery-osa-screening-matters
#18
Connie Hardy Tabet, Kathy Lopez-Bushnell
PURPOSE: This study was aimed to identify potential obstructive sleep apnea (OSA) in ambulatory surgical patients and create perianesthesia nursing protocols using a reliable and validated screening tool. DESIGN: Descriptive survey. METHODS: A nurse-initiated OSA survey was conducted in 1,118 preoperative ambulatory patients using the STOP-Bang Questionnaire to identify patients at risk for OSA. The findings resulted in the development of protocols, patient education, and interventions...
January 31, 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29374469/perioperative-incidence-of-airway-obstructive-and-hypoxemic-events-in-patients-with-confirmed-or-suspected-sleep-apnea-a-prospective-randomized-pilot-study-comparing-propofol-remifentanil-and-sevoflurane-remifentanil-anesthesia
#19
Philipp Fassbender, Silja Bürgener, Ali Haddad, Marie-Therese Silvanus, Jürgen Peters
BACKGROUND: Obstructive sleep apnea (OSA) is a risk factor for perioperative complications but data on anesthesia regimen are scarce. METHODS: In patients with established or strongly suspected OSA, we assessed in a prospective, randomized design the effects on nocturnal apnea-hypopnea-index (AHI) and oxygen saturation (SpO2 ) of propofol/remifentanil or sevoflurane/remifentanil based anesthesia. Patients were selected by a history for OSA and / or a positive STOP - questionnaire and received general anesthesia using remifentanil (12 μg/kg/h) combined either with propofol (4-6 mg/kg/h, n = 27) or sevoflurane (approx...
January 27, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29362042/implementing-microstream-end-tidal-co-2-in-the-pacu
#20
Kimberly Latham, Tamera Bird, Joyce Burke
Managing patients with undiagnosed Obstructive Sleep Apnea (OSA) can be a challenge in the postoperative phase. OSA is a chronic disease defined by pauses in breathing that are repetitive during sleep that can last for one minute or longer. This can occur more than five times in an hour. As many as 80-90% of patients undergoing elective surgery have undiagnosed sleep apnea and an increased risk of respiratory complications postoperatively. Capnography is a monitoring tool that can detect increases in end-tidal carbon dioxide levels, which is a sign of respiratory decline...
February 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
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