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risk of surgery in patients with obstructive sleep apnea

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https://www.readbyqxmd.com/read/28738388/updated-friedman-staging-system-for-obstructive-sleep-apnea
#1
Michael Friedman, Anna M Salapatas, Lauren B Bonzelaar
In the practice of sleep medicine, the first step is identification of those patients at high risk for sleep apnea. Nearly every physician and every hospital has preferred methods of screening. Many patient questionnaires or surveys as well as some objective physical measurements have been suggested to predict the presence of sleep apnea. Screening is well established, and laboratory and home testing are widely available. An early assessment with a physical examination can help direct treatment planning. The Friedman tongue position, lingual tonsil hypertrophy grading, and the effects of oral positioning on the hypopharynx should be used in early assessment for treatment planning, and as screening tools to assess the sight of obstruction...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738377/updated-nasal-surgery-for-obstructive-sleep-apnea
#2
David M Johnson, Ryan J Soose
Numerous studies report that difficulty breathing through the nose is associated with reduced sleep quality, increased daytime dysfunction, and increased risk of snoring and obstructive sleep apnea (OSA). Additionally, chronic nasal obstruction often complicates and limits successful medical device therapy for OSA, particularly with continuous positive airway pressure (CPAP). When medical evaluation and management of the nose is inadequate, surgical therapy to lower nasal resistance has been shown to substantially improve sleep and breathing outcome measures...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28715063/peripehral-artery-atherosclerotic-disease-and-sleep-disordered-breathing-paradise-trial-protocol-for-an-observational-cohort-study
#3
Filip M Szymański, Zbigniew Gałązka, Anna E Płatek, Dariusz Górko, Tomasz Ostrowski, Karolina Adamkiewicz, Paweł Łęgosz, Anna Ryś, Karolina Semczuk, Krzysztof Celejewski, Krzysztof J Filipiak
BACKGROUND: Peripheral arterial disease (PAD) is in fact a group of disease entities with different symptoms and course but a common underlying cause that is atherosclerosis. Atherosclerosis is known to be aggravated by several cardiovascular risk factors, including obstructive sleep apnea (OSA). AIM: Following paper is a protocol for Peripehral ARtery Atherosclerotic DIsease and SlEep disordered breathing (PARADISE) trial, which aims to describe the prevalence of OSA in PAD patients scheduled for revascularization and to determine the effect of OSA on the procedure outcomes...
July 17, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28682951/preoperatively-screened-obstructive-sleep-apnea-is-associated-with-worse-postoperative-outcomes-than-previously-diagnosed-obstructive-sleep-apnea
#4
Ana Fernandez-Bustamante, Karsten Bartels, Claudia Clavijo, Benjamin K Scott, Rachel Kacmar, Kenneth Bullard, Angela F D Moss, William Henderson, Elizabeth Juarez-Colunga, Leslie Jameson
BACKGROUND: Obstructive sleep apnea (OSA) affects up to 26% of US adults, is often undiagnosed, and increases perioperative morbidity. We hypothesized that patients screened on the day of surgery as moderate/high risk for OSA (S-OSA) present similar perioperative respiratory complications, hospital use, and mortality than patients with previously diagnosed OSA (D-OSA). Second, we hypothesized that both OSA groups have more respiratory complications than No-OSA patients. METHODS: The electronic medical database from 1 academic and 2 community hospitals was retrospectively queried to identify adults undergoing nonemergent inpatient surgery (January 1, 2012, to December 31, 2014)...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28675811/effects-of-expansion-sphincter-pharyngoplasty-on-the-apnea-hypopnea-index-and-heart-rate-variability
#5
Ahmet Emre Süslü, Gözde Pamuk, Ahmet Erim Pamuk, Serdar Özer, Shamkhal Jafarov, T Metin Önerci
PURPOSE: Heart rate variability (HRV) is a noninvasive and sensitive method used to evaluate autonomic function of the heart based on specific polysomnographic parameters. This study aimed to determine the effect of expansion sphincter pharyngoplasty (ESP) on HRV and the apnea-hypopnea index (AHI) in patients with obstructive sleep apnea (OSA). MATERIALS AND METHODS: This retrospective cohort study included patients who presented to the Department of Otorhinolaryngology, Hacettepe University Hospital (Ankara, Turkey), were diagnosed with OSA, and underwent ESP...
June 10, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28671280/impact-of-obstructive-sleep-apnea-in-transsphenoidal-pituitary-surgery-an-analysis-of-inpatient-data
#6
Sei Y Chung, Michael J Sylvester, Varesh R Patel, Michael Zaki, Soly Baredes, James K Liu, Jean Anderson Eloy
OBJECTIVES/HYPOTHESIS: Although previous studies have reported increased perioperative complications among obstructive sleep apnea (OSA) patients undergoing any surgery requiring general anesthesia, there is a paucity of literature addressing the impact of OSA on postoperative transsphenoidal surgery (TSS) complications. The aim of this study was to analyze postoperative outcomes in transsphenoidal pituitary surgery patients with OSA. Secondarily, we examined patient characteristics and comorbidities...
July 3, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28653474/single-triangular-suture-a-modified-technique-for-hyoid-suspension-as-a-treatment-for-obstructive-sleep-apnea-our-experience-with-twenty-four-patients
#7
Sherif M Askar, Mohammad Waheed El-Anwar, Hazem Saeed Amer, Ali Awad
1 Hyoid suspension is a part of a multilevel surgery concept that is often combined with other procedures as uvulopalatopharyngoplasty to treat obstructive sleep apnea. 2 Between February 2012 and November 2016, twenty- four patients underwent the single triangular suture technique for hyoid suspension as a treatment for obstructive sleep apnea. 3.Successful outcome was reported in 12 patients, while 9 patients were responders (reduced cardiovascular risk). 4.Postoperatively, the mean AHI dropped significantly and the mean lowest oxygen saturation level increased significantly...
June 27, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28648911/influence-of-bimaxillary-surgery-on-pharyngeal-airway-in-class-iii-deformities-and-effect-on-sleep-apnea-a-stop-bang-questionnaire-and-cone-beam-computed-tomography-study
#8
Narayan H Gandedkar, Chai Kiat Chng, Yong Chen Por, Vincent Kok Leng Yeow, Andrew Tjin Chiew Ow, Tian Ee Seah
PURPOSE: To evaluate pharyngeal airway space (PAS; nasopharyngeal, oropharyngeal, and total airway) volume and the correlation of an obstructive sleep apnea (OSA) and hypopnea syndrome screening questionnaire (STOP-BANG) with various mandibular setbacks during bimaxillary surgery and compare these findings with an age- and gender-matched skeletal Class I control group. PATIENTS AND METHODS: This retrospective cohort study was composed of patients with skeletal Class III discrepancy who underwent bimaxillary jaw surgery and were assessed with STOP-BANG score, cephalometry, and cone-beam computed tomography (of the PAS)...
June 1, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28623540/identification-of-surgical-patients-at-high-risk-of-osas-using-the-berlin-questionnaire-to-detect-potential-high-risk-of-adverse-respiratory-events-in-post-anesthesia-care-unit
#9
Fei Liu, Li Liu, Fang Zheng, Xiangdong Tang, Yongxin Bao, Yunxia Zuo
Obstructive sleep apnea syndrome (OSAS) increases the risk of post-surgery complications. This study uses Berlin Questionnaire (BQ) to identify Chinese adult surgical patients who are at a high risk of OSAS and to determine if the BQ could be used to detect potential high risk of adverse respiratory events in the post anesthesia care unit (PACU). Results indicated that only 11.4% of the patients were considered at a high risk of OSAS. Age and body mass index are the key factors for the risk of OSAS prevalence in China and also gender specific...
June 7, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28587728/incidence-of-children-at-risk-for-obstructive-sleep-apnea-undergoing-common-day-surgery-procedures
#10
Emma M Holmes, Heena H K Singh, Valerie G Kirk, Mary Brindle, Jeremy Luntley, Bryce A Weber, Warren K Yunker
OBJECTIVE: The purpose of this study was to evaluate the prevalence of sleep-related breathing disorders (SRBD) in children undergoing elective day surgery procedures. METHODS: A validated Pediatric Sleep Questionnaire (PSQ) was distributed to the parents of children aged 2months to 18 years who met inclusion criteria and were undergoing urologic, otolaryngologic, and general surgical day surgery procedures a 3-month period of time. The prevalence of children at risk for pediatric SRBD was determined from PSQ results...
May 28, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28549834/obstructive-sleep-apnea-the-effect-of-bariatric-surgery-after-12%C3%A2-months-a-prospective-multicenter-trial
#11
P Peromaa-Haavisto, H Tuomilehto, J Kössi, J Virtanen, M Luostarinen, J Pihlajamäki, P Käkelä, M Victorzon
BACKGROUND: Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder, particularly in bariatric patients. It is known to be tightly linked with metabolic abnormalities and cardiovascular morbidity. Obesity is the most noteworthy individual risk factor for OSA. The aim of this study was to investigate the effect of a laparoscopic Roux-en-Y gastric bypass (LRYGB) on OSA one year after surgery. METHODS: In this prospective multicenter study standard overnight cardiorespiratory recording was conducted 12 months after bariatric surgery in 132 patients who had OSA in the baseline recording prior to the operation...
July 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28544488/obstructive-sleep-apnea-in-down-syndrome-benefits-of-surgery-and-noninvasive-respiratory-support
#12
Benjamin Dudoignon, Alessandro Amaddeo, Annick Frapin, Briac Thierry, Livio de Sanctis, Jorge Olmo Arroyo, Sonia Khirani, Brigitte Fauroux
Children with Down syndrome are at increased risk of obstructive sleep apnea (OSA). The aim of the study was to describe the management of OSA in a large cohort of children with Down syndrome. A retrospective analysis of sleep studies and consequent management was performed for all consecutive Down syndrome patients evaluated between September 2013 and April 2016. The data of 57 patients were analyzed: 51/53 had an interpretable overnight polygraphy and 4 the recording of nocturnal gas exchange. Mean age at baseline sleep study was 6...
May 24, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28522085/blood-pressure-after-modified-uvulopalatopharyngoplasty-results-from-the-skup-3-randomized-controlled-trial
#13
Johan Fehrm, Danielle Friberg, Johan Bring, Nanna Browaldh
OBJECTIVE: Obstructive sleep apnea (OSA) is a risk factor for hypertension. The SKUP(3) study showed that modified uvulopalatopharyngoplasty (UPPP) significantly improved nocturnal respiration, sleepiness, and quality of life. The aim of this study was to evaluate the impact of surgery on blood pressure in patients with OSA. METHODS: We used a single-center randomized controlled trial to compare modified UPPP with controls at baseline and after six months. The controls received delayed surgery with an additional six-month follow-up...
June 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28508712/changing-rates-of-morbidity-and-mortality-in-obstructive-sleep-apnea-surgery
#14
Jacob J Friedman, Anna M Salapatas, Lauren B Bonzelaar, Michelle S Hwang, Michael Friedman
Objective Whereas uvulopalatopharyngoplasty (UPPP) was the standard surgical procedure for obstructive sleep apnea prior to 2007, multilevel surgery has become the standard since that time. This study compares morbidity and mortality rates of the stand-alone UPPP with those of multilevel sleep surgery that includes UPPP. Methods Patients undergoing UPPP between 2007 and 2014 were identified in the American College of Surgeons National Surgical Quality Improvement Program database. UPPP was defined by Current Procedural Terminology codes 42145 and 42950...
May 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28482650/obesity-and-perioperative-noninvasive-ventilation-in-bariatric-surgery
#15
Michele Carron, Francesco Zarantonello, Giovanna Ieppariello, Carlo Ori
The incidence and prevalence of obesity continues to increase globally. Physicians will therefore provide care for an increasing number of obese patients in their clinical practice. Optimal management of these patients is required to minimize the risk of perioperative complications that increase morbidity and mortality. Obesity affects the respiratory function. It is generally associated with reduced lung volume with increased atelectasis, decreased lung and chest wall compliance, increased airway resistance, and moderate to severe hypoxemia...
June 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28454600/sleep-and-breathing-the-first-night-after-adenotonsillectomy-in-obese-children-with-obstructive-sleep-apnea
#16
Aliva De, Temima Waltuch, Nathan J Gonik, Ngoc Nguyen-Famulare, Hiren Muzumdar, John P Bent, Carmen R Isasi, Sanghun Sin, Raanan Arens
STUDY OBJECTIVES: There are few studies measuring postoperative respiratory complications in obese children with obstructive sleep apnea (OSA) undergoing adenotonsillectomy (AT). These complications are further compounded by perioperative medications. Our objective was to study obese children with OSA for their respiratory characteristics and sleep architecture on the night of AT. METHODS: This was a prospective study at a tertiary pediatric hospital between January 2009-February 2012...
June 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28433385/perioperative-risks-of-narcolepsy-in-patients-undergoing-general-anesthesia-a-case-control-study
#17
Alexandre N Cavalcante, Ryan E Hofer, Maja Tippmann-Peikert, Juraj Sprung, Toby N Weingarten
STUDY OBJECTIVE: To compare the perioperative outcomes between patients with narcolepsy and matched controls undergoing anesthetic management. DESIGN: Retrospective 2:1 matched study design. SETTING: Large tertiary medical center. PATIENTS: Narcoleptic patients who underwent general anesthesia from January 1, 2011, through September 30, 2015, were matched with controls by age, sex, and type and year of surgery. MEASUREMENTS: Medical records were reviewed for episodes of respiratory depression during phase I recovery and for other meaningful perioperative outcomes...
April 19, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28396972/prevalence-and-associated-factors-of-obstructive-sleep-apnea-in-morbidly-obese-patients-undergoing-bariatric-surgery
#18
Weerapat Kositanurit, Dittapol Muntham, Suthep Udomsawaengsup, Naricha Chirakalwasan
PURPOSE: Our goal in this study is to determine the prevalence and associated factors of obstructive sleep apnea (OSA) in morbidly obese patients undergoing bariatric surgery. METHODS: This descriptive study was conducted at King Chulalongkorn Memorial Hospital from 2007 to 2015. Data of morbidly obese patients who underwent bariatric surgery were included using ICD-10 code for principle diagnosis "morbid obesity" (E668) and ICD-9 code for "bariatric surgery" (4389, 4438, 4439)...
April 11, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28395291/undiagnosed-obstructive-sleep-apnea-and-postoperative-outcomes-a-prospective-observational-study
#19
Uma Devaraj, Srinivas Rajagopala, Ajay Kumar, Priya Ramachandran, Philip J Devereaux, George A D'Souza
BACKGROUND: The prevalence of undiagnosed obstructive sleep apnea (OSA) during preoperative evaluation and the best method to screen OSA and its association with postoperative complications remain unclear. OBJECTIVES: To determine the prevalence of undiagnosed OSA in preoperative Indian patients undergoing noncardiac surgery, to compare the diagnostic accuracy of the STOP-BANG questionnaire to a preoperative level III sleep study, and to assess the association of OSA with postoperative complications...
2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28372953/noninvasive-positive-pressure-ventilation-in-the-immediate-post-bariatric-surgery-care-of-patients-with-obstructive-sleep-apnea-a-systematic-review
#20
REVIEW
Solomon Tong, Jonathan Gower, Austin Morgan, Kyle Gadbois, Gordon Wisbach
BACKGROUND: Obstructive sleep apnea is common in morbidly obese patients, and noninvasive positive pressure ventilation (NIPPV) is the standard treatment. Postoperatively, NIPPV is highly effective in preventing hypoxia and apneic episodes; however, the concern of gastric distention leading to increased risk of an anastomotic dehiscence limits universal acceptance. OBJECTIVE: To perform a systematic review of the literature to determine if the use of NIPPV during immediate post-bariatric surgery care is safe...
February 20, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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