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Perioperative CPAP

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https://www.readbyqxmd.com/read/29530778/a-multidisciplinary-protocol-driven-approach-to-improve-extubation-times-after-cardiac-surgery
#1
Joshua L Chan, Justin G Miller, Mandy Murphy, Ann Greenberg, Margaret Iraola, Keith A Horvath
BACKGROUND: Prolonged intubation after cardiac surgery is associated with significant morbidity. A fast-track extubation protocol primarily driven by bedside providers was instituted for all postoperative cardiac surgery patients to facilitate safe and expeditious extubation. METHODS: A retrospective review of 1,581 cardiac surgery patients over an 8-year period was performed. Before 2011, nonprotocolized standard perioperative management was utilized (n = 807)...
March 9, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29423766/the-patient-s-perioperative-perspective-during-the-treatment-of-obstructive-sleep-apnea-a-pilot-study
#2
Megan A Rudolph, Janine M Rotsides, Philip E Zapanta
PURPOSE: This study aims to determine patients' pre-operative and post-operative experiences relating to surgical treatment for obstructive sleep apnea (OSA), while understanding how patients' perceptions influence their outcome and satisfaction. METHODS: This is a phenomenological qualitative study using a semi-structured interview to evaluate patients who failed continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea and underwent airway surgery...
February 8, 2018: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29371130/individualised-perioperative-open-lung-approach-versus-standard-protective-ventilation-in-abdominal-surgery-iprove-a-randomised-controlled-trial
#3
Carlos Ferrando, Marina Soro, Carmen Unzueta, Fernando Suarez-Sipmann, Jaume Canet, Julián Librero, Natividad Pozo, Salvador Peiró, Alicia Llombart, Irene León, Inmaculada India, Cesar Aldecoa, Oscar Díaz-Cambronero, David Pestaña, Francisco J Redondo, Ignacio Garutti, Jaume Balust, Jose I García, Maite Ibáñez, Manuel Granell, Aurelio Rodríguez, Lucía Gallego, Manuel de la Matta, Rafael Gonzalez, Andrea Brunelli, Javier García, Lucas Rovira, Francisco Barrios, Vicente Torres, Samuel Hernández, Estefanía Gracia, Marta Giné, María García, Nuria García, Lisset Miguel, Sergio Sánchez, Patricia Piñeiro, Roger Pujol, Santiago García-Del-Valle, José Valdivia, María J Hernández, Oto Padrón, Ana Colás, Jaume Puig, Gonzalo Azparren, Gerardo Tusman, Jesús Villar, Javier Belda
BACKGROUND: The effects of individualised perioperative lung-protective ventilation (based on the open-lung approach [OLA]) on postoperative complications is unknown. We aimed to investigate the effects of intraoperative and postoperative ventilatory management in patients scheduled for abdominal surgery, compared with standard protective ventilation. METHODS: We did this prospective, multicentre, randomised controlled trial in 21 teaching hospitals in Spain. We enrolled patients who were aged 18 years or older, were scheduled to have abdominal surgery with an expected time of longer than 2 h, had intermediate-to-high-risk of developing postoperative pulmonary complications, and who had a body-mass index less than 35 kg/m2 ...
March 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29362043/obstructive-sleep-apnea-emphasis-on-discharge-education-after-surgery
#4
Arbert Nazareno, Cresilda Newsom, Esther Lee, Joseph Burkard
In the United States, the prevalence of obstructive sleep apnea (OSA) in the adult population is increasing. More than half of the surgical patients with OSA are predisposed to increased incidence of perioperative complications. Based on the recent evidence, obstructive events are at the highest on the third day after surgery, which predisposes them for postoperative complications. The American Society of Perianesthesia Nurses recommends that discharge education on OSA should be provided after surgery to patients diagnosed with OSA to promote continuous positive airway pressure (CPAP) compliance and self-care behaviors at home...
February 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29339545/perioperative-implementation-of-noninvasive-positive-airway-pressure-therapies
#5
REVIEW
David R Hillman, Carla R Jungquist, Dennis Auckley
Noninvasively applied positive airway pressure therapy (PAP) is available in 3 basic modes: continuous positive airway pressure (CPAP), bi-level positive airway pressure (BPAP), and adaptive servo-ventilation. These are in widespread use in home and hospital settings to treat a variety of disorders of ventilation or gas exchange, including obstructive sleep apnea, sleep-related hypoventilation, periodic breathing, acute and chronic hypercapnic respiratory failure, and acute respiratory failure. They are increasingly being used perioperatively to prevent or treat upper airway obstruction, hypoventilation, and periodic breathing, and they have been found to improve postoperative outcomes in the case of obstructive sleep apnea...
April 2018: Respiratory Care
https://www.readbyqxmd.com/read/29176373/obstructive-sleep-apnea-and-bariatric-surgical-guidelines-summary-and-update
#6
Christel A L de Raaff, Nico de Vries, Bart A van Wagensveld
PURPOSE OF REVIEW: Increasing numbers of bariatric surgical procedures and the high prevalence of obstructive sleep apnea (OSA) in this population have resulted in a growing interest in the perioperative management of OSA in bariatric surgery. This review provides a summary of the first consensus guideline on this topic as well as an update of the newest literature available. RECENT FINDINGS: All bariatric patients should be screened for OSA and obesity hypoventilation syndrome (OHS) to reduce the risk of perioperative complications...
February 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29175283/influence-of-continuous-positive-airway-pressure-on-postoperative-leakage-in-bariatric-surgery
#7
Christel A L de Raaff, Marianne C Kalff, Usha K Coblijn, Claire E E de Vries, Nico de Vries, H Jaap Bonjer, Bart A van Wagensveld
BACKGROUND: Obstructive sleep apnea (OSA) affects two third of morbidly obese individuals undergoing bariatric surgery. Perioperative usage of continuous positive airway pressure (CPAP) is advised for moderately and severe OSA to avoid respiratory failure and cardiac events. CPAP increases the air pressure in the upper airway, but also may elevate the air pressure in the esophagus and stomach. Concern exists that this predisposes to mechanical stress resulting in suture or staple line disruption (further referred to as suture line disruption)...
February 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29171131/cpap-by-helmet-for-treatment-of-acute-respiratory-failure-after-pediatric-liver-transplantation
#8
F Chiusolo, V Fanelli, M L Ciofi Degli Atti, G Conti, F Tortora, R Pariante, L Ravà, C Grimaldi, J de Ville de Goyet, S Picardo
ARF after pediatric liver transplantation accounts for high rate of morbidity and mortality associated with this procedure. The role of CPAP in postoperative period is still unknown. The aim of the study was to describe current practice and risk factors associated with the application of helmet CPAP. In this retrospective observational cohort study, 119 recipients were divided into two groups based on indication to CPAP after extubation. Perioperative variables were studied, and determinants of CPAP application were analyzed in a multivariate logistic model...
February 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29077813/death-or-near-death-in-patients-with-obstructive-sleep-apnoea-a-compendium-of-case-reports-of-critical-complications
#9
Y Subramani, M Nagappa, J Wong, J Patra, F Chung
The care of surgical patients with obstructive sleep apnoea (OSA) invokes concerns with safety and liability because of the risk that exists for perioperative death or near-death. The purpose of this review is to analyse the available literature to identify risk factors for perioperative critical complications in patients with OSA. Literature reports were screened for life threatening complications and deaths in surgical patients with OSA. The critical complications were sub-grouped as death/near-death events (death and anoxic brain damage) vs critical respiratory events (CRE)/other events and analysed for various risk factors...
November 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29075982/pterygomandibular-suspension-suture-a-simple-modification-of-uvulopalatopharyngoplasty-for-severe-obstructive-sleep-apnea
#10
Yen-Ting Lu, Shyh-Kuan Tai, Tsung-Lun Lee
BACKGROUNDS: The aim of this study is to introduce pterygomandibular suspension suture as a simple modification of uvulopalatopharyngoplasty for severe obstructive sleep apnea in dealing with lateral pharyngeal wall and retropalatal space collapse. METHODS: This retrospective study was conducted at Taipei Veterans General Hospital, Taiwan. Ten adult patients underwent modified uvulopalatopharyngoplasty with pterygomandibular suspension suture according to following inclusion criteria: severe obstructive sleep apnea (apnea-hypopnea index [AHI] > 30 events/h), type I Fujita with lateral pharyngeal wall collapse, and failure for continuous positive airway pressure (CPAP) therapy...
January 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29064879/the-successful-implementation-of-a-modified-enhanced-recovery-after-surgery-eras-program-for-bariatric-surgery-in-a-south-african-teaching-hospital
#11
Emil Loots, Benn Sartorius, Imran M Paruk, Damian L Clarke
BACKGROUND: This study assessed the impact of strict adherence to perioperative pathways incorporating an enhanced recovery after surgery protocol on the outcomes of bariatric surgery at our center. METHODS: Prospective data were collected on 62 patients undergoing bariatric surgery between January 2011 and March 2016. Outcomes were compared between those who adhered to the perioperative pathway and those who did not. RESULTS: Fifty-three patients underwent laparoscopic sleeve gastrectomy, and 9 patients underwent Laparoscopic Roux-en-Y Gastric Bypass...
February 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28402089/perioperative-management-of-obstructive-sleep-apnea-a-systematic-review
#12
Ruggero Corso, Vincenzo Russotto, Cesare Gregoretti, Davide Cattano
INTRODUCTION: Obstructive sleep apnea (OSA) is the leading sleep disordered breathing condition, with a prevalence rate of moderate to severe OSA of approximately 10-17% in the general population. EVIDENCE ACQUISITION: We performed an Ovid-Medline search of all articles published up to August 2016. We included all articles providing updated evidence on epidemiology, pathophysiologic mechanisms and perioperative interventions. EVIDENCE SYNTHESIS: OSA is associated with a number of comorbidities and increased perioperative risks...
January 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27861433/understanding-phenotypes-of-obstructive-sleep-apnea-applications-in-anesthesia-surgery-and-perioperative-medicine
#13
REVIEW
Yamini Subramani, Mandeep Singh, Jean Wong, Clete A Kushida, Atul Malhotra, Frances Chung
Obstructive sleep apnea (OSA) is a prevalent sleep-disordered breathing with potential long-term major neurocognitive and cardiovascular sequelae. The pathophysiology of OSA varies between individuals and is composed of different underlying mechanisms. Several components including the upper airway anatomy, effectiveness of the upper airway dilator muscles such as the genioglossus, arousal threshold of the individual, and inherent stability of the respiratory control system determine the pathogenesis of OSA...
January 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27833866/long-term-outcomes-of-radiofrequency-ablation-of-the-inferior-turbinates
#14
Casey Means, Macario Camacho, Robson Capasso
Radiofrequency ablation of the inferior turbinates (RFAIT) is a minimally invasive surgical technique that reduces turbinate size and decreases nasal obstruction. Few studies have assessed long-term outcomes of this procedure using standardized, symptom-specific evaluation instruments. The primary aim of this study is to assess the long-term effectiveness of RFAIT using a standardized, symptom-specific evaluation instrument. An additional outcome evaluated is the effect of RFAIT on therapeutic CPAP pressures in centimetres of water pressure (cwp) and overall CPAP use...
December 2016: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/27368449/supraglottoplasty-outcomes-in-children-with-down-syndrome
#15
Cara C Cockerill, Christopher D Frisch, Sarah E Rein, Laura J Orvidas
OBJECTIVE: Children with Down syndrome have a higher incidence of upper airway obstruction and laryngomalacia. We sought to determine outcomes of supraglottoplasty in this patient population. METHODS: A retrospective chart review was performed from January 2000 through January 2014. Children (n = 18) at our institution with the diagnosis of Down syndrome who underwent supraglottoplasty were included. We reviewed patient characteristics, preoperative findings, and surgical outcomes (stridor, feeding problems, respiratory distress, weight, sleep apnea, and tracheostomy or feeding tube dependence)...
August 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27330205/morbidly-obese-patient-with-obstructive-sleep-apnoea-for-major-spine-surgery-an-anaesthetic-challenge
#16
Shruti Redhu, Prabhakar Suman Prakash, Virendra Jain, Hari Hara Dash
Morbidly obese patients with clinical features of obstructive sleep apnoea can present a myriad of challenges to the anaesthesiologists which must be addressed to minimise the perioperative risks. Initiation of continuous positive airway pressure (CPAP) therapy early in the pre- and post-operative period along with appropriate anaesthetic planning is of paramount importance in such patients. This case report emphasises the usefulness of CPAP therapy, even for a short duration, to minimise morbidity, improve recovery and hasten early discharge from the hospital after major surgery...
June 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27220851/do-changes-in-perioperative-and-postoperative-treatment-protocol-influence-the-frequency-of-pulmonary-complications-a-retrospective-analysis-of-four-different-bariatric-groups
#17
Mervi Hannele Javanainen, Tom Scheinin, Harri Mustonen, Marja Leivonen
The current understanding of prophylaxis of pulmonary complications in bariatric surgery is weak. PURPOSE: The aim of this study was to observe how changes in perioperative and postoperative treatments affect the incidence of pulmonary complications in bariatric patients. MATERIALS: This is a retrospective clinical study of 400 consecutive bariatric patients. The patients, who either underwent a sleeve gastrectomy or a Roux-en-Y gastric bypass, were divided consecutively into four subgroups with different approaches to perioperative treatment...
January 2017: Obesity Surgery
https://www.readbyqxmd.com/read/27206775/perioperative-risks-of-untreated-obstructive-sleep-apnea-in-the-bariatric-surgery-patient-a-retrospective-study
#18
Wing Tai Kong, Shawn Chopra, Michael Kopf, Carlos Morales, Shahzad Khan, Keith Zuccala, Laura Choi, John Chronakos
BACKGROUND: The use of continuous positive airway pressure (CPAP) perioperatively in bariatric surgery patients with obstructive sleep apnea (OSA) has been controversial. Although studies have demonstrated that CPAP use is safe in bariatric patients, prior studies have not shown improvement in outcomes in these patients. METHODS: A retrospective review of patients who underwent bariatric surgery from 2005 to 2009 was performed. All patients underwent polysomnography preoperatively...
December 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27030678/prevalence-of-and-treatment-outcomes-for-patients-with-obstructive-sleep-apnoea-identified-by-preoperative-screening-compared-with-clinician-referrals
#19
Akshay Dwarakanath, Vinod Palissery, Mark W Elliott
Obstructive sleep apnoea (OSA) has implications perioperatively. We compared the prevalence of OSA and outcome with continuous positive airway pressure (CPAP) in patients diagnosed through preoperative screening and following referrals from other clinicians.Among 1412 patients (62% males) the prevalence of OSA, Epworth Sleepiness Score (ESS), the number referred for CPAP, and short and longer term use of CPAP were compared between the two groups.The prevalence of OSA was similar (62% versus 58%). There were differences in mean±sd age (61±16 versus 55±13 years; p<0...
July 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/26904267/screening-for-sleep-disordered-breathing-in-a-bariatric-population
#20
Kate Reed, Martino F Pengo, Joerg Steier
BACKGROUND: Obstructive sleep apnea (OSA) is the most common form of sleep-disordered breathing frequently associated with obesity. Obese subjects undergoing elective surgical procedures with general anesthesia are potentially at risk if this condition is not identified. Our aim was to assess the prevalence of bariatric patients with undiagnosed OSA following pre-operative assessment and who could benefit from peri-procedural respiratory management. METHODS: Patients who were referred for prospective bariatric surgery were screened using the STOP-BANG questionnaire...
February 2016: Journal of Thoracic Disease
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