High risk for obstructive sleep apnea hypopnea syndrome predicts new onset atrial fibrillation after cardiac surgery: a retrospective analysis

Patel, Samir; Gill, Hartej; Shahi, Diwas; Rajabalan, Ajai; Patel, Palak; Sonani, Rajesh; Bhatt, Parth; Rodriguez, Rafael David; Bautista, Manuel; Deshmukh, Abhishek; Gonzalez, Juan Viles; Patel, Sanjay R.

doi:10.1007/s11325-018-1645-3

Cited by 14 publications

(15 citation statements)

References 30 publications

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“…Another meta-analysis of 11 studies of patients undergoing cardiac surgery (1801 patients, 688 OSA vs. 1113 non-OSA patients) found major adverse cardiac or cerebrovascular events associated with OSA (OR 2.4 [95% CI 1.38-4.2]) and postoperative atrial fibrillation (OR 1.94 [95% CI 1.13-3.33]). Others have also reported an association between OSA and postoperative atrial fibrillation [43,44]. Chan et al [45] performed a multicenter observational trial in five countries to assess if OSA posed a potential risk for major cardiovascular complications following major noncardiac surgery and found patients with OSA had higher risk (adjusted hazard ratio [HR] 1.49 [95% CI 1.19-2.01]).…”

Section: Obstructive Sleep Apnea and Life-threatening Postoperative R...mentioning

confidence: 99%

Perioperative considerations for adult patients with obstructive sleep apnea

Weingarten

Šprung

2022

Current Opinion in Anaesthesiology

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Purpose of reviewObstructive sleep apnea (OSA) is a common, but often undiagnosed, sleep breathing disorder affecting approximately a third of adult surgical patients. OSA patients have increased sensitivity to anesthetic agents, sedatives, and opioid analgesics.Recent findingsNewer technologies (e.g., bedside capnography) have demonstrated that OSA patients have repetitive apneic spells, beginning in the immediate postoperative period and peaking in frequency during the first postoperative night. Compared to patients without OSA, OSA patients have double the risk for postoperative pulmonary as well as other complications, and OSA has been linked to critical postoperative respiratory events leading to anoxic brain injury or death. Patients with OSA who have respiratory depression during anesthesia recovery have been found to be high-risk for subsequent pulmonary complications. Gabapentinoids have been linked to respiratory depression in these patients.SummarySurgical patients should be screened for OSA and patients with OSA should continue using positive airway pressure devices postoperatively. Use of shorter acting and less sedating agents and opioid sparing anesthetic techniques should be encouraged. In particular, OSA patients exhibiting signs of respiratory depression in postanesthesia recovery unit should receive enhancer respiratory monitoring following discharge to wards.

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Section: Obstructive Sleep Apnea and Life-threatening Postoperative R...mentioning

confidence: 99%

Perioperative considerations for adult patients with obstructive sleep apnea

Weingarten

Šprung

2022

Current Opinion in Anaesthesiology

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“…i online. A total of 13 articles met our inclusion criteria. 3,[11][12][13][14][15][16][17][18][19][20][21][22] The main characteristics of the included studies are described in Table 2. Total primary and secondary pooled outcomes in patients with and without OSA were demonstrated in Table 3.…”

Section: Study Selection Characteristics and Quality Assessmentmentioning

confidence: 99%

“…Of the 13 reports, three contained CHD patients following elective CABG + valvular surgery. 3,12,19 Metaregression analysis was performed to examine whether the above pooled outcomes could be modified by the valvular surgery. The results were shown in Table 3.…”

Section: Study Selection Characteristics and Quality Assessmentmentioning

confidence: 99%

OSA-induced multi-organ dysfunction after elective coronary artery bypass surgery in coronary heart disease patients

Wang¹,

Wang²,

Yu³

et al. 2020

Preprint

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Background The aim of this study was to explore the underlying impact of obstructive sleep apnea (OSA) on postoperative parameters of multi-organ function, including cardiac and cerebral vascular, respiratory as well as renal postoperative complications, among coronary heart disease (CHD) patients following elective coronary artery bypass grafting (CABG). Methods Electronic literature databases, including PubMed, ISI Web of Science, Directory of Open Access Journals, and the Cochrane Library electronic databases, were searched manually and automatically for relevant English articles. All of the selected articles focused on a comparison of the incidence of primary and secondary outcomes in CHD patients undergoing elective CABG with and without OSA. Results A total of 13 articles met our inclusion criteria. The current study demonstrated OSA significantly increased the incidence of major adverse cardiac and cerebrovascular events (MACCEs) in CHD patients undergoing elective CABG compared with the controls (odds risk (OR), 1.97; 95% confidence interval (CI), 1.50 to 2.59, p <0.0001). In addition, OSA was associated with an increased risk of new revascularization in CHD patients undergoing elective CABG (OR, 9.47; 95% CI, 2.69 to 33.33, p <0.0001). Moreover, reintubation and tracheostomy in the OSA group was increased (OR, 3.43; 95% CI, 1.35 to 8.71; p =0.009) and 372% (OR, 4.72; 95% CI, 1.23 to 18.13; p=0.024), respectively, compared with the control group. Besides, we also confirmed OSA significantly increased the acute kidney injury (AKI) incidence by 124% (OR, 2.24; 95% CI, 1.07 to 4.72; P < 0.0001). Finally, our results demonstrated that OSA increased medical resource utilization including length of postoperative hospital stay and ICU stay. Conclusions OSA may contribute to postoperative multi-organ dysfunction among CHD patients undergoing elective CABG by increasing the incidence of MACCEs, especially new revascularization, as well as respiratory, and renal complications. Peri- and postoperative management of CHD patients with OSA may be optimized to minimize the rate of postoperative parameters of multi-organ dysfunction, further reducing the consumption of limited medical resources.

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“…The selection process is illustrated in Figure 1. A total of 13 articles met our inclusion criteria (3,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). The main characteristics of the included studies are described in Table 2.…”

Section: Study Selection Characteristics and Quality Assessmentmentioning

confidence: 99%

“…Total primary and secondary pooled outcomes in patients with and without OSA were demonstrated in Table 3. Of the 13 reports, three contained CHD patients following elective CABG + valvular surgery (3,12,19). Meta-regression analysis was performed to examine whether the above pooled outcomes could be modified by the valvular surgery.…”

Section: Study Selection Characteristics and Quality Assessmentmentioning

confidence: 99%

Obstructive sleep apnea-induced multi-organ dysfunction after elective coronary artery bypass surgery in coronary heart disease patients

Wang

et al. 2020

J Thorac Dis

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Background: The aim of this study was to explore the underlying impact of obstructive sleep apnea (OSA) on postoperative parameters of multi-organ function among coronary heart disease (CHD) patients following elective coronary artery bypass grafting (CABG). Methods: Electronic literature databases were searched manually and automatically for relevant English articles. All of the included articles focused on a comparison of the incidence of postoperative parameters of multi-organ function in CHD patients undergoing elective CABG with and without OSA. Studies were excluded if they met any one of the following criteria: (I) duplicate publication; (II) ongoing or unpublished studies; (III) only published as abstracts or conference proceedings; and (IV) less than 30 patients in the patient cohort. Results: A total of 13 articles met our inclusion criteria. The current study demonstrated OSA significantly increased the incidence of major adverse cardiac and cerebrovascular events (MACCEs) in CHD patients undergoing elective CABG compared with the controls [odds risk (OR), 1.97; 95% CI, 1.50 to 2.59, P<0.0001]. In addition, OSA was associated with an increased risk of new revascularization in CHD patients undergoing elective CABG (OR, 9.47; 95% CI, 2.69 to 33.33, P<0.0001). Moreover, reintubation and tracheostomy in the OSA group was increased 243% (OR, 3.43; 95% CI, 1.35 to 8.71; P=0.009) and 372% (OR, 4.72; 95% CI, 1.23 to 18.13; P=0.024), respectively, compared with the control group. Besides, we also confirmed OSA significantly increased the acute kidney injury (AKI) incidence by 124% (OR, 2.24; 95% CI, 1.07 to 4.72; P<0.0001). Conclusions: OSA may contribute to postoperative multi-organ dysfunction among CHD patients undergoing elective CABG by increasing the incidence of MACCEs, especially new revascularization, as well as respiratory, and renal complications.

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High risk for obstructive sleep apnea hypopnea syndrome predicts new onset atrial fibrillation after cardiac surgery: a retrospective analysis

Cited by 14 publications

References 30 publications

Perioperative considerations for adult patients with obstructive sleep apnea

Perioperative considerations for adult patients with obstructive sleep apnea

OSA-induced multi-organ dysfunction after elective coronary artery bypass surgery in coronary heart disease patients

Obstructive sleep apnea-induced multi-organ dysfunction after elective coronary artery bypass surgery in coronary heart disease patients

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