The Impact of Untreated Obstructive Sleep Apnea on Cardiopulmonary Complications in General and Vascular Surgery: A Cohort Study

Abdelsattar, Zaid M.; Hendren, Samantha; Wong, Sandra L.; Campbell, Darrell A.; Ramachandran, Satya Krishna

doi:10.1016/j.jamcollsurg.2014.07.265

Cited by 33 publications

(52 citation statements)

References 15 publications

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“…In surgical patients with newly diagnosed OSA, Liao [25]. These two large retrospective database studies provide early evidence of the merit of CPAP therapy in pre-operative patients.…”

Section: Pre-optimisationmentioning

confidence: 99%

The importance of obstructive sleep apnoea management in peri-operative medicine

2016

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“…In surgical patients with newly diagnosed OSA, Liao [25]. These two large retrospective database studies provide early evidence of the merit of CPAP therapy in pre-operative patients.…”

Section: Pre-optimisationmentioning

confidence: 99%

The importance of obstructive sleep apnoea management in peri-operative medicine

2016

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“…Even if OSA is treated, because of the upper respiratory tract pathology and associated obesity, the perioperative risk is greater in these patients when compared with normal individuals. [11,12] Preoperative evaluation of our patient did not reveal any comorbidity (diabetes, hypertension, heart failure) apart from obesity and OSA.…”

Section: Discussionmentioning

confidence: 71%

Anesthesia in a Patient with Diaphragmatic Hernia and Obstructive Sleep Apnea: Case Report

Temizel¹,

Kuzucuoğlu²,

Arslan³

et al. 2018

South Clin Ist Euras

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Traumatic diaphragmatic hernia (TDH) is a serious, frequently overlooked complication observed secondary to a thoracoabdominal trauma. The treatment of TDH is surgical and diaphragmatic repair, usually performed with a thoracotomy approach. During a thoracotomy, the lung on the operation side is collapsed and single-lung ventilation is employed. This procedure facilitates the work of the surgeon; however, it makes the administration of anesthesia more difficult. Obstructive sleep apnea (OSA) is a disorder characterized by attacks of apnea and hypopnea due to partial or complete obstruction of the upper respiratory tract during sleep. Administration of anesthesia to patients with OSA involves several difficulties with respect to ventilation and intubation, as well as potential respiratory complications during the postoperative period. In this case report, critical issues faced during the administration of anesthesia to a 46-year-old male patient with OSA who was diagnosed with TDH 1 year after a trauma were discussed in the context of the literature.

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“…A recent meta-analysis of 6 studies including 904 patients showed no significant difference in post-operative adverse events between CPAP and non-CPAP treatment groups in patients undergoing general surgery 28 . There is some evidence for improvement in cardiovascular morbidity in a retrospective cohort of 26,842 patients with OSA undergoing vascular surgery where those not treated with positive airway pressure preoperatively were at increased risks for cardiopulmonary complications including unplanned reintubations (OR 2.5) and myocardial infarction (OR 2.6) compared with treated OSA patients 29 . The effect of CPAP on patients with OSA undergoing cardiac surgery has not been examined in randomized controlled trials.…”

Section: Effect Of Continuous Positive Airway Pressure On Postoperatimentioning

confidence: 99%

Obstructive sleep apnoea in patients undergoing cardiac surgery: Screening, postoperative outcomes and perioperative care

Mason¹

2018

J Cardiol and Cardiovasc Sciences

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Obstructive sleep apnoea (OSA) is common and high prevalence has been described amongst patients undergoing cardiac revascularisation surgery. An excess of postoperative complications has been reported in patients with untreated Obstructive Sleep Apnoea (OSA) following surgical procedures, including those undergoing cardiac surgery. This has led some clinicians towards pre-operative screening for OSA though the best screening methodology has not yet been established. Moreover, the effect of screening and of treatment for OSA on surgical outcomes remains unknown. Does current evidence justify screening and treating patients before they present for surgery? Is this leading to potential delay in surgery whilst awaiting sleep diagnostics and commencing the treatment? This review article will examine the available evidence base and endeavour to answer these questions and identify implications for future research. OSA and cardiovascular diseaseSleep Disordered Breathing is a term used to cover a range of breathing events encountered during sleep and includes obstructive sleep apnoea (OSA), central sleep apnoea, Cheyne-Stokes respiration and respiratory effort related arousals. OSA is the most common form of sleep disordered breathing. OSA is common 1 and the reported prevalence has increased in the last two decades 1 with the new data reported mainly in European population of adults 40-85 years old showing that at least mild OSA (apnoea-hypopnoea index ≥5) was present in 84% of men and 61% of women and at least moderate disease (apnoea-hypopnoea index ≥15) was present in 50% of men and 23 % of women 2 . OSA and cardiac disease share some common risk factors and in patients undergoing coronary artery bypass graft (CABG) procedures reported prevalence is high, ranging between 41 and 87% 3-5 .High proportions of patients may present for surgery without a previous diagnosis of OSA 6,7 and may be at risk of worse postoperative outcomes 8 . In patients with moderate to severe OSA syndrome Continuous Positive Airway Pressure (CPAP) is the conventional treatment with established clinical and cost effectiveness 9 but its effect on cardiovascular outcomes has not been confirmed. A recent, large, randomised controlled trial of adults with moderate to severe OSA and pre-existing cardiovascular disease showed that the use of CPAP had no significant effect on the prevention of recurrent serious cardiovascular events 10 . It is possible that patients with compliance exceeding 4h/night may

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The Impact of Untreated Obstructive Sleep Apnea on Cardiopulmonary Complications in General and Vascular Surgery: A Cohort Study

Cited by 33 publications

References 15 publications

The importance of obstructive sleep apnoea management in peri-operative medicine

The importance of obstructive sleep apnoea management in peri-operative medicine

Anesthesia in a Patient with Diaphragmatic Hernia and Obstructive Sleep Apnea: Case Report

Obstructive sleep apnoea in patients undergoing cardiac surgery: Screening, postoperative outcomes and perioperative care

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