Perioperative Management of Sleep Apnea and Noninvasive Respiratory Management for the Hospitalist-References

References

Pdf Summary

This comprehensive reference list supports the perioperative management and noninvasive respiratory care of patients with obstructive sleep apnea (OSA), highlighting its implications for anesthesiologists, hospitalists, and surgical teams. Multiple studies document the high prevalence of undiagnosed OSA among adult surgical patients and its significant impact on postoperative complications, including respiratory events, cardiovascular complications (such as atrial fibrillation and coronary heart disease), and increased resource utilization.<br /><br />Screening tools like the STOP-Bang and Berlin questionnaires are emphasized for preoperative identification of patients at risk, with evidence supporting their predictive accuracy and utility in clinical settings. Several guidelines from the American Society of Anesthesiologists and the Society of Anesthesia and Sleep Medicine provide frameworks for preoperative assessment, intraoperative management, and postoperative care.<br /><br />Continuous positive airway pressure (CPAP) therapy is repeatedly shown to reduce the risk of adverse cardiovascular events, improve postoperative outcomes, and lower the incidence of recurrent atrial fibrillation after ablation procedures. Meta-analyses and randomized trials support perioperative use of CPAP and auto-titrated positive airway pressure in reducing postoperative respiratory and cardiovascular complications in OSA patients.<br /><br />Research also links OSA with various comorbidities, including hypertension, heart failure, diabetes, and gastroesophageal reflux, which compound perioperative risks. Studies suggest that untreated OSA significantly elevates the risk for cardiopulmonary complications and mortality after surgery, underscoring the importance of diagnosis and treatment.<br /><br />Overall, the references collectively underscore the need for vigilant screening, perioperative monitoring, and implementation of positive airway pressure therapies to improve surgical outcomes and reduce morbidity in patients with sleep-disordered breathing. The evolving evidence base calls for integrated approaches by hospitalists and anesthesiologists to manage these high-risk patients effectively throughout the surgical continuum.

Keywords

obstructive sleep apnea

perioperative management

noninvasive respiratory care

postoperative complications

STOP-Bang questionnaire

Berlin questionnaire

continuous positive airway pressure

cardiovascular complications

perioperative screening

sleep-disordered breathing