A screening instrument for sleep apnea predicts airway maneuvers in patients undergoing advanced endoscopic procedures

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dc.contributor.author Azar, Riad
dc.contributor.author Cote, Gregory A.
dc.contributor.author Hovis, Christine E.
dc.contributor.author Hovis, Richard M.
dc.contributor.author Waldbaum, Lawrence
dc.contributor.author Early, Dayna S.
dc.date.accessioned 2016-06-22T08:16:41Z
dc.date.available 2016-06-22T08:16:41Z
dc.date.copyright 2010 en_US
dc.date.issued 2016-06-22
dc.identifier.issn 1542-3565 en_US
dc.identifier.uri http://hdl.handle.net/10725/4123
dc.description.abstract Background & Aims Among patients undergoing advanced endoscopy, unrecognized obstructive sleep apnea (OSA) could predict sedation-related complications (SRCs) and the need for airway maneuvers (AMs). By using an OSA screening tool, we sought to define the prevalence of patients at high risk for OSA and to correlate OSA with the frequency of AMs and SRCs. Methods We enrolled 231 consecutive patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) (n = 176) and endoscopic ultrasound (n = 55). Propofol-based sedation and patient monitoring were performed by a nurse anesthetist and an anesthesiologist. A previously validated screening tool for OSA (STOP-BANG) was used to identify patients at high risk for OSA (score, ≥3 of 8; SB+) or low risk (SB−). AMs were defined as a chin lift, modified mask ventilation, nasal airway, bag-mask ventilation, and endotracheal intubation. SRCs were defined as any duration of pulse oximetry less than 90%, systolic blood pressure less than 90 mm Hg, apnea, or early procedure termination. Results The prevalence of SB+ was 43.3%. The frequency of hypoxemia was significantly higher among patients with SB+ than SB− (12.0% vs 5.2%; relative risk [RR], 1.83; 95% confidence interval [CI], 1.32–2.54). The rate of AMs was also significantly higher among SB+ (20.0%) compared with SB− (6.1%) patients (RR, 1.8; 95% CI, 1.3–2.4). These rates remained significant after adjusting for American Society of Anesthesiologists class 3 or higher (RR, 1.70; 95% CI, 1.28–2.2 for AMs; RR, 1.63; 95% CI, 1.19–2.25 for hypoxemia). Each element of the STOP-BANG was reported more commonly in SB+ patients (P < .0001 for each comparison). Conclusions A significant number of patients undergoing advanced endoscopic procedures are at risk for OSA. AMs and hypoxemia occur at an increased frequency in these patients. en_US
dc.language.iso en en_US
dc.title A screening instrument for sleep apnea predicts airway maneuvers in patients undergoing advanced endoscopic procedures en_US
dc.type Article en_US
dc.description.version Published en_US
dc.author.school SOM en_US
dc.author.idnumber 200902767 en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Clinical Gastroenterology and Hepatology en_US
dc.journal.volume 8 en_US
dc.journal.issue 8 en_US
dc.article.pages 660-665.e1 en_US
dc.keywords ERCP en_US
dc.keywords EUS en_US
dc.keywords Monitored Anesthesia Care en_US
dc.keywords Interventional Endoscopy en_US
dc.identifier.doi http://dx.doi.org/10.1016/j.cgh.2010.05.015 en_US
dc.identifier.ctation Coté, G. A., Hovis, C. E., Hovis, R. M., Waldbaum, L., Early, D. S., Edmundowicz, S. A., ... & Jonnalagadda, S. S. (2010). A screening instrument for sleep apnea predicts airway maneuvers in patients undergoing advanced endoscopic procedures. Clinical Gastroenterology and Hepatology, 8(8), 660-665. en_US
dc.author.email riad.azar@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url http://www.sciencedirect.com/science/article/pii/S154235651000501X en_US

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