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STOPBANG is a validated screening tool for OSA and OHS

article-g03_400_379

OHS important subgroup of patients with higher morbidity and mortality risk

  • BMI >30kg/m2
  • Awake PaCO2 > 45mmHg
  • OSA or Sleep Hypoventilation or Combination

What makes it different:

  • Pronounced decrease in lung volumes
  • Impaired respiratory function
  • Greater reductions in inspiratory muscle compliance
  • Greater hypoxic burden
  • Failure of normal compensatory mechanisms

ASA Guidance:

  • Consider pre-operative initiation of CPAP, particularly if OSA severe”
  • For non-responders to CPAP, consider non-invasive ventilation

Peri-operative:

  • CPAP likely protective against peri-op complication
  • But poor evidence for when to initiate

Bottom Line: Post-op CPAP essential and consider HDU

Links:

OHS Patient Resource

Sleep-disordered breathing

AAGBI Dissomnias

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