J A N U A R Y 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 1 3 3
Key Takeaways From the New OSA Guidelines
What the latest obstructive sleep apnea recommendations mean to you.
C
hances
are,
there
are patients with
obstructive
sleep apnea sit-
ting in your wait-
ing room or
lying in your
pre-op bays right
now. And they
might not even
know they have
OSA. To help
you recognize and treat the condition, Frances Chung, MBBS, FRCPC, a
professor of anesthesia at the University of Toronto, recently chaired a
task force to update guidelines for screening and assessing adult OSA
patients (osmag.net/x4xssv). Here are the key takeaways.
• Proceed in most cases, but with caution. Is sleep apnea reason
enough to delay or cancel surgery? No, says the task force — only if
patients have additional problems that suggest disturbed ventilation
or gas exchange. These include evidence of hypoventilation, severe
pulmonary hypertension or resting hypoxemia in the absence of other
diagnosed cardiopulmonary disease. Patients with these comorbidi-
ties have much higher rates of complications and should undergo fur-
ther evaluations before having surgery.
There's also evidence to support delaying surgery in morbidly obese
patients undergoing bariatric surgery. Roughly half of severely obese
Anesthesia Alert
Jim Burger
• POSITIVE RESULTS Since CPAP therapy may reduce the risk of cardiovascular events, patients
should wear their devices both pre- and post-operatively.
