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Start Over Descriptor "Cpap treatment" Language spanish; castilian
2 results on '"Cpap treatment"'

1. Manejo perioperatorio del paciente con síndrome de apnea-hipopnea obstructiva del sueño (SAHOS)

Author

Patricia Hidalgo-Martínez, Ana Helena Perea-Bello, and Angélica Paola Fajardo-Escolar

Subjects
Respiratory complications, Hospital setting, medicine.medical_treatment, Sedation, Anestesia, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, medicine, Cpap treatment, In patient, Anesthesia, Continuous positive airway pressure, Intraoperative Complications, Sleep Apnea, Obstructive, business.industry, Hypnotics and Sedatives, Procedimientos quirúrgicos operativos, General Medicine, Surgical Procedures, Operative, Apnea del sueño obstructiva, 61 Ciencias médicas, Medicina / Medicine and health, Complicaciones intraoperatorias, Airway management, medicine.symptom, business, 030217 neurology & neurosurgery, Hipnóticos y Sedantes
Abstract

Los pacientes con diagnóstico de síndrome de apnea-hipopnea obstructiva del sueño (SAHOS) pueden ser llevados de forma segura a cualquier procedimiento quirúrgico, incluso de manera ambulatoria si tienen control adecuado de sus otras comorbilidades. El tratamiento con presión positiva continúa en vía aérea (CPAP) en pacientes con diagnóstico confirmado disminuye el riesgo de presentar complicaciones cardiovasculares a largo plazo. La sedación debe ser hecha por un anestesiólogo, quien, además, debe vigilar al paciente y disponer del equipo adecuado para atender complicaciones respiratorias emergentes. Se sugiere que, en estos pacientes, los procedimientos sean hechos en el ámbito hospitalario, donde se tenga disponibilidad en la unidad de cuidados post-anestésicos y personal para monitoreo por al menos una hora tras finalizar el procedimiento. El tratamiento con CPAP debe continuar según sea ordenado por el médico tratante. Es importante que desde la valoración preanestésica se identifique a los pacientes con riesgo de SAHOS para lograr trazar un plan anestésico que disminuya las complicaciones a nivel respiratorio y del manejo de la vía área. Patients diagnosed with obstructive sleep apnea-hypopnea syndrome (OSAHS) can safely undergo a surgical procedure, even on an outpatient basis, if other comorbidities are adequately controlled. Continuous positive airway pressure (CPAP) treatment in patients with a confirmed diagnosis decreases the risk of long-term cardiovascular complications. Sedation should be done by an anesthesiologist, who must also monitor the patient and have the appropriate equipment to deal with emerging respiratory complications.Procedures undergone by these patients should be performed in a hospital setting, in which a post-anesthetic care unit and staff are available for follow-up, at least for an hour after the procedure ends. CPAP treatment should be continued as ordered by the treating physician. Identifying patients with OSAHS risk during the preanesthetic evaluation is important to propose an anesthetic plan that reduces respiratory complications and improves airway management.

Published
2017

2. Intra- and Inter-Physician Agreement in Therapeutic Decision for Sleep Apnea Syndrome.

Author

Lugo VM, Torres M, Garmendia O, Suarez-Giron M, Ruiz C, Carmona C, Chiner E, Tarraubella N, Dalmases M, Pedro AM, Egea CJ, Abellana M, Mayos M, Monasterio C, Masa JF, Farré R, and Montserrat JM

Subjects
Continuous Positive Airway Pressure, Humans, Reproducibility of Results, Spain, Physicians, Sleep Apnea, Obstructive diagnosis
Abstract

Background: Large variation in diagnostic procedures and treatment recommendations may hinder the management of obstructive sleep apnea (OSA) and also compromise correct interpretation of the results of multicenter clinical trials, especially in subjects with non-severe OSA. The aim of this study was to analyze the therapeutic decision-making between different sleep physicians in patients with AHI<40events/h., Methods: Six experienced senior sleep specialists from different sleep centers of Spain were asked to make a therapeutic decision (CPAP treatment) based on anonymized recordings of patients with suspected OSA that has previously performed a sleep study. The clinical data was shown in an online database and included anthropometric features, clinical questionnaires, comorbidities, physical examination and sleep study results. Intra- and inter-observer decision-making were analyzed by the Fleiss' Kappa statistics (Kappa)., Results: A total of 720 medical decisions were taken to analyze the agreement between sleep professionals. Overall intra-observer evaluation reliability was almost perfect (Kappa=0.83, 95% CI, 0.75-0.90, p<0.001). However, overall inter-observer concordance decreased to moderate agreement (Kappa=0.46, 95% CI, 0.42-0.51, p<0.001). Nevertheless, it was especially low when considering AHI<15events/h., Conclusions: This study demonstrates a good intra-observer concordance in the therapeutic decision-making of different sleep physicians treating patients with low/moderate OSA. However, when analyzing inter-observer agreement the results were considerably worse. These findings underline the importance of developing improved consensus management protocols., (Copyright © 2019. Publicado por Elsevier España, S.L.U.)

Published
2020
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