SleepApneaGR - PerioperativeManagementof...

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Perioperative Management of  the Sleep Apnea Patient Grand Rounds June 6, 2007 Richard Browning, M.D.
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Goals Review Incidence Learn how to diagnose Understand the pathophysiology Develop a plan for pre-, intra- and post- op management
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Incidence Among middle-aged adults –  Estimated that 80-95% are undiagnosed Testing increasing 124% every 3 years Therefore, diagnosis of OSA will  increase 5 to 10-fold over next decade.
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Causes / Risk Factors Obesity, Obesity, Obesity Increasing age Male gender Structural abnormalties Tonsillar hypertrophy, nasal pathology Alcohol, smoking and family history
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Causes / Risk Factors Up to 90% of adult patients with OSA  are obese OSA parallels the obesity epidemic
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Table 1. Distribution by Age of Categorical  Levels of AHI* (AHI=Apneas + Hypopneas/Hour of Sleep)                   Habitual                        Snoring        AHI > 5        AHI > 10        AHI > 15 Age (Yrs)        (%)          (%)          (%)             (%) <25                    14                 10                  2                     0 26-50                  41                 26                 15                    0 >50                    46                 61                 50                    36 AHI = Apnea Hypopnea Index
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Definition of OSA OSA is defined as a cessation of airflow  for more than 10 seconds despite  continuing ventilatory effort, 5 or more  times per hour of sleep and a decrease  of more than 4% in S a O 2 .
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This note was uploaded on 12/28/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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SleepApneaGR - PerioperativeManagementof...

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