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Communications to the Editor |

Perioperative Cardiopulmonary Evaluation and Management : Are We Ignoring Obstructive Sleep Apnea Syndrome? FREE TO VIEW

Rakesh M. Gupta, MD; Peter C. Gay, MD, FCCP
Author and Funding Information

Mayo Foundation Rochester, MN

Correspondence to: Peter C. Gay, MD, FCCP, Mayo Sleep Disorders Center, 200 First St, SW, Rochester, MN 55905; e-mail: pgay@mayo.edu



Chest. 1999;116(6):1843. doi:10.1378/chest.116.6.1843
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To the Editor:

As pulmonary physicians, we greatly appreciate the publication of an exhaustive and comprehensive review of the cardiopulmonary issues relevant to the perioperative period (May 1999).1However, being somnologists too, we could not help noticing that there was no mention of obstructive sleep apnea syndrome (OSAS) as a perioperative risk factor. Was that because OSAS is classified as a sleep disorder rather than a respiratory disease? More likely, the reason is a lack of published data other than a few case reports on this subject, which undermines the importance of OSAS as a risk factor. In preliminary observations, we have noted that serious and life-threatening complications may occur in patients with unrecognized OSAS.2 Forced supine posture and narcotic analgesics may increase the frequency and severity of upper airway obstructions postoperatively. In contrast to some cardiopulmonary complications, these events may be easily preventable by perioperative use of continuous positive airway pressure therapy. Urgent steps are needed to increase awareness of the potential for postoperative complications as an important consequence of OSAS in addition to widely recognized consequences such as daytime sleepiness and increased cardiovascular risk.

Mark, JBD (1999) Perioperative cardiopulmonary evaluation and management.Chest115(suppl),43S
 
Gupta, RM, Gay, PC Postoperative complications in patients with undiagnosed obstructive sleep apnea. Sleep. 1999;;22(suppl) ,.:691
 

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Mark, JBD (1999) Perioperative cardiopulmonary evaluation and management.Chest115(suppl),43S
 
Gupta, RM, Gay, PC Postoperative complications in patients with undiagnosed obstructive sleep apnea. Sleep. 1999;;22(suppl) ,.:691
 
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