| Title: |
Prediction of Opioid-Induced Respiratory Depression on Inpatient Wards Using Continuous Capnography and Oximetry: An International Prospective, Observational Trial. |
| Authors: |
Khanna, Ashish K; Bergese, Sergio D; Jungquist, Carla R; Morimatsu, Hiroshi; Uezono, Shoichi; Lee, Simon; Ti, Lian Kah; Urman, Richard D; McIntyre, Robert; Tornero, Carlos; Dahan, Albert; Saager, Leif; Weingarten, Toby N; Wittmann, Maria; Auckley, Dennis; Brazzi, Luca; Le Guen, Morgan; Soto, Roy; Schramm, Frank; Ayad, Sabry; Kaw, Roop; Di Stefano, Paola; Sessler, Daniel I; Uribe, Alberto; Moll, Vanessa; Dempsey, Susan J; Buhre, Wolfgang; Overdyk, Frank J; Tanios, Marianne; Rivas, Eva; Mejia, Miluska; Elliott, Kavita; Ali, Assad; Fiorda-Diaz, Juan; Carrasco-Moyano, Ruben; Mavarez-Martinez, Ana; Gonzalez-Zacarias, Alicia; Roeth, Cory; Kim, January; Esparza-Gutierrez, Alan; Weiss, Carleara; Chen, Chiahui; Taniguchi, Arata; Mihara, Yuko; Ariyoshi, Makiko; Kondo, Ichiro; Yamakawa, Kentaro; Suga, Yoshifumi; Ikeda, Kohei; Takano, Koji; Kuwabara, Yuuki; Carignan, Nicole; Rankin, Joyce; Egan, Katherine; Waters, Lakeisha; Sim, Ming Ann; Lean, Lyn Li; Liew, Qi En Lydia; Siu-Chun Law, Lawrence; Gosnell, James; Shrestha, Salina; Okponyia, Chisom; Al-Musawi, Mohammed H; Gonzalez, María José Parra; Neumann, Claudia; Guttenthaler, Vera; Männer, Olja; Delis, Achilles; Winkler, Anja; Marchand, Bahareh; Schmal, Frauke; Aleskerov, Fuad; Nagori, Mohammedumer; Shafi, Muhammad; McPhee, Gloria; Newman, Cynthia; Lopez, Elizabeth; Har, Sabrina Ma; Asbahi, Moumen; Nordstrom McCaw, Kim; Theunissen, Maurice; Smit-Fun, Valerie |
| Source: |
Articles, Abstracts, and Reports |
| Publisher Information: |
Providence Digital Commons |
| Publication Year: |
2020 |
| Collection: |
Providence St. Joseph Health Digital Commons |
| Subject Terms: |
Anesthesiology |
| Description: |
BACKGROUND: Opioid-related adverse events are a serious problem in hospitalized patients. Little is known about patients who are likely to experience opioid-induced respiratory depression events on the general care floor and may benefit from improved monitoring and early intervention. The trial objective was to derive and validate a risk prediction tool for respiratory depression in patients receiving opioids, as detected by continuous pulse oximetry and capnography monitoring. METHODS: PRediction of Opioid-induced respiratory Depression In patients monitored by capnoGraphY (PRODIGY) was a prospective, observational trial of blinded continuous capnography and oximetry conducted at 16 sites in the United States, Europe, and Asia. Vital signs were intermittently monitored per standard of care. A total of 1335 patients receiving parenteral opioids and continuously monitored on the general care floor were included in the analysis. A respiratory depression episode was defined as respiratory rate ≤5 breaths/min (bpm), oxygen saturation ≤85%, or end-tidal carbon dioxide ≤15 or ≥60 mm Hg for ≥3 minutes; apnea episode lasting >30 seconds; or any respiratory opioid-related adverse event. A risk prediction tool was derived using a multivariable logistic regression model of 46 a priori defined risk factors with stepwise selection and was internally validated by bootstrapping. RESULTS: One or more respiratory depression episodes were detected in 614 (46%) of 1335 general care floor patients (43% male; mean age, 58 ± 14 years) continuously monitored for a median of 24 hours (interquartile range [IQR], 17-26). A multivariable respiratory depression prediction model with area under the curve of 0.740 was developed using 5 independent variables: age ≥60 (in decades), sex, opioid naivety, sleep disorders, and chronic heart failure. The PRODIGY risk prediction tool showed significant separation between patients with and without respiratory depression (P < .001) and an odds ratio of 6.07 (95% confidence interval [CI], ... |
| Document Type: |
text |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
https://digitalcommons.providence.org/publications/3668; https://digitalcommons.providence.org/context/publications/article/4582/viewcontent/32925318.pdf |
| Availability: |
https://digitalcommons.providence.org/publications/3668; https://digitalcommons.providence.org/context/publications/article/4582/viewcontent/32925318.pdf |
| Accession Number: |
edsbas.14581F04 |
| Database: |
BASE |