| Title: |
Prediction of opioid-induced respiratory depression on inpatient wards using continuous capnography and oximetry: an international prospective, observational trial |
| Authors: |
Khanna, A.K.; Bergese, S.D.; Jungquist, C.R.; Morimatsu, H.; Uezono, S.; Lee, S.; Ti, L.K.; Urman, R.D.; McIntyre, R.; Tornero, C.; Dahan, A.; Saager, L.; Weingarten, T.N.; Wittmann, M.; Auckley, D.; Brazzi, L.; Guen, M. le; Soto, R.; Schramm, F.; Ayad, S.; Kaw, R.; Stefano, P. di; Sessler, D.I.; Uribe, A.; Moll, V.; Dempsey, S.J.; Buhre, W.; Overdyk, F.J.; PRODIGY Grp Collaborators |
| Source: |
Anesthesia & Analgesia |
| Publication Year: |
2020 |
| Collection: |
Leiden Repository (Leiden University) |
| 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 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% ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://hdl.handle.net/1887/3182786 |
| DOI: |
10.1213/ANE.0000000000004788 |
| Availability: |
https://hdl.handle.net/1887/3182786; https://journals.lww.com/anesthesia-analgesia/Fulltext/2020/10000/Prediction_of_Opioid_Induced_Respiratory.6.aspx; https://doi.org/10.1213/ANE.0000000000004788 |
| Accession Number: |
edsbas.AE2FF63E |
| Database: |
BASE |