A risk stratification algorithm using non-invasive respiratory volume monitoring to improve safety when using post-operative opioids in the PACU

Journal of Clinical Monitoring and Computing
Christopher VoscopoulosEdward George

Abstract

Late detection of respiratory depression in non-intubated patients compromises patient safety. SpO2 is a lagging indicator of respiratory depression and EtCO2 has proven to be unreliable in non-intubated patients. A decline in minute ventilation (MV) is the earliest sign of respiratory depression. A non-invasive respiratory volume monitor (RVM) that provides accurate, continuous MV measurements enables clinicians to predict and quantify respiratory compromise. For this observational study, practitioners were blinded to the RVM measurements and pain management followed the usual routine. Patients were stratified by their MV on PACU admission and classified as "At-Risk" or "Not-At-Risk," with progression to "Low MV" status following opioids assessed for each category. The purpose was to determine if stratifying based on MV on PACU arrival could identify patients at higher risk for respiratory depression. Ability to identify in advance patients at higher risk for respiratory depression following standard opioid dosing would drive changes in pain management and improve patient care. RVM and opioid administration data from 150 PACU patients following elective joint-replacement surgery were collected in an observational study. "Predi...Continue Reading

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Citations

Feb 27, 2018·Journal of Clinical Monitoring and Computing·D S KarbingM B Jaffe
Oct 7, 2017·Current Opinion in Anaesthesiology·Steven D BoggsRichard D Urman
Aug 14, 2018·Journal of Clinical Monitoring and Computing·Jing LiuLu Yu
Jul 17, 2020·Journal of Applied Physiology·Tiffany W DongRichard E Moon
Aug 5, 2019·Pain Management Nursing : Official Journal of the American Society of Pain Management Nurses·Carla R JungquistRosemary C Polomano

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