Introduction: Respiratory therapists (RTs) in the intensive care unit can at times find themselves involved in and assisting during the performance of the apnea test (ApT). The ApT is a clinically complex procedure and is the last part of the clinical declaration of death by neurologic criteria (DNC) protocol and requires close collaboration between the physicians and the RTs. As such, the ApT should be performed with the upmost attention to detail.
Context And Aims: The RTs need to be versed on the intricacies of the ApT. Except in very large medical centers, the ApT is not a procedure performed with high enough frequency as to maintain high level of proficiency. For a successful ApT, structured knowledge and preparation are paramount. This publication attempts to fill that gap, for adult hospitalized patients not on ECMO (extracorporeal membrane oxygenation). To generate this report, we make use of the published guidelines, and our personal experience on performing ApTs in large medical centers.
Conclusion: We provide a structure by means of a checklist, from the RTs' perspective, to guide and help them lead on the efficient performance of the ApT.
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http://dx.doi.org/10.4081/mrm.2022.843 | DOI Listing |
Perioper Med (Lond)
January 2025
Department of Surgery, Yale School of Medicine, New Haven, CT, 06510, USA.
Background: Irrespective of baseline diabetes status, preoperative hemoglobin A1c (A1C) influences perioperative care in patients undergoing metabolic and bariatric surgery (MBS). Accordingly, the American Society of Metabolic and Bariatric Surgery (ASMBS) endorses that patients undergoing MBS should receive a preoperative A1C test. We aimed to assess the proportion of MBS patients who received a preoperative A1C test and determine whether baseline diabetes status influences receipt of a test.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA.
Background: Intermittent hypoxia, a consequence of sleep-disordered breathing (SDB), may contribute to an increased risk of cognitive decline. However, the association between SDB and cognition remains highly variable.
Methods: Fifty-two community-dwelling healthy older adults (28 women) were recruited.
Background: The present study examined OSA using an objective home sleep test in 81 adults with DS (aged 25 ∼ 61 years) and evaluated associations between sleep-disordered breathing problems and biomarkers of AD pathology (PET Aβ and tau) and symptomology (cognitive performance and depressed mood).
Method: As part of the ABC-DS study, participants completed a 2.5-hour battery of cognitive measures and underwent MRI and PET imaging scans and a blood draw.
Alzheimers Dement
December 2024
Geriatric Research Education and Clinical Center William S. Middleton VA Hospital, Madison, WI, USA.
Background: Obstructive sleep apnea (OSA) is associated with hypoxia-induced neuronal impairment and dysfunction-key risk factors for the pathogeneses of age-related neurodegenerative diseases such as Alzheimer's disease (AD). This study examined longitudinal associations between OSA severity and CSF biomarkers associated with AD, synaptic dysfunction, and neuroinflammation in a sample of late-middle-aged adults with increased risk for AD.
Method: N=25 cognitively unimpaired adults (64% female, mean age 65.
Background: Control of breathing is known to be adversely affected by cognitive impairment, often associated with sleep apnea or disordered breathing during sleep in MCI/AD. The origin of this disorder is thought to be in the dysfunction of the respiratory control centers of the brainstem or in the impaired afferent signaling from cortical regions. Continuous breathing data were collected in a multi-center study in Los Angeles (USC), Kansas City (KUMC) and Dallas (UT-SWMC), and used to compute respiratory rate variability (RRV) to test the hypothesis that voluntary control of breathing is impaired in MCI and mild AD patients relative to cognitively normal controls, and whether this impairment is more severe in mild AD than MCI patients.
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