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Correspondence
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Volume 341:613-614 August 19, 1999 Number 8
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Preoperative Pulmonary Evaluation

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by Smetana, G. W.
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To the Editor: The informative review of preoperative pulmonary evaluation by Dr. Smetana (March 25 issue)1 omitted any reference to sleep apnea and its complications in the postoperative setting. Sleep apnea is associated with an increased risk of acute upper-airway obstruction after extubation,2 more severe postoperative oxygen desaturation than that in normal persons,3 and increased risks of atrial fibrillation4 and cardiorespiratory arrest,2 even if the operation does not involve the upper airway.

A comprehensive preoperative evaluation should include simple questions about symptoms of sleep apnea: the presence of loud, habitual snoring, episodes of apnea witnessed by a bed partner, episodes . . . [Full Text of this Article]

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