PMID- 35405725
OWN - NLM
STAT- MEDLINE
DCOM- 20221206
LR  - 20230928
IS  - 1549-8425 (Electronic)
IS  - 1549-8417 (Print)
IS  - 1549-8417 (Linking)
VI  - 18
IP  - 8
DP  - 2022 Dec 1
TI  - Continuous Monitoring Detected Respiratory Depressive Episodes in Proximity to 
      Adverse Respiratory Events During the PRODIGY Trial.
PG  - 738-741
LID - 10.1097/PTS.0000000000001003 [doi]
AB  - PURPOSE: The PRediction of Opioid-induced respiratory Depression In patients 
      monitored by capnoGraphY (PRODIGY) trial was a multicenter prospective trial 
      conducted to develop a risk prediction score for opioid-induced respiratory 
      depressive (OIRD) episodes. Several subjects in the PRODIGY trial developed 
      critical respiratory depressive events, which were qualified as reportable 
      adverse events (AEs). In this study, we determine whether those patients also had 
      an episode of OIRD as detected by continuous capnography and pulse oximetry 
      leading up to the critical clinical event. METHODS: Blinded capnography and pulse 
      oximetry data from PRODIGY patients who had critical respiratory depressive AE 
      were reviewed. The occurrence and timing of OIRD episodes were recorded in 
      relationship to the AE. RESULTS: Of the 1335 subjects in PRODIGY, 7 patients had 
      8 reportable pulmonary AE and 187 OIRDs (150 apnea episodes, 14 bradypnea 
      episodes, 23 hypoxic episodes) with median 12 (5-19.5) OIRDs per patient. Five 
      patients were monitored before the AE, and multiple preceding OIRD episodes were 
      detected. One patient had 2 AE, the first (hypoxemia) was recognized upon 
      application of pulse oximetry. This patient subsequently had multiple OIRDs until 
      the second AE occurred (somnolence requiring naloxone administration). Another 
      patient's AE (hypotension and bradypnea) was recognized upon monitor application 
      and subsequently had many OIRD episodes. CONCLUSIONS: In the PRODIGY trial, 
      patients who had a pulmonary AE had multiple preceding OIRDs detected by 
      continuous capnography and pulse oximetry. When monitoring was initiated before 
      the AE, numerous OIRDs, mostly apneic episodes preceded AE, suggesting continuous 
      monitoring of both ventilation and oxygenation may allow for early detection and 
      possible prediction of future clinical decompensation.
CI  - Copyright (c) 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Kor, Jennifer J
AU  - Kor JJ
AD  - From the Kentucky College of Osteopathic Medicine, Pikeville, Kentucky.
FAU - Sprung, Juraj
AU  - Sprung J
AD  - Departments of Anesthesiology and Perioperative Medicine, Mayo Clinic College of 
      Medicine and Science, Rochester, Minnesota.
FAU - Khanna, Ashish K
AU  - Khanna AK
FAU - Weingarten, Toby N
AU  - Weingarten TN
AD  - Departments of Anesthesiology and Perioperative Medicine, Mayo Clinic College of 
      Medicine and Science, Rochester, Minnesota.
LA  - eng
SI  - ClinicalTrials.gov/NCT02811302
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20220427
PL  - United States
TA  - J Patient Saf
JT  - Journal of patient safety
JID - 101233393
RN  - 0 (Analgesics, Opioid)
SB  - IM
MH  - Humans
MH  - *Analgesics, Opioid/adverse effects
MH  - Prospective Studies
MH  - *Capnography
MH  - Monitoring, Physiologic
MH  - Oximetry
PMC - PMC9698081
COIS- T.N.W. has received consulting fees from Medtronic and Merck. A.K.K. has received 
      consulting fees from Medtronic, Merck, and Edwards Lifesciences. The other 
      authors disclose no conflict of interest.
EDAT- 2022/04/12 06:00
MHDA- 2022/12/07 06:00
PMCR- 2022/11/25
CRDT- 2022/04/11 20:18
PHST- 2022/04/12 06:00 [pubmed]
PHST- 2022/12/07 06:00 [medline]
PHST- 2022/04/11 20:18 [entrez]
PHST- 2022/11/25 00:00 [pmc-release]
AID - 01209203-202212000-00002 [pii]
AID - JPS_220200 [pii]
AID - 10.1097/PTS.0000000000001003 [doi]
PST - ppublish
SO  - J Patient Saf. 2022 Dec 1;18(8):738-741. doi: 10.1097/PTS.0000000000001003. Epub 
      2022 Apr 27.