Use of CPAP Machines in the Perioperative Setting in Ambulatory Surgical Centers

INTRODUCTION: Obstructive sleep apnea is a common sleep-related breathing disorder that is associated with significant perioperative complications. In 2012 and 2017, Society of Ambulatory Anesthesia and Society of Anesthesia and Sleep Medicine published consensus statements for the selection of patients with OSA scheduled for ambulatory surgery. Despite these recommendations, the need for a CPAP device in the immediate postoperative period at ambulatory surgical centers remains controversial because these ambulatory patients are healthier and have fewer complications. This study aims to investigate the compliance rate with this recommendation among busy ASCs. METHODS: We created a survey to investigate if ASCs require patients to bring their CPAP devices to the facility. The survey measured compliance rates of ASCs to SAMBA’s recommended guidelines of having CPAP machines available. RESULTS: The survey had a response rate of 60.9% encompassing 408,147 cases among 1946 providers. Of the facilities that responded, only 59.7% of them required their patients to bring their CPAP devices on the day of surgery. Out of the 67 facilities that responded, only 25.37% reported using a CPAP machine postoperatively within the past 2 years, with the highest CPAP usage at one facility being 20 times in that 2-year period. DISCUSSION: This would mean that 40.3% of ASCs that did respond do not have access to a CPAP device on-site and may possibly lack the proper equipment needed to handle these complications. The frequency and fatality rate associated with postoperative respiratory complications requiring a CPAP device are still inconclusive, making the need for CPAP devices during perioperative management controversial. Studies further in-depth are therefore necessary to assess postoperative complications that require the use of a CPAP device to determine the urgency of ASCs implementing SAMBA’s recommendations.