Positive Airway Pressure Therapy for Perioperative Patients

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Positive airway pressure (PAP) therapy can be administered as a fixed pressure level, a variable autotitrating pressure, or a bilevel setting. Evidence for use of PAP therapy in postoperative patients comes from patients with postextubation respiratory failure or from preemptive efforts to prevent reintubation. Patients with obstructive sleep apnea (OSA) or other forms of sleep-disordered breathing are recognized as having additional risks for postoperative complications. Protocols are being proposed to manage postoperative patients with known or suspected OSA with PAP therapy. The role of preoperative diagnosis of OSA and preoperative PAP therapy treatment is also being explored.