Applying Best Clinical Practices to Patients at High Risk of Respiratory Complications
Respiratory Complication, Obstructive Sleep Apnea
About this trial
This is an interventional prevention trial for Respiratory Complication focused on measuring Respiratory Complication, Clinical Decision Support, Sugammadex
Eligibility Criteria
Inclusion Criteria:
- UCLA Ronald Reagan or Santa Monica patients aged 18 and older who had a general anesthetic with either rocuronium or vecuronium.
- Patients who receive sugammadex from the specified study supply
Exclusion Criteria:
- Patients under the age of 18
- Patients with a preoperative glomerular filtration rate less than 30 or on hemodialysis
- Patients with known hypersensitivity to any of the following: rocuronium, vecuronium, sugammadex, neostigmine or glycopyrrolate
- Patients with known neuromuscular disease
- Patients who remain intubated after surgery or leave the operating room with a tracheostomy in-situ
- Patients who did not receive reversal of neuromuscular blockade (with neostigmine in the pre-period or sugammadex in the post-period).
Sites / Locations
- Ronald Reagan UCLA Medical CenterRecruiting
Arms of the Study
Arm 1
Experimental
CDS pathway
When the anesthesiologist completes the preoperative evaluation for a patient who is flagged as having either respiratory disease or OSA and will receive general anesthesia, the anesthesiologist will receive a pop-up window reminding them of the best practice guidelines for pulmonary management in high-risk patients. We anticipate that the pathway will suggest 1) use of sugammadex to reverse neuromuscular blockade if rocuronium was used 2) use of objective train of four monitoring throughout the case and to confirm reversal 3) use of a tidal volume of 6-8 cc/kg 4) use of at least 5 cmH2O of PEEP