Effect of CPAP on Postoperative Delirium

Duke University

Status: Completed

Conditions: Delirium; Sleep Apnea, Obstructive

Treatments: Device: CPAP

Study type: Interventional

Funder types: Other

Identifiers

NCT01816685

Pro00041457

Details and patient eligibility

About

Patients with a medical condition known as obstructive sleep apnea may be at increased risk of delirium following surgery. This study loans autotitrating CPAP machines to randomly-selected patients who are at high-risk for obstructive sleep apnea with the goal of preventing post-operative delirium.

Full description

Patients undergoing elective knee and hip replacements will be prospectively enrolled. These surgical procedures all have an expected length of stay > 3 days. Immediately following enrollment, patients will be randomized to receive CPAP or routine peri-operative care. Patients in the CPAP group will be instructed to wear an autotitrating positive airway pressure (APAP) device any time they sleep prior to surgery and on postoperative days 0, 1, and 2.

Enrollment: 135 patients

Sex: All

Ages: 50+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 50 and above
• Scheduled for an elective knee or hip replacement
• Ability to speak English and give informed consent
• At risk for obstructive sleep apnea as defined by a STOP-BANG score > 2

Exclusion criteria

• History of psychiatric or neurologic illness that would confound delirium assessment
• Severe tracheal or lung disease
• Contraindications to face-mask CPAP
• Treated OSA

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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135 participants in 2 patient groups

CPAP

Experimental group

Description:

Patients in the CPAP group will be instructed to wear an autotitrating positive airway pressure (APAP) device any time they sleep prior to surgery and on postoperative days 0, 1, and 2.

Treatment:

Device: CPAP

Routine Care

No Intervention group