• Lioudmila V Karnatovskaia, Augustine S Lee, S Patrick Bender, Daniel Talmor, Emir Festic, and US Critical Illness and Injury Trials Group: Lung Injury Prevention Study Investigators (USCIITG–LIPS).
• Division of Pulmonary and Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL.
• J Clin Sleep Med. 2014 Jun 15;10(6):657-62.

BackgroundObstructive sleep apnea (OSA) may increase the risk of respiratory complications and acute respiratory distress syndrome (ARDS) among surgical patients. OSA is more prevalent among obese individuals; obesity can predispose to ARDS.HypothesisIt is unclear whether OSA independently contributes towards the risk of ARDS among hospitalized patients.MethodsThis is a pre-planned retrospective subgroup analysis of the prospectively identified cohort of 5,584 patients across 22 hospitals with at least one risk factor for ARDS at the time of hospitalization from a trial by the US Critical Illness and Injury Trials Group designed to validate the Lung Injury Prediction Score. A total of 252 patients (4.5%) had a diagnosis of OSA at the time of hospitalization; of those, 66% were obese. Following multivariate adjustment in the logistic regression model, there was no significant relationship between OSA and development of ARDS (OR = 0.65, 95%CI = 0.32-1.22). However, body mass index (BMI) was associated with subsequent ARDS development (OR = 1.02, 95%CI = 1.00-1.04, p = 0.03). Neither OSA nor BMI affected mechanical ventilation requirement or mortality.ConclusionsPrior diagnosis of OSA did not independently affect development of ARDS among patients with at least one predisposing condition, nor the need for mechanical ventilation or hospital mortality. Obesity appeared to independently increase the risk of ARDS.

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