Predicting Opioid-Induced Respiratory Depression
A PPM Brief
Medtronic (Dublin, Ireland) announced1 prelim results from their prediction of opioid-induced respiratory depression in patients monitored by capnography (PRODIGY) score, a prospective, multicenter study to identify people at high risk for opioid-induced respiratory depression (OIRD). The study was presented at the 2019 Society of Critical Care Medicine’s Congress in San Diego, CA, by lead investigator Ashish K. Khanna, MD, associate professor of anesthesiology and intensivist at Wake Forest School of Medicine.
The study included 1,496 patients across 16 hospital sites in the US, Europe, and Asia, where approximately 46% of patients on the general care floor experienced OIRD, a significantly higher percentage than has been reported in the medical literature. Variables used to develop the risk-assessment score included: age, gender, sleep disorders, chronic heart failure, and opioid naivety.
The PRODIGY score successfully identified 76% of patients with confirmed respiratory depression (AUC = 0.7620). Continuous capnography and pulse oximetry data were collected, and all patients experiencing these events were reviewed and confirmed by an independent clinical event committee of physicians with expertise in perioperative respiratory medicine. According to Medtronic’s news release, this is the largest known study using continuous capnography and oximetry.
"Clinical evidence shows that acute and unexpected respiratory compromise on the general care floor is increasingly common. Until now, we have not been successful in predicting which patients are at high risk when recovering on the general care floor," said Dr. Khanna in a news release. "Early identification and intervention in these high-risk patients has the potential to improve patient safety and decrease the economic and clinical burden of unplanned ICU admissions."
