Pulse oximetry is a simple, noninvasive bedside technology that can accurately measure changes in arterial blood oxygen saturation and pulse rate. Capnography measures exhaled carbon dioxide during the respiration cycle as well as respiratory rate.
Published online in the
'Although respiratory depression occurs in 46% of patients receiving opioids on the general care floor, the cost-benefit of capnography and oximetry for continuous monitoring of patients had not yet been examined,' said
The economic model was designed using a decision tree framework simulating costs and outcomes of continuous Nellcor pulse oximetry and Microstream capnography monitoring* versus intermittent pulse oximetry monitoring* for patients at high risk, high and intermediate risk, and any risk of respiratory depression based on their PRODIGY score(opens new window). Patients' PRODIGY score was derived from five independent patient characteristics - age, gender, sleep-disordered breathing, opioid naivety, and chronic heart failure. The model applied the results of the PRODIGY study to a hypothetical median-sized
'Respiratory compromise is a common, costly, potentially deadly - and preventable - condition. RC is a leading cause of ICU admissions and is one of the key contributing factors for code blues,1,2' said
Additionally, the primary objective of the PRODIGY trial was to develop and validate a risk stratification tool to assist clinicians in the identification of high risk patients receiving opioids.3 The PRODIGY risk stratification tool may support the recent updates from
For additional information about the PRODIGY clinical trial, please visit: medtronic.com/prodigy(opens new window).
About Respiratory Compromise
Respiratory compromise is a potentially life-threatening, progressive condition negatively impacting a person's ability to breathe adequately to maintain oxygenation and carbon dioxide removal. Patients with respiratory depression may experience shallow, slow, or no breathing after opioid administration which undetected can lead to cardiopulmonary arrest and death.5 This condition is rapidly becoming the third-most costly hospital inpatient expense in the
About the Patient Monitoring Operating Unit at Medtronic
The Patient Monitoring business at Medtronic is working together with the global healthcare community to solve clinically meaningful problems, with technologies and solutions for blood oxygen management, respiratory compromise, and perioperative complications.
About Medtronic
Any forward-looking statements are subject to risks and uncertainties such as those described in Medtronic's periodic reports on file with the
Pulse oximetry and capnography monitoring systems should not be used as the sole basis for diagnosis or therapy and are intended only as an adjunct in patient assessment.
Continuous pulse oximetry and capnography device pricing assumptions used list pricing for the following: a Capnostream portable respiratory monitor prorated over 7 years; a Microstream capnography filterline, and a disposable Nellcor pulse oximetry sensor, resulting in
1 Schein RM, Hazday N, Pena M, Ruben BH, Sprung CL. Clinical antecedents to in-hospital cardiopulmonary arrest. Chest. 1990; 98(6):1388-1392.
2 Fecho K, Jackson F, Smith F, OverdykF. In-hospital resuscitation: opioids and other factors influencing survival.
3 Khanna AK, Bergese S, Jungquist CR, et al. Prediction of opioid-induced respiratory depression on inpatient wards using continuous capnography and oximetry: an international prospective, observational trial. Anesth Analg. 2020;131:1012-1024.
4 https://www.jointcommission.org/standards/standard-faqs/hospital-and-hospital-clinics/leadership-ld/000002161/(opens new window)
5 Morris TA, Gay PC,
6 Wier LM, Henke R, Friedman B. Diagnostic groups with rapidly iCosts, by payer, 2001-2007: statistical brief #91.
7 Belcher AW, Khanna AK, Leung S, et al. Long-acting patient-controlled opioids are not associated with more postoperative hypoxemia than short-acting patient-controlled opioids after noncardiac surgery: a cohort analysis. Anesth Analg. 2016;123(6):1471-9.
8 Khanna AK, Sessler DI, Sun Z, et al. Using the STOP-BANG questionnaire to predict hypoxaemia in patients recovering from noncardiac surgery: a prospective cohort analysis. Brit J Anaesth. 2016;116(5):632-40.
9 Sun Z, Sessler DI, Dalton JE, et al. Postoperative hypoxemia is common and persistent: a prospective blinded observational study. Anesth Analg. 2015;121(3):709-15.
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