Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast Episode 128: Opioid Induced Respiratory Depression (The PRODIGY Trial) with Dr. Ashish Khanna
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Jul 9, 2019 Ashish Khanna, critical care anesthesiologist and associate professor who led the PRODIGY trial, discusses a large multi-continent study on opioid-induced respiratory depression. He recounts running a 16-site trial, why continuous monitoring matters versus snapshots, how common monitor-detected events were, and the creation of a five-variable risk score. Practical rollout challenges and future data uses are also covered.
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Postop Events Are Common And Hard To Predict
- Postoperative cardiorespiratory events are common and often unpredictable with current screening tools.
- Ashish Khanna argues proactive continuous surveillance is needed to reduce downstream ICU admissions and mortality.
Postop Mortality Is A Major Hidden Burden
- Thirty-day postoperative mortality would rank third in US causes of death if counted as one disease entity.
- The Get With The Guidelines registry found in-hospital mortality after acute floor events can be about 40%.
Clinical Work Showing Hidden Hypoxemia
- Khanna recounts Cleveland Clinic work showing 90% of hypoxemic episodes were missed by routine four-hour vital checks.
- That finding directly motivated designing the PRODIGY continuous-monitoring study.