title: Rapid reduction of antihypertensive medications and insulin requirements after tracheostomy in a patient with severe obstructive sleep apnea syndrome.
abstract: We report a patient with severe obstructive sleep apnea syndrome, diabetes mellitus, and hypertension, with postoperative complications following tracheostomy. His stormy postoperative course is presented with emphasis on glycemic control and hypertension. We present a cautionary tale of a significant reduction in medications to control blood pressure and hyperglycemia following tracheostomy for severe OSA. The severe reduction in blood pressure and hypoglycemia could mimic sepsis and clinicans need to be vigilant to these dramatic effects following tracheostomy and appropriately adjust baseline medications.
authors.affiliation: Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA.
authors.forename: Arvind
authors.initials: A
authors.lastname: Bhimaraj
authors.forename: Navasuma
authors.initials: N
authors.lastname: Havaligi
authors.forename: Siva
authors.initials: S
authors.lastname: Ramachandran
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy* / Q000378:metabolism; D004334:Drug Administration Schedule; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000175:diagnosis; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis; D013997:Time Factors; D014139:Tracheostomy
chemical_list: D000959:Antihypertensive Agents; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin