Immediate continuous positive airway pressure (CPAP) therapy after sleeve gastrectomy

Hewidy, Asem A.; Suliman, Lucy A.; Hefnawy, Emad El; Hassan, Adel Ali

doi:10.1016/j.ejcdt.2016.01.012

Cited by 13 publications

(16 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The quality of evidence for prophylactic non-invasive ventilation was low. We identified six RCTs investigating single level continuous positive airway pressure363738394041 and two investigating bi-level pressure support ventilation,4243 with a pooled total of 437 patients. These modes of ventilatory support use positive pressure to splint open airways and improve work of breathing through improvement in respiratory system compliance and augmentation of inspiratory effort.…”

Section: Resultsmentioning

confidence: 99%

“…In the studies of continuous positive airway pressure, a positive end expiratory pressure of at least 8 cm H 2 O was applied without interruption for at least eight to 12 hours following extubation or admission to a post-anaesthetic care unit 3638. Meta-analysis suggests that starting continuous positive airway pressure prophylactically in the postoperative period for major abdominal and thoracic surgical patients may reduce PPCs (risk ratio 0.49, 0.24 to 0.99); however, included RCTs were small and the cumulative z curve did not cross the calculated trial sequential monitoring boundary.…”

Section: Resultsmentioning

confidence: 99%

“…Duration of ventilatory support ranged from two 120 minute cycles of helmet continuous positive airway pressure on the first postoperative day only to bi-level positive airway pressure provided preoperatively for seven days and then daily during the postoperative inpatient stay 43. Five of the nine trials involved provision of the intervention for less than 24 hours,2836373841 and one trial for three days,40 whereas the remainder continued to provide ventilator support while patients were in hospital 39424345. Full details of included trials and individual meta-analysis of prophylactic non-invasive ventilation are provided in appendix 2, section 6.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Perioperative interventions for prevention of postoperative pulmonary complications: systematic review and meta-analysis

Odor

Bampoe

Gilhooly

et al. 2020

BMJ

134

120

View full text Add to dashboard Cite

OBJECTIVE To identify, appraise, and synthesise the best available evidence on the efficacy of perioperative interventions to reduce postoperative pulmonary complications (PPCs) in adult patients undergoing non-cardiac surgery. DESIGNSystematic review and meta-analysis of randomised controlled trials. DATA SOURCESMedline, Embase, CINHAL, and CENTRAL from January 1990 to December 2017. ELIGIBILITY CRITERIARandomised controlled trials investigating short term, protocolised medical interventions conducted before, during, or after non-cardiac surgery were included. Trials with clinical diagnostic criteria for PPC outcomes were included. Studies of surgical technique or physiological or biochemical outcomes were excluded. DATA EXTRACTION AND SYNTHESISReviewers independently identified studies, extracted data, and assessed the quality of evidence. Metaanalyses were conducted to calculate risk ratios with 95% confidence intervals. Quality of evidence was summarised in accordance with GRADE methods. The primary outcome was the incidence of PPCs. Secondary outcomes were respiratory infection, atelectasis, length of hospital stay, and mortality. Trial sequential analysis was used to investigate the reliability and conclusiveness of available evidence. Adverse effects of interventions were not measured or compared. RESULTS117 trials enrolled 21 940 participants, investigating 11 categories of intervention. 95 randomised controlled trials enrolling 18 062 participants were included in meta-analysis; 22 trials were excluded from meta-analysis because the interventions were not sufficiently similar to be pooled. No high quality evidence was found for interventions to reduce the primary outcome (incidence of PPCs). Seven interventions had low or moderate quality evidence with confidence intervals indicating a probable reduction in PPCs: enhanced recovery pathways (risk ratio 0.35, 95% confidence interval 0.21 to 0.58), prophylactic mucolytics (0.40, 0.23 to 0.67), postoperative continuous positive airway pressure ventilation (0.49, 0.24 to 0.99), lung protective intraoperative ventilation (0.52, 0.30 to 0.88), prophylactic respiratory physiotherapy (0.55, 0.32 to 0.93), epidural analgesia (0.77, 0.65 to 0.92), and goal directed haemodynamic therapy (0.87, 0.77 to 0.98). Moderate quality evidence showed no benefit for incentive spirometry in preventing PPCs. Trial sequential analysis adjustment confidently supported a relative risk reduction of 25% in PPCs for prophylactic respiratory physiotherapy, epidural analgesia, enhanced recovery pathways, and goal directed haemodynamic therapies. Insufficient data were available to support or refute equivalent relative risk reductions for other interventions. CONCLUSIONSPredominantly low quality evidence favours multiple perioperative PPC reduction strategies. Clinicians may choose to reassess their perioperative care pathways, but the results indicate that new trials with a low risk of bias are needed to obtain conclusive evidence of efficacy for many of these interventions. STUDY REGIS...

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Perioperative interventions for prevention of postoperative pulmonary complications: systematic review and meta-analysis

Odor

Bampoe

Gilhooly

et al. 2020

BMJ

134

120

View full text Add to dashboard Cite

show abstract

“…The 17 trials included in this review were published between 1981 and 2022 (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44). The pooled sample size was 6,108 participants, with the largest study contributing 78% to the overall sample (43).…”

Section: Study Characteristicsmentioning

confidence: 99%

Prophylactic Postoperative Noninvasive Ventilation in Adults Undergoing Upper Abdominal Surgery: A Systematic Review and Meta-Analysis

Lockstone

Denehy

Truong

et al. 2022

Critical Care Medicine

View full text Add to dashboard Cite

OBJECTIVES: Postoperative pulmonary complications (PPCs) are a leading cause of morbidity and mortality following upper abdominal surgery. Applying either noninvasive ventilation (NIV) or continuous positive airway pressure (CPAP) in the early postoperative period is suggested to prevent PPC. We aimed to assess whether postoperative NIV or CPAP or both prevent PPCs compared with standard care in adults undergoing upper abdominal surgery, including in those identified at higher PPC risk. Additionally, the different interventions used were evaluated to assess whether there is a superior approach. DATA SOURCES: We searched PubMed, Embase‚ CINAHL, CENTRAL, and Scopus from inception to May 17, 2021. STUDY SELECTION: We performed a systematic search of the literature for randomized controlled trials evaluating prophylactic NIV and/or CPAP in the postoperative period. DATA EXTRACTION: Two authors independently performed study selection and data extraction. Individual study risk of bias was assessed using the PEDro scale, and certainty in outcomes was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework. DATA SYNTHESIS: We included 17 studies enrolling 6,108 patients. No significant benefit was demonstrated for postoperative NIV/CPAP to reduce PPC (risk ratio [RR], 0.89; 95% CI, 0.78–1.01; very low certainty), including in adults identified at higher PPC risk (RR, 0.91; 95% CI, 0.77–1.07; very low certainty). No intervention approach was identified as superior, and no significant benefit was demonstrated when comparing: 1) CPAP (RR, 0.90; 95% CI, 0.79–1.04; very low certainty), 2) NIV (RR, 0.68; 95% CI, 0.41–1.13; very low certainty), 3) continuous NIV/CPAP (RR, 0.90; 95% CI, 0.77–1.05; very low certainty), or 4) intermittent NIV/CPAP (RR, 0.66; 95% CI, 0.39–1.10; very low certainty) to standard care. CONCLUSIONS: These findings suggest routine provision of either prophylactic NIV or CPAP following upper abdominal surgery may not be effective to reduce PPCs‚ including in those identified at higher risk.

show abstract

“…Andrade et al (2016) indicated that CPAP delivered through the oronasal route may compromise the effectiveness of CPAP in treating OSA. Hewidy, Suliman, El Hefnawy, and Hassan (2016) provided evidence that non-invasive CPAP ventilation may improve post-operative oxygenation and lung function and reduce post-operative complications in morbidly obese patients undergoing sleeve gastrectomy. The authors evaluated the effect of immediate post-operative CPAP therapy after sleeve gastrectomy.…”

mentioning

confidence: 99%

Advances in multisensor information fusion: A Markov–Kalman viscosity fuzzy statistical predictor for analysis of oxygen flow, diffusion, speed, temperature, and time metrics in CPAP

Rodger

2018

Expert Systems

View full text Add to dashboard Cite

The efficacies of continuous positive airway pressure (CPAP) are well documented in decreasing the apnoea–hypopnoea index in patients with obstructive sleep apnoea. To guarantee these efficacies, CPAP manufacturers must thoroughly test these devices to ensure the flow of oxygenated air to the patient at various temperatures during a prescribed time frame. The calculation of the percent oxygen in a “bimixture” of gas can be done by measuring the travel time of a sound wave through the gas, and the travel time is proportional to the density of the air. We utilized existing multisensor tubes that were developed to collect and measure oxygen flow, diffusion, speed, temperature, and time metrics. Then these metrics were analysed using a Markov fuzzy, statistical, artificial neural network, nearest‐neighbour predictive approach to determine the interactions between these variables. An improved Kalman filter method was employed to reduce noise, increase viscosity, and obtain correct data from the CPAP system.

show abstract

Immediate continuous positive airway pressure (CPAP) therapy after sleeve gastrectomy

Cited by 13 publications

References 15 publications

Perioperative interventions for prevention of postoperative pulmonary complications: systematic review and meta-analysis

Perioperative interventions for prevention of postoperative pulmonary complications: systematic review and meta-analysis

Prophylactic Postoperative Noninvasive Ventilation in Adults Undergoing Upper Abdominal Surgery: A Systematic Review and Meta-Analysis

Advances in multisensor information fusion: A Markov–Kalman viscosity fuzzy statistical predictor for analysis of oxygen flow, diffusion, speed, temperature, and time metrics in CPAP

Contact Info

Product

Resources

About