Evidence map›Paper›PMID 26896040›Full record

SynthesisLung2016

Optimizing Prophylactic CPAP in Patients Without Obstructive Sleep Apnoea for High-Risk Abdominal Surgeries: A Meta-regression Analysis.

Preet Mohinder Singh, Anuradha Borle, Dipal Shah, Ashish Sinha, Jeetinder Kaur Makkar, Anjan Trikha, Basavana Gouda Goudra

Abstract readMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Lung, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 3 pooled it
1.8field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 3 syntheses or guidelines pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 2 countries.

Preet Mohinder SinghDepartment of Anesthesia, All India Institute of Medical Sciences, New Delhi, India.
Anuradha BorleDepartment of Anesthesia, All India Institute of Medical Sciences, New Delhi, India.
Dipal ShahDepartment of Anesthesia, All India Institute of Medical Sciences, New Delhi, India.
Ashish SinhaAnesthesiology and Perioperative Medicine, Drexel University College of Medicine, 245 N. 15th Street, MS 310, Philadelphia, PA, 19102, USA.
Jeetinder Kaur MakkarPost Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Anjan TrikhaDepartment of Anesthesia, All India Institute of Medical Sciences, New Delhi, India.
Basavana Gouda GoudraDepartment of Anesthesia, Hospital of the University of Pennsylvania, Philadelphia, USA. goudrab@uphs.upenn.edu.
All India Institute of Medical Sciences · INDrexel University · USHospital of the University of Pennsylvania · USPost Graduate Institute of Medical Education and Research · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionProphylactic continuous positive airway pressure (CPAP) can prevent pulmonary adverse events following upper abdominal surgeries. The present meta-regression evaluates and quantifies the effect of degree/duration of (CPAP) on the incidence of postoperative pulmonary events.

methodsMedical databases were searched for randomized controlled trials involving adult patients, comparing the outcome in those receiving prophylactic postoperative CPAP versus no CPAP, undergoing high-risk abdominal surgeries. Our meta-analysis evaluated the relationship between the postoperative pulmonary complications and the use of CPAP. Furthermore, meta-regression was used to quantify the effect of cumulative duration and degree of CPAP on the measured outcomes.

resultsSeventy-three potentially relevant studies were identified, of which 11 had appropriate data, allowing us to compare a total of 362 and 363 patients in CPAP and control groups, respectively. Qualitatively, Odds ratio for CPAP showed protective effect for pneumonia [0.39 (0.19-0.78)], atelectasis [0.51 (0.32-0.80)] and pulmonary complications [0.37 (0.24-0.56)] with zero heterogeneity. For prevention of pulmonary complications, odds ratio was better for continuous than intermittent CPAP. Meta-regression demonstrated a positive correlation between the degree of CPAP and the incidence of pneumonia with a regression coefficient of +0.61 (95 % CI 0.02-1.21, P = 0.048, τ (2) = 0.078, r (2) = 7.87 %). Overall, adverse effects were similar with or without the use of CPAP.

conclusionsProphylactic postoperative use of continuous CPAP significantly reduces the incidence of postoperative pneumonia, atelectasis and pulmonary complications in patients undergoing high-risk abdominal surgeries. Quantitatively, increasing the CPAP levels does not necessarily enhance the protective effect against pneumonia. Instead, protective effect diminishes with increasing degree of CPAP.

Indexed as

Continuous Positive Airway PressureAbdomenAnesthesia, GeneralHumansIncidenceLung DiseasesOdds RatioPneumoniaPostoperative ComplicationsPreoperative CarePulmonary AtelectasisRandomized Controlled Trials as TopicRisk FactorsTreatment OutcomeAtelectasisPneumoniaPostoperative pulmonary complicationProphylactic CPAP

Identifiers

PMID26896040
OpenAlexW2281979085

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.