Observational studyJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2016
Outcomes Associated with Early Postoperative Noninvasive Ventilation in Bariatric Surgical Patients with Sleep Apnea.
Observational study in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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.
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Who cites it
3 citing papers in PubMed, 12 citations in OpenAlex.
- Use and limitations of databases and big data in sleep-disordered breathing research.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
- ISCCM Guidelines for the Use of Non-invasive Ventilation in Acute Respiratory Failure in Adult ICUs.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2020Article
- Letter to the Editor: Regarding The Evaluation of Screening Questionnaires for Obstructive Sleep Apnea to Identify High-Risk Obese Patients Undergoing Bariatric Surgery.Obesity surgery · 2019Article
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
STUDY
objectivesTo examine the relationship of early initiation of noninvasive ventilation (NIV) with postoperative outcomes in patients with obstructive sleep apnea (OSA) undergoing bariatric surgery.
methodsWe included 5,266 patients with OSA undergoing bariatric surgeries at 161 hospitals in the United States. We defined early postoperative NIV as NIV used on the day of or the day after surgery; this could include prophylactic NIV or NIV used for early signs of respiratory deterioration. We developed a hierarchical model to identify factors associated with early use of NIV. Then, in a propensity matched cohort, we assessed the association between NIV use and outcomes.
resultsOverall, 996 patients (18.9%) were treated with early postoperative NIV. Predictors of NIV initiation were: male sex (odds ratio: 1.34, 95% confidence interval 1.14-1.59), older age, chronic obstructive pulmonary disease (COPD; odds ratio 1.39, confidence interval: 1.17-1.64), gastric bypass surgery, short-acting narcotics intravenous on the day of surgery and admission to a hospital with high rate of OSA diagnosis. In a propensity matched analysis, we found no significant association between early initiation of NIV and receipt of invasive mechanical ventilation (IMV) (early NIV 4.5% vs. no NIV 3.8% p = 0.46), cardiovascular complications or mortality. Results were consistent in several sensitivity analyses.
conclusionsIn this large observational study of patients with OSA undergoing bariatric surgery, early postoperative NIV use was not associated with better outcomes including less intubation and mortality. Properly designed controlled trials will be necessary to provide more definitive answers to this important clinical question.
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