Evidence map›Paper›PMID 33975540›Full record

ArticleBMC anesthesiology2021

Perioperative adherence to continuous positive airway pressure and its effect on postoperative nocturnal hypoxemia in obstructive sleep apnea patients: a prospective cohort study.

Colin Suen, Jean Wong, Kahiye Warsame, Yamini Subramani, Tony Panzarella, Rida Waseem, Dennis Auckley, Rabail Chaudhry, Sazzadul Islam, Frances Chung

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC anesthesiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02796846 (The Association of CPAP Compliance and Nocturnal Hypoxemia in the Perioperative Period), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 18% 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.

NCT02796846 completednot on this map

The Association of CPAP Compliance and Nocturnal Hypoxemia in the Perioperative Period

TypeobservationalSponsorUniversity Health Network, TorontoRan2015 to 2019Enrolled158ConditionsObstructive Sleep Apnea
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Protocolizing perioperative OSA screening and management: moving in the right direction.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022
    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

10 authors at 5 institutions in 2 countries.

Colin SuenDepartment of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, MCL 2-405, 399 Bathurst St., Toronto, ON, M5T2S8, Canada.
Jean WongDepartment of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, MCL 2-405, 399 Bathurst St., Toronto, ON, M5T2S8, Canada.
Kahiye WarsameDepartment of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, MCL 2-405, 399 Bathurst St., Toronto, ON, M5T2S8, Canada.
Yamini SubramaniDepartment of Anesthesia and Perioperative Medicine, London Health Science Centre, St. Joseph Health Care, Western University, London, ON, Canada.
Tony PanzarellaDivision of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Rida WaseemDepartment of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, MCL 2-405, 399 Bathurst St., Toronto, ON, M5T2S8, Canada.
Dennis AuckleyDivision of Pulmonary, Critical Care and Sleep Medicine, MetroHealth Medical Center, Case Western Reserve University, School of Medicine, Cleveland, OH, USA.
Rabail ChaudhryDepartment of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, MCL 2-405, 399 Bathurst St., Toronto, ON, M5T2S8, Canada.
Sazzadul IslamDepartment of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, MCL 2-405, 399 Bathurst St., Toronto, ON, M5T2S8, Canada.
Frances ChungDepartment of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, MCL 2-405, 399 Bathurst St., Toronto, ON, M5T2S8, Canada. frances.chung@uhn.ca.
University of Toronto · CAMetroHealth Medical Center · USToronto Western Hospital · CAUniversity Health Network · CAWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough continuous positive airway pressure (CPAP) is the first line treatment for obstructive sleep apnea (OSA) patients, the perioperative adherence rate is unclear. The objective of this study was to determine the perioperative adherence rate of patients with OSA with a CPAP prescription and the effect of adherence on nocturnal oxygen saturation.

methodsThis prospective cohort study included adult surgical patients with a diagnosis of OSA with CPAP prescription undergoing elective non-cardiac surgery. Patients were divided into CPAP adherent and non-adherent groups based on duration of usage (≥ 4 h/night). Overnight oximetry was performed preoperatively and on postoperative night 1 and 2 (N1, N2). The primary outcome was adherence rate and the secondary outcome was nocturnal oxygen saturation.

resultsOne hundred and thirty-two patients completed the study. CPAP adherence was 61% preoperatively, 58% on postoperative N1, and 59% on N2. Forty-nine percent were consistently CPAP adherent pre- and postoperatively. Using a linear fixed effects regression, oxygen desaturation index (ODI) was significantly improved by CPAP adherence (p = 0.0011). The interaction term CPAP x N1 was significant (p = 0.0015), suggesting that the effect of CPAP adherence varied on N1 vs preoperatively. There was no benefit of CPAP adherence on postoperative mean SpO

conclusionsAmong patients with a preoperative CPAP prescription, approximately 50% were consistently adherent. CPAP adherence was associated with improved preoperative ODI and the benefit was maintained on N1. These modest effects may be underestimated by a higher severity of OSA in the CPAP adherent group and a higher rate of oxygen supplementation in the non-adherent group.

trial registrationClinicalTrials.Gov registry ( NCT02796846 ).

Indexed as

Continuous Positive Airway PressurePatient CompliancePerioperative CareCohort StudiesFemaleHumansHypoxiaMaleMiddle AgedPostoperative ComplicationsSleep Apnea, ObstructiveAdherenceContinuous positive airway pressureNocturnal hypoxemiaObstructive sleep apneaPerioperative outcomesSleep disordered breathing

Identifiers

PMID33975540
PMCPMC8111893
OpenAlexW3112583341

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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.