Evidence map›Paper›PMID 37794334›Full record

Trial reportBMC anesthesiology2023

Incidence of postoperative opioid-induced respiratory depression episodes in patients on room air or supplemental oxygen: a post-hoc analysis of the PRODIGY trial.

Anthony G Doufas, Mariana L Laporta, C Noelle Driver, Fabio Di Piazza, Marco Scardapane, Sergio D Bergese, Richard D Urman, Ashish K Khanna, Toby N Weingarten, Prediction of Opioid-induced respiratory Depression In patients monitored by capnoGraphY (PRODIGY) Group Investigators

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

Trial report in BMC anesthesiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02811302 (PRediction of Opioid-induced Respiratory Depression In Patients Monitored by capnoGraphY), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.8field-weighted citation impact, top 14% 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.

NCT02811302 nacompletednot on this map

PRediction of Opioid-induced Respiratory Depression In Patients Monitored by capnoGraphY (PRODIGY)

TypeinterventionalSponsorMedtronic - MITGRan2017 to 2018Enrolled1,495ConditionsRespiratory DepressionArmsCapnostream Monitor
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Article
  3. 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 7 institutions in 2 countries.

Anthony G DoufasDepartment of Anesthesiology, Perioperative and Pain Medicine, Center for Sleep and Circadian Sciences, Stanford University School of Medicine, 300 Pasteur Drive, H3580, Stanford, San Francisco, CA, 94305-5640, USA. agdoufas@stanford.edu.
Mariana L LaportaDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
C Noelle DriverDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Fabio Di PiazzaMedtronic Core Clinical Solutions, Global Clinical Data Solutions, Rome, Italy.
Marco ScardapaneMedtronic Core Clinical Solutions, Global Clinical Data Solutions, Rome, Italy.
Sergio D BergeseDepartment of Anesthesiology and Neurological Surgery, Stony Brook University School of Medicine, Stony Brook, New York, USA.
Richard D UrmanDepartment of Anesthesiology, The Ohio State University and Wexner Medical Center, Columbus, OH, USA.
Ashish K KhannaSection On Critical Care Medicine, Department of Anesthesiology, Wake Forest Center for Biomedical Informatics, Perioperative Outcomes and Informatics Collaborative (POIC), Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Toby N WeingartenDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Prediction of Opioid-induced respiratory Depression In patients monitored by capnoGraphY (PRODIGY) Group Investigators
Mayo Clinic in Arizona · USMedtronic (Italy) · ITMayo Clinic in Florida · USNeurological Surgery · USOutcomes Research Consortium · USStanford Medicine · USThe Ohio State University Wexner Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSupplemental oxygen (SO) potentiates opioid-induced respiratory depression (OIRD) in experiments on healthy volunteers. Our objective was to examine the relationship between SO and OIRD in patients on surgical units.

methodsThis post-hoc analysis utilized a portion of the observational PRediction of Opioid-induced respiratory Depression In patients monitored by capnoGraphY (PRODIGY) trial dataset (202 patients, two trial sites), which involved blinded continuous pulse oximetry and capnography monitoring of postsurgical patients on surgical units. OIRD incidence was determined for patients receiving room air (RA), intermittent SO, or continuous SO. Generalized estimating equation (GEE) models, with a Poisson distribution, a log-link function and time of exposure as offset, were used to compare the incidence of OIRD when patients were receiving SO vs RA.

resultsWithin the analysis cohort, 74 patients were always on RA, 88 on intermittent and 40 on continuous SO. Compared with when on RA, when receiving SO patients had a higher risk for all OIRD episodes (incidence rate ratio [IRR] 2.7, 95% confidence interval [CI] 1.4-5.1), apnea episodes (IRR 2.8, 95% CI 1.5-5.2), and bradypnea episodes (IRR 3.0, 95% CI 1.2-7.9). Patients with high or intermediate PRODIGY scores had higher IRRs of OIRD episodes when receiving SO, compared with RA (IRR 4.5, 95% CI 2.2-9.6 and IRR 2.3, 95% CI 1.1-4.9, for high and intermediate scores, respectively).

conclusionsDespite oxygen desaturation events not differing between SO and RA, SO may clinically promote OIRD. Clinicians should be aware that postoperative patients receiving SO therapy remain at increased risk for apnea and bradypnea.

trial registrationClinicaltrials.gov: NCT02811302, registered June 23, 2016.

Indexed as

Analgesics, OpioidRespiratory InsufficiencyApneaCapnographyHumansIncidenceOximetryOxygenPostoperative ComplicationsAnalgesics, OpioidOxygenApneaCapnographyContinuous monitoringPulse oximetryRespiratory depressionRoom airSpot check monitoringSupplemental oxygen

Identifiers

PMID37794334
PMCPMC10548743
OpenAlexW4387340686

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.