Evidence map›Paper›PMID 40089395›Full record

ArticleBritish journal of anaesthesia2025

Pulmonary complications associated with sugammadex or neostigmine in patients recovering from advanced diagnostic or interventional bronchoscopy: a retrospective two-centre analysis.

Ehab Farag, Karan Shah, Maged Argalious, Basem Abdelmalak, Thomas Gildea, John Seif, Shuyi Li, Edward J Mascha, Daniel I Sessler

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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

5 citing papers in PubMed.

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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

9 authors.

Ehab FaragDivision of Multi-Specialty Anesthesiology, Department of Anesthesiology, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: FARAGE@ccf.org.
Karan ShahDepartment of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
Maged ArgaliousDivision of Multi-Specialty Anesthesiology, Department of Anesthesiology, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, OH, USA.
Basem AbdelmalakDivision of Multi-Specialty Anesthesiology, Department of Anesthesiology, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, OH, USA.
Thomas GildeaDepartment of Pulmonary Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, OH, USA.
John SeifDivision of Multi-Specialty Anesthesiology, Department of Anesthesiology, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, OH, USA.
Shuyi LiDepartment of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
Edward J MaschaDepartment of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
Daniel I SesslerCenter for Outcomes Research, and Department of Anesthesiology, UTHealth, Houston, TX, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMany diagnostic and interventional procedures are performed in bronchoscopy suites in high-risk patients. Minor impairment in respiratory muscle function caused by incomplete reversal of neuromuscular block can contribute to postoperative pulmonary complications (PPCs). We assessed whether there are fewer serious PPCs after diagnostic or therapeutic bronchoscopy when neuromuscular block is reversed with sugammadex rather than neostigmine.

methodsThis is a retrospective cohort study for bronchoscopy under general anaesthesia with the use of neuromuscular blockers between July 2016 and June 2022. The primary outcome was a composite of PPCs. The secondary outcome was hypoxaemia. We used inverse probability of treatment weighting (IPTW) to adjust for confounding, fitting weighted outcome regression models to evaluate the association between the treatment and outcomes.

resultsWe analysed 8557 bronchoscopies across 6123 patients for the primary analysis. Adequate balance was achieved on all potential confounders after IPTW. The unweighted PPC incidence was 85/3830 (2.2%) for sugammadex and 93/4727 (2.0%) for neostigmine. The weighted PPC incidence was 2.7% for sugammadex and 1.9% for neostigmine. Sugammadex was associated with higher odds of experiencing the primary outcome of PPCs (odds ratio [OR]: 1.44; 95% confidence interval [CI]: 1.02-2.05; P=0.038), but not the secondary outcome of hypoxaemia (OR: 0.98; 95% CI: 0.81-1.20; P=0.878).

conclusionsSugammadex was associated with a higher risk of PPCs than neostigmine. However, the absolute difference observed (0.8%) might not be clinically meaningful. Randomised trials are needed to more accurately determine the effect of neuromuscular block reversal agent selection on respiratory complications.

Indexed as

BronchoscopyLung DiseasesNeostigminePostoperative ComplicationsSugammadexAdultAgedAnesthesia, GeneralFemaleHumansHypoxiaMaleMiddle AgedNeuromuscular BlockadeRetrospective StudiesNeostigmineSugammadexbronchoscopyinterventional pulmonologyneostigmineneuromuscular blockpostoperative pulmonary complicationssugammadex

Identifiers

PMID40089395
PMCPMC12226741

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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.