Safety of Continuous Postoperative Pulse Oximetry Monitoring Without Obstructive Sleep Apnea Screening in &gt; 5000 Patients Undergoing Bariatric Surgery

Veldhuisen, Sophie L. van; Arslan, İbrahim; Deden, Laura N.; Aarts, Edo O.; Hazebroek, Eric J.

doi:10.1007/s11695-019-04297-2

Cited by 14 publications

(7 citation statements)

References 30 publications

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“…20 More recent prospective studies and reviews demonstrate a consistently low incidence of cardiopulmonary and neurovascular complications after bariatric surgery, and statistical analyses fail to indicate a direct causative link to OSA. [21][22][23] Evidence-based guidelines for perioperative care of potential OSA in bariatric patients are lacking. 24 Therefore, a wide variety of perioperative modalities has emerged, which all aim to minimise the risk of serious adverse events related to untreated OSA.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

“…In this approach, all patients receive the same intervention to achieve adequate saturation levels in the early postoperative phase. 21 Obesity and obesity-related disorders increasingly demand utilisation of available healthcare resources. Justification of high screening expenses for OSA is debatable given the low incidence of OSA-related complications, despite the high prevalence of OSA.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

“…The main symptom of OSA, daytime sleepiness, will be assessed by the Epworth Sleepiness Scale questionnaire. 43 Patients report the likelihood of falling asleep during eight daytime activities on a Likert scale of 0-3, indicating results that range from normal daytime sleepiness (score 0-5) to severe excessive daytime sleepiness (score [16][17][18][19][20][21][22][23][24].…”

Section: Osa-related Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…In this approach, all patients receive the same intervention to achieve adequate saturation levels in the early postoperative phase. 21 …”

Section: Introductionmentioning

confidence: 99%

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Protocol of a multicentre, prospective cohort study that evaluates cost-effectiveness of two perioperative care strategies for potential obstructive sleep apnoea in morbidly obese patients undergoing bariatric surgery

et al. 2020

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IntroductionDespite the high prevalence of obstructive sleep apnoea (OSA) in obese patients undergoing bariatric surgery, OSA is undiagnosed in the majority of patients and thus untreated. While untreated OSA is associated with an increased risk of preoperative and postoperative complications, no evidence-based guidelines on perioperative care for these patients are available. The aim of the POPCORN study (Post-Operative Pulse oximetry without OSA sCreening vs perioperative continuous positive airway pressure (CPAP) treatment following OSA scReeNing by polygraphy (PG)) is to evaluate which perioperative strategy is the most cost-effective for obese patients undergoing bariatric surgery without a history of OSA.Methods and analysisIn this multicentre observational cohort study, data from 1380 patients who will undergo bariatric surgery will be collected. Patients will receive either postoperative care with pulse oximetry monitoring and supplemental oxygen during the first postoperative night, or care that includes preoperative PG and CPAP treatment in case of moderate or severe OSA. Local protocols for perioperative care in each participating hospital will determine into which cohort a patient is placed. The primary outcome is cost-effectiveness, which will be calculated by comparing all healthcare costs with the quality-adjusted life-years (QALYs, calculated using EQ-5D questionnaires). Secondary outcomes are mortality, complications within 30 days after surgery, readmissions, reoperations, length of stay, weight loss, generic quality of life (QOL), OSA-specific QOL, OSA symptoms and CPAP adherence. Patients will receive questionnaires before surgery and 1, 3, 6 and 12 months after surgery to report QALYs and other patient-reported outcomes.Ethics and disseminationApproval from the Medical Research Ethics Committees United was granted in accordance with the Dutch law for Medical Research Involving Human Subjects Act (WMO) (reference number W17.050). Results will be submitted for publication in peer-reviewed journals and presented at (inter)national conferences.Trial registration numberNTR6991.

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Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Section: Osa-related Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…In this approach, all patients receive the same intervention to achieve adequate saturation levels in the early postoperative phase. 21 …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Protocol of a multicentre, prospective cohort study that evaluates cost-effectiveness of two perioperative care strategies for potential obstructive sleep apnoea in morbidly obese patients undergoing bariatric surgery

et al. 2020

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Bariatric Surgery

de Raaff,

de Vries,

van Wagensveld

2023

Obstructive Sleep Apnea

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Evaluation of CPAP adherence in bariatric patients diagnosed with obstructive sleep apnea: outcomes of a multicenter cohort study

et al. 2022

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Purpose Obstructive sleep apnea (OSA) is highly prevalent but mostly undiagnosed in obese patients scheduled for bariatric surgery. To prevent cardiopulmonary complications, many clinics perform preoperative OSA screening. Consequently, adequate adherence to continuous positive airway pressure (CPAP) therapy is essential but challenging. We aimed to evaluate CPAP adherence and its influence on postoperative outcomes. Methods In a prospective multicenter cohort study, we compared different perioperative strategies for handling undiagnosed OSA in bariatric patients. In this subgroup analysis, patients newly diagnosed with OSA were compared to those with pre-existing OSA. We assessed inadequate CPAP adherence, defined as < 4 h/night, between the preoperative period and 6 months postoperative. Cardiopulmonary complications and (un)scheduled ICU admissions were also evaluated. Results In total, 272 patients with newly diagnosed OSA (67.4%) and 132 patients with pre-existing OSA (32.6%) were included. Before surgery, 41 newly diagnosed patients used CPAP inadequately, compared to 5 patients with pre-existing OSA (15% vs. 4%, p = 0.049). Six months after surgery, inadequate CPAP use increased to 73% for newly diagnosed patients and 39% for patients with pre-existing OSA, respectively ( p < 0.001). Incidences of cardiopulmonary complications, scheduled, and unscheduled ICU admissions were similar in the two study groups ( p = 0.600, p = 0.972, and p = 0.980, respectively). Conclusion Inadequate CPAP adherence is higher in bariatric patients newly diagnosed with OSA when compared to patients with pre-existing OSA. Strategies to increase CPAP adherence may be valuable when considering routine OSA screening and CPAP therapy in patients undergoing bariatric surgery. Further studies are needed to improve current guidelines on perioperative OSA management of obese patients. Trial registration POPCORN study, registered at Netherlands Trial Register, https://www.trialregister.nl/trial/6805 . ID no: 6805.

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Safety of Continuous Postoperative Pulse Oximetry Monitoring Without Obstructive Sleep Apnea Screening in > 5000 Patients Undergoing Bariatric Surgery

Cited by 14 publications

References 30 publications

Protocol of a multicentre, prospective cohort study that evaluates cost-effectiveness of two perioperative care strategies for potential obstructive sleep apnoea in morbidly obese patients undergoing bariatric surgery

Protocol of a multicentre, prospective cohort study that evaluates cost-effectiveness of two perioperative care strategies for potential obstructive sleep apnoea in morbidly obese patients undergoing bariatric surgery

Bariatric Surgery

Evaluation of CPAP adherence in bariatric patients diagnosed with obstructive sleep apnea: outcomes of a multicenter cohort study

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