Review articleNoninvasive positive pressure ventilation in the immediate post–bariatric surgery care of patients with obstructive sleep apnea: a systematic review☆,☆☆
Section snippets
Methods
Between January 1, 1995 and January 1, 2015, a comprehensive search of electronic databases, was performed, including Cochrane Library, MEDLINE, PubMed, BMJ Clinical Evidence, and Database of Abstracts of Reviews of Effects. The search strategy used controlled vocabulary—the National Library of Medicine’s Medical Subject Headings (MeSH). MeSH terms used were “obstructive sleep apnea” or “positive pressure ventilation” or “BiPAP” or “CPAP,” which then were combined with the following terms:
Study selection
After the initial screening process, bibliographies of key papers were searched for potentially relevant articles, and a total of 824 studies were identified. After careful assessment of these studies and based on our inclusion criteria, 87 studies were identified for full-text article evaluation (Fig. 1). Of these studies, a total of 13 met our inclusion criteria and were selected for our data extraction and critique process [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27]
Discussion
Proper diagnosis and management of OSA is particularly relevant perioperatively due to the risks of respiratory and hemodynamic complications that can lead to significant morbidity and mortality. NIPPV administration in obese patients is associated with a decreased rate of reintubation and unplanned intensive care unit admission; there were no NIPPV-related cases of anastomotic leak or serious adverse events [15], [29].
Despite this established treatment modality for OSA, the application of
Conclusion
This systematic review of the available literature did not provide evidence that there is a signal of an increased anastomotic dehiscence risk when NIPPV is administered during immediate post–bariatric surgery care.
Disclosures
The authors have no commercial associations that might be a conflict of interest in relation to this article.
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Accepted as poster for Obesity Week 2016 in New Orleans, Louisiana
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The views expressed herein are our own and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the U.S. Government.