Perioperative medicine & outcomes
Effect of noninvasive respiratory support after extubation on postoperative pulmonary complications in obese patients: A systematic review and network meta-analysis
Authors' conclusion
Among the four postoperative NRS techniques, HFNC seems to be the optimal choice for obese patients which shows certain advantages in reducing the risk of PPCs and shortening LOS.
Study context
- Population
- Obese patients after GA, PACU and inpatient ward
- Participants
- 1,184 patients · 20 RCTs
- Comparison
- Continuous positive airway pressure (CPAP) vs BiPAP vs high-flow nasal cannula (HFNC) vs conventional oxygen therapy after GA
- Outcome
- Incidence of PPCs (e.g., atelectasis, pneumonia, hypoxemia, respiratory failure)
Methodological detailsSUCRA ranking
- SUCRA ranking
Pooled result
As reported in the abstract
PPCs
- BiPAP and HFNC both reduced postoperative atelectasis vs conventional oxygen therapy (COT)
- No significant differences in other postoperative pulmonary complications (PPCs) (pneumonia, hypoxemia, respiratory failure) between the four noninvasive respiratory support (NRS) techniques
Further pooled results
Oxygenation and LOS
- CPAP superior in improving oxygenation; HFNC superior in shortening LOS
Oxygen treatment failure and anastomotic leakage
- No differences between NRS techniques
SUCRA ranking
- HFNC ranked first in five of the eight outcomes (hypoxemia, respiratory failure, treatment failure, anastomotic leakage, LOS)
Original publication
Effect of noninvasive respiratory support after extubation on postoperative pulmonary complications in obese patients: A systematic review and network meta-analysis. J Clin Anesth. Published 4 October 2023. doi:10.
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