Bariatric Surgery, Obstructive Sleep Apnea (OSA)
Conditions
Keywords
obstructive sleep apnea, bariatric surgery, oxygen therapy
Brief summary
The goal of this observational study is to learn about the effect of supplemental oxygen therapy during the first night after bariatric and metabolic surgery in a population that is not (routinely) tested for obstructive sleep apnea preoperatively. The main question to answer in this study is: How many desaturations occur while participants receive supplemental oxygen therapy and how many, and what type of nursing interventions are needed? Another question we want to answer is: are there characteristics that seems to increase the risk of developing a desaturation?
Detailed description
This is a prospective observational study that aims to characterize the number of desaturations and nursing interventions in a population with a unknown structive sleep apnea status receiving supplemental oxygen therapy during the first night after metabolic and bariatric surgery. The secondary aim is to to identify patient characteristics that are associated with a higher risk of developing desaturations. Methods: Participants receive standard of care, which includes 2 liters of supplemental oxygen therapy during the first postoperative night after metabolic and bariatric surgery while being continously monitored. The desaturations, saturation and number and type of nursing intervention were collected along with patient characteristics (see outcomes) Sample size: A population proportion sample size was used, a CI 95%, margin of error 5% , proportion of 0.50, gave a required sample size of 385 participants. Mann Whitney U-test (continuous data) and Fishers exact test (categorical data) are used to compare spo2 and nursing interventions between participants with and without desaturations. Binary logistic regression will be used to estimate the risk for developing desaturations.
Interventions
None listed
Sponsors
Rijnstate Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Undergoing primary metabolic and bariatric surgery * Overnight hospital stay
Exclusion criteria
* Undergoing secundary metabolic and bariatric surgery (e.g. redo surgery) * Having treated obstructive sleep apnea (CPAP, oral application) * Having chronic obstructive pulmonary disease * No overnight hospital stay at the nursing ward (same-day discharge or overnight stay at medium or intensive care)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Type of nursing intervention | First postoperative night | which nursing intervention the nursed provided was documented on a form (e.g. putting back nasal cannula, increasing oxygen flow, jaw thrust) |
| Number of desaturations per patient | First postoperative night | Participants were continuously monitored and all desaturations (spo2\<90%) were collected. |
| Number of nursing interventions | First postoperative night | If nurses had to intervene because of a desaturation or to prevent a desaturation (e.g. waking patient, putting back nasal cannula, increasing oxygen flow) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The effect of the patient characterisic sex on the risk of developing desaturations | First postoperative night | — |
| The effect of the patient characterisic smoking status on the risk of developing desaturations | First postoperative night | Somking status before surgery |
| The effect of the patient characterisic chronic benzodiazepine use on the risk of developing desaturations | First postoperative night | Use of benzodiazepine at home |
| The effect of the patient characterisic diabetes mellitus type 2 on the risk of developing desaturations | First postoperative night | Preoperative diabetes mellitus type 2 status (yes/no) |
| The effect of the patient characterisic hypertension on the risk of developing desaturations | First postoperative night | Preoperative hypertension status (yes/no) |
| The effect of operating time on the risk of developing desaturations | First postoperative night | Duration of the surgery |
| The effect postoperatively used morphine milligram equivalent on the risk of developing desaturations | First postoperative night | The postoperative used opioid were converted to oral morphine milligram equivalent |
| The effect intraoperatively used morphine milligram equivalent on the risk of developing desaturations | First postoperative night | The intraoperative used opioid were converted to oral morphine milligram equivalent |
| The effect of rocuronium on the risk of developing desaturations | First postoperative night | The intraoperative used dose of rocuronium |
| The effect of sugammadex on the risk of developing desaturations | First postoperative night | The intraoperative use of sugammadex |
| The effect of the patient characterisic dyslipidemia on the risk of developing desaturations | First postoperative night | Preoperative dyslipidemia status (yes/no) |
| The effect of the patient characterisic age on the risk of developing desaturations | First postoperative night | Age on day of surgery |
| The effect of the patient characterisic body mass index on the risk of developing desaturations | First postoperative night | Body mass index on day of surgery |
Other
| Measure | Time frame | Description |
|---|---|---|
| Saturation during the night | First postoperative night | Every 10 minutes a mean saturation from the continuous monitoring was was saved. |
Countries
Netherlands
Outcome results
None listed