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Perioperative Continuous Positive Airway Pressure Therapy: A Review With the Emphasis on Randomized Controlled Trials
M Jonsson Fagerlund1,2, K A Franklin3
1From the Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care, Karolinska Institutet, Stockholm, Sweden.
Anesthesia and Analgesia
|April 15, 2021
Summary
Continuous positive airway pressure (CPAP) therapy can improve postoperative oxygenation and reduce complications for patients with obstructive sleep apnea (OSA). Further research is needed to address adherence and optimize perioperative CPAP use.
Area of Science:
- Anesthesiology
- Pulmonology
- Critical Care Medicine
Background:
- Obstructive sleep apnea (OSA) is a common risk factor for surgical complications.
- Many OSA patients are undiagnosed preoperatively, hindering optimization.
- Current perioperative guidelines for CPAP use are based on limited evidence.
Purpose of the Study:
- To review the current evidence on perioperative continuous positive airway pressure (CPAP) therapy for patients with obstructive sleep apnea (OSA).
- To evaluate the impact of CPAP on postoperative outcomes in surgical patients with OSA.
Main Methods:
- Systematic review of 21 randomized controlled trials.
- Analysis of studies investigating CPAP's effect on postoperative physiology and complications.
Main Results:
- CPAP therapy post-surgery shows potential to improve oxygenation.
- Evidence suggests CPAP reduces reintubation and mechanical ventilation needs.
- CPAP effectively decreases apnea, hypopnea frequency, and postoperative hypoxemia.
Conclusions:
- Perioperative CPAP may enhance cardiorespiratory outcomes in OSA patients.
- Poor adherence to CPAP is a significant limitation.
- Larger, multicenter studies are required to confirm findings and address adherence.
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