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?
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.
Study Type
OBSERVATIONAL
Enrollment
563
Vitalys obesity clinic, part of Rijnstate Hospital
Arnhem, Gelderland, Netherlands
Number of desaturations per patient
Participants were continuously monitored and all desaturations (spo2\<90%) were collected.
Time frame: First postoperative night
Number of nursing interventions
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)
Time frame: First postoperative night
Type of nursing intervention
which nursing intervention the nursed provided was documented on a form (e.g. putting back nasal cannula, increasing oxygen flow, jaw thrust)
Time frame: First postoperative night
The effect of the patient characterisic "sex" on the risk of developing desaturations
Time frame: First postoperative night
The effect of the patient characterisic "age" on the risk of developing desaturations
Age on day of surgery
Time frame: First postoperative night
The effect of the patient characterisic "body mass index" on the risk of developing desaturations
Body mass index on day of surgery
Time frame: First postoperative night
The effect of the patient characterisic "smoking status" on the risk of developing desaturations
Somking status before surgery
Time frame: First postoperative night
The effect of the patient characterisic "chronic benzodiazepine use" on the risk of developing desaturations
Use of benzodiazepine at home
Time frame: First postoperative night
The effect of the patient characterisic "diabetes mellitus type 2" on the risk of developing desaturations
Preoperative diabetes mellitus type 2 status (yes/no)
Time frame: First postoperative night
The effect of the patient characterisic "hypertension" on the risk of developing desaturations
Preoperative hypertension status (yes/no)
Time frame: First postoperative night
The effect of the patient characterisic "dyslipidemia" on the risk of developing desaturations
Preoperative dyslipidemia status (yes/no)
Time frame: First postoperative night
The effect of operating time on the risk of developing desaturations
Duration of the surgery
Time frame: First postoperative night
The effect postoperatively used morphine milligram equivalent on the risk of developing desaturations
The postoperative used opioid were converted to oral morphine milligram equivalent
Time frame: First postoperative night
The effect intraoperatively used morphine milligram equivalent on the risk of developing desaturations
The intraoperative used opioid were converted to oral morphine milligram equivalent
Time frame: First postoperative night
The effect of rocuronium on the risk of developing desaturations
The intraoperative used dose of rocuronium
Time frame: First postoperative night
The effect of sugammadex on the risk of developing desaturations
The intraoperative use of sugammadex
Time frame: First postoperative night
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