Sugammadex Reduced the Incidence of Postoperative Pulmonary Complications in Susceptible Patients Identified by ARISCAT Risk Index: Systematic Review and Meta-analysis
Introduction The efficacy of sugammadex on postoperative pulmonary complications (PPCs) in susceptible patients, compared with neostigmine, remains indeterminate. The Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) Group Investigators proposed a risk index for the early identification of susceptible patients, with excellent externally validated discrimination ability. Meta-analytical techniques were applied to evaluate the efficacy of sugammadex on PPCs in patients with ARISCAT-defined risk factors. Methods The study is registered on PROSPERO, number CRD42021261156. We searched PubMed, Scopus, Embase, Cochrane library, GreyNet, and OpenGrey for eligible randomized controlled trials (RCTs) without restricting the language or year of publication. Results Twelve RCTs consisting of 1182 patients susceptible to PPCs were included. A robust reduction was observed on the incidence of PPCs in susceptible patients who received sugammadex [RR 0.66; 95% CI (0.54, 0.80), p < 0.01], with a low level of between-study heterogeneity (I2 = 45.98%; H2 = 1.85). Similar protective effects were also proved in avoiding residual neuromuscular block (NMB) [RR 0.25; 95% CI (0.11, 0.56); p < 0.01], atelectasis [RR 0.74; 95% CI (0.59, 0.95); p = 0.02], pneumonia [RR 0.49; 95% CI (0.28, 0.88); p = 0.02], and respiratory failure [RR 0.61; 95% CI (0.39, 0.96); p = 0.03]. No difference was observed regarding adverse events [RR 0.85; 95% CI (0.72, 1.01); p = 0.06]. Conclusion Low to moderate quality of evidence demonstrated the edge of sugammadex over neostigmine for NMB reversal in reducing the likelihood of PPCs and residual NMB in patients with ARISCAT-defined risk factors. Clinicians may reassess the type of reversal agent when treating patients susceptible to PPCs..
| Medienart: |
Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:40 |
|---|---|
| Enthalten in: |
Advances in therapy - 40(2023), 9 vom: 23. Juni, Seite 3784-3803 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Bai, Yun-Xiao [VerfasserIn] |
|---|
| Links: |
Volltext [lizenzpflichtig] |
|---|
| BKL: | |
|---|---|
| Themen: |
Aspiration pneumonitis |
| Anmerkungen: |
© The Author(s), under exclusive licence to Springer Healthcare Ltd., part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
|---|
| doi: |
10.1007/s12325-023-02535-9 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
OLC2145033092 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | OLC2145033092 | ||
| 003 | DE-627 | ||
| 005 | 20240118102349.0 | ||
| 007 | tu | ||
| 008 | 240118s2023 xx ||||| 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s12325-023-02535-9 |2 doi | |
| 035 | |a (DE-627)OLC2145033092 | ||
| 035 | |a (DE-He213)s12325-023-02535-9-p | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 082 | 0 | 4 | |a 610 |q VZ |
| 084 | |a 44.40$jPharmazie$jPharmazeutika |2 bkl | ||
| 100 | 1 | |a Bai, Yun-Xiao |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Sugammadex Reduced the Incidence of Postoperative Pulmonary Complications in Susceptible Patients Identified by ARISCAT Risk Index: Systematic Review and Meta-analysis |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a © The Author(s), under exclusive licence to Springer Healthcare Ltd., part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. | ||
| 520 | |a Introduction The efficacy of sugammadex on postoperative pulmonary complications (PPCs) in susceptible patients, compared with neostigmine, remains indeterminate. The Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) Group Investigators proposed a risk index for the early identification of susceptible patients, with excellent externally validated discrimination ability. Meta-analytical techniques were applied to evaluate the efficacy of sugammadex on PPCs in patients with ARISCAT-defined risk factors. Methods The study is registered on PROSPERO, number CRD42021261156. We searched PubMed, Scopus, Embase, Cochrane library, GreyNet, and OpenGrey for eligible randomized controlled trials (RCTs) without restricting the language or year of publication. Results Twelve RCTs consisting of 1182 patients susceptible to PPCs were included. A robust reduction was observed on the incidence of PPCs in susceptible patients who received sugammadex [RR 0.66; 95% CI (0.54, 0.80), p < 0.01], with a low level of between-study heterogeneity (I2 = 45.98%; H2 = 1.85). Similar protective effects were also proved in avoiding residual neuromuscular block (NMB) [RR 0.25; 95% CI (0.11, 0.56); p < 0.01], atelectasis [RR 0.74; 95% CI (0.59, 0.95); p = 0.02], pneumonia [RR 0.49; 95% CI (0.28, 0.88); p = 0.02], and respiratory failure [RR 0.61; 95% CI (0.39, 0.96); p = 0.03]. No difference was observed regarding adverse events [RR 0.85; 95% CI (0.72, 1.01); p = 0.06]. Conclusion Low to moderate quality of evidence demonstrated the edge of sugammadex over neostigmine for NMB reversal in reducing the likelihood of PPCs and residual NMB in patients with ARISCAT-defined risk factors. Clinicians may reassess the type of reversal agent when treating patients susceptible to PPCs. | ||
| 650 | 4 | |a Residual neuromuscular blockade | |
| 650 | 4 | |a Postoperative pulmonary complications | |
| 650 | 4 | |a Atelectasis | |
| 650 | 4 | |a Pneumonia | |
| 650 | 4 | |a Respiratory failure | |
| 650 | 4 | |a Aspiration pneumonitis | |
| 700 | 1 | |a Han, Jing-Jing |4 aut | |
| 700 | 1 | |a Liu, Jie |4 aut | |
| 700 | 1 | |a Li, Xia |4 aut | |
| 700 | 1 | |a Xu, Zhen-Zhen |4 aut | |
| 700 | 1 | |a Lv, Yong |4 aut | |
| 700 | 1 | |a Liu, Ke-Xuan |4 aut | |
| 700 | 1 | |a Wu, Qing-Ping |0 (orcid)0000-0002-9164-1051 |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Advances in therapy |d Springer Healthcare, 1984 |g 40(2023), 9 vom: 23. Juni, Seite 3784-3803 |w (DE-627)168085585 |w (DE-600)632651-1 |w (DE-576)482252200 |x 0741-238X |7 nnns |
| 773 | 1 | 8 | |g volume:40 |g year:2023 |g number:9 |g day:23 |g month:06 |g pages:3784-3803 |
| 856 | 4 | 1 | |u https://doi.org/10.1007/s12325-023-02535-9 |z lizenzpflichtig |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a SYSFLAG_A | ||
| 912 | |a GBV_OLC | ||
| 936 | b | k | |a 44.40$jPharmazie$jPharmazeutika |q VZ |0 106423304 |0 (DE-625)106423304 |
| 951 | |a AR | ||
| 952 | |d 40 |j 2023 |e 9 |b 23 |c 06 |h 3784-3803 | ||