Swarna Gaddam1, Sameer K Gunukula1, M Jeffery Mador2. 1. Department of Internal Medicine, State University of New York at Buffalo, Buffalo, NY, USA. 2. Division of Pulmonary, Sleep and Critical Care Medicine, University at Buffalo and Western New York Veteran Affairs Healthcare System, 3495 Bailey Ave, Buffalo, NY, 14215, USA. mador@buffalo.edu.
Abstract
BACKGROUND: Obstructive sleep apnea (OSA) is becoming increasingly more prevalent with the rise in obesity. Complications from gastrointestinal (GI) endoscopy in this patient population have been reported in several studies, but the modest complication rates from these procedures make it difficult to come to definitive conclusions based on single studies. The objective of our study was to systematically review these studies reporting the incidence of post-procedure complications in patients with OSA undergoing endoscopy to determine whether the presence of OSA increases post-procedure complications. METHODS: We conducted a systematic review using the Cochrane Collaboration Methodology. We searched Medline via Ovid, PubMed, Embase, and Evidence Based Medicine Reviews databases from 1950 to August 2013. We rated the quality of evidence for each outcome using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Meta-analysis was done using Review Manager Version 5.0.20. RESULTS: Our search resulted in seven eligible studies. There was no significant association between diagnosis of OSA and post-GI endoscopy complications including hypoxemia, respiratory distress, variations in blood pressure or heart rate, bradypnea, or need for significant interventions. Subgroup analysis based on the type of GI endoscopy or the type of anesthesia used did not show any significant associations either. CONCLUSIONS: Obstructive sleep apnea patients and/or patients at high risk for obstructive sleep apnea do not appear to be at increased risk of adverse outcomes from GI endoscopy.
BACKGROUND:Obstructive sleep apnea (OSA) is becoming increasingly more prevalent with the rise in obesity. Complications from gastrointestinal (GI) endoscopy in this patient population have been reported in several studies, but the modest complication rates from these procedures make it difficult to come to definitive conclusions based on single studies. The objective of our study was to systematically review these studies reporting the incidence of post-procedure complications in patients with OSA undergoing endoscopy to determine whether the presence of OSA increases post-procedure complications. METHODS: We conducted a systematic review using the Cochrane Collaboration Methodology. We searched Medline via Ovid, PubMed, Embase, and Evidence Based Medicine Reviews databases from 1950 to August 2013. We rated the quality of evidence for each outcome using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Meta-analysis was done using Review Manager Version 5.0.20. RESULTS: Our search resulted in seven eligible studies. There was no significant association between diagnosis of OSA and post-GI endoscopy complications including hypoxemia, respiratory distress, variations in blood pressure or heart rate, bradypnea, or need for significant interventions. Subgroup analysis based on the type of GI endoscopy or the type of anesthesia used did not show any significant associations either. CONCLUSIONS:Obstructive sleep apneapatients and/or patients at high risk for obstructive sleep apnea do not appear to be at increased risk of adverse outcomes from GI endoscopy.
Authors: R M Corso; E Piraccini; V Agnoletti; M Lippi; M Buccioli; A Negro; G Gambale; E Ricci Journal: Minerva Anestesiol Date: 2011-11-09 Impact factor: 3.051
Authors: Gregory A Coté; Christine E Hovis; Richard M Hovis; Lawrence Waldbaum; Dayna S Early; Steven A Edmundowicz; Riad R Azar; Daniel K Mullady; Sreenivasa S Jonnalagadda Journal: Clin Gastroenterol Hepatol Date: 2010-05-23 Impact factor: 11.382
Authors: Mohammed A Qadeer; John J Vargo; John A Dumot; Rocio Lopez; Patricia A Trolli; Tyler Stevens; Mansour A Parsi; Madhusudhan R Sanaka; Gregory Zuccaro Journal: Gastroenterology Date: 2009-05 Impact factor: 22.682