{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:25:14Z","timestamp":1791390314916,"version":"4.3.3"},"reference-count":43,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund","doi-asserted-by":"publisher","award":["11220226"],"award-info":[{"award-number":["11220226"]}],"id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100025520","name":"Medical Research Future Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100025520","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001782","name":"University of Melbourne","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001782","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP2022850"],"award-info":[{"award-number":["APP2022850"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjaopen.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["BJA Open"],"published-print":{"date-parts":[[2026,3]]},"DOI":"10.1016\/j.bjao.2026.100531","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T13:15:22Z","timestamp":1770729322000},"page":"100531","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"special_numbering":"C","title":["Sugammadex, neostigmine, and postoperative pulmonary complications: protocol of the SNaPP multicentre randomised controlled trial"],"prefix":"10.1016","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8512-3517","authenticated-orcid":false,"given":"Kate","family":"Leslie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1997-3999","authenticated-orcid":false,"given":"Sabine","family":"Braat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jai N.","family":"Darvall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip J.","family":"Peyton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Devlin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul S.","family":"Myles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom\u00e1s B.","family":"Corcoran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy G.","family":"Short","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew T.V.","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2650-7593","authenticated-orcid":false,"given":"Benjamin L.","family":"Olesnicky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"An","family":"Tran-Duy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Maxwell-Wright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9168-1273","authenticated-orcid":false,"given":"Cindy","family":"Schultz-Ferguson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0163-5505","authenticated-orcid":false,"given":"Sofia","family":"Sidiropoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Story","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.bjao.2026.100531_bib1","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1093\/bja\/aex002","article-title":"Postoperative pulmonary complications","volume":"118","author":"Miskovic","year":"2017","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.bjao.2026.100531_bib2","article-title":"Preoperative physiotherapy for the prevention of respiratory complications after upper abdominal surgery: pragmatic, double blinded, multicentre randomised controlled trial","volume":"360","author":"Boden","year":"2018","journal-title":"BMJ"},{"key":"10.1016\/j.bjao.2026.100531_bib3","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/S0140-6736(14)60416-5","article-title":"High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomised controlled trial","volume":"384","author":"Hemmes","year":"2014","journal-title":"Lancet"},{"key":"10.1016\/j.bjao.2026.100531_bib4","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1001\/jamasurg.2016.4065","article-title":"Postoperative pulmonary complications, early mortality, and hospital stay following noncardiothoracic surgery: a multicenter study by the Perioperative Research Network Investigators","volume":"152","author":"Fernandez-Bustamante","year":"2017","journal-title":"JAMA Surg"},{"key":"10.1016\/j.bjao.2026.100531_bib5","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/2047-0525-3-7","article-title":"Incidence, outcome, and attributable resource use associated with pulmonary and cardiac complications after major small and large bowel procedures","volume":"3","author":"Fleisher","year":"2014","journal-title":"Perioper Med (Lond)"},{"key":"10.1016\/j.bjao.2026.100531_bib6","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1056\/NEJMoa1301082","article-title":"A trial of intraoperative low-tidal-volume ventilation in abdominal surgery","volume":"369","author":"Futier","year":"2013","journal-title":"N Engl J Med"},{"key":"10.1016\/j.bjao.2026.100531_bib7","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1001\/jama.2020.12866","article-title":"Effect of intraoperative low tidal volume vs conventional tidal volume on postoperative pulmonary complications in patients undergoing major surgery: a randomized clinical trial","volume":"324","author":"Karalapillai","year":"2020","journal-title":"JAMA"},{"key":"10.1016\/j.bjao.2026.100531_bib8","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.bja.2020.01.016","article-title":"Randomised controlled trial of sugammadex or neostigmine for reversal of neuromuscular block on the incidence of pulmonary complications in older adults undergoing prolonged surgery","volume":"124","author":"Togioka","year":"2020","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.bjao.2026.100531_bib9","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1097\/EJA.0000000000000646","article-title":"Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - an observational study in 29 countries","volume":"34","year":"2017","journal-title":"Eur J Anaesthesiol"},{"key":"10.1016\/j.bjao.2026.100531_bib10","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.jamcollsurg.2004.05.276","article-title":"Hospital costs associated with surgical complications: a report from the private-sector National Surgical Quality Improvement Program","volume":"199","author":"Dimick","year":"2004","journal-title":"J Am Coll Surg"},{"key":"10.1016\/j.bjao.2026.100531_bib11","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1097\/ALN.0b013e3181fc6e0a","article-title":"Prediction of postoperative pulmonary complications in a population-based surgical cohort","volume":"113","author":"Canet","year":"2010","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bjao.2026.100531_bib12","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1097\/01.sla.0000179621.33268.83","article-title":"Determinants of long-term survival after major surgery and the adverse effect of postoperative complications","volume":"242","author":"Khuri","year":"2005","journal-title":"Ann Surg"},{"key":"10.1016\/j.bjao.2026.100531_bib13","first-page":"558","article-title":"A comprehensive estimation of the costs of 30-day postoperative complications using actual costs from multiple, diverse hospitals","volume":"46","author":"Merkow","year":"2020","journal-title":"Jt Comm J Qual Patient Saf"},{"key":"10.1016\/j.bjao.2026.100531_bib14","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2014-007224","article-title":"Surgical complications and their impact on patients' psychosocial well-being: a systematic review and meta-analysis","volume":"6","author":"Pinto","year":"2016","journal-title":"BMJ Open"},{"key":"10.1016\/j.bjao.2026.100531_bib15","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/ALN.0000000000003943","article-title":"Perioperative pulmonary atelectasis: part I. Biology and mechanisms","volume":"136","author":"Zeng","year":"2022","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bjao.2026.100531_bib16","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1097\/ALN.0000000000004009","article-title":"Perioperative pulmonary atelectasis: part II. Clinical implications","volume":"136","author":"Lagier","year":"2022","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bjao.2026.100531_bib17","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1097\/00000542-199711000-00005","article-title":"Functional assessment of the pharynx at rest and during swallowing in partially paralyzed humans: simultaneous videomanometry and mechanomyography of awake human volunteers","volume":"87","author":"Eriksson","year":"1997","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bjao.2026.100531_bib18","first-page":"Cd012763","article-title":"Efficacy and safety of sugammadex versus neostigmine in reversing neuromuscular blockade in adults","volume":"8","author":"Hristovska","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.bjao.2026.100531_bib19","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1097\/ALN.0000000000003256","article-title":"Sugammadex versus neostigmine for reversal of neuromuscular blockade and postoperative pulmonary complications (STRONGER): a multicenter matched cohort analysis","volume":"132","author":"Kheterpal","year":"2020","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bjao.2026.100531_bib20","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1111\/anae.15940","article-title":"The effects of sugammadex vs. neostigmine on postoperative respiratory complications and advanced healthcare utilisation: a multicentre retrospective cohort study","volume":"78","author":"Suleiman","year":"2023","journal-title":"Anaesthesia"},{"key":"10.1016\/j.bjao.2026.100531_bib21","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S2213-2600(18)30294-7","article-title":"Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study","volume":"7","author":"Kirmeier","year":"2019","journal-title":"Lancet Respir Med"},{"key":"10.1016\/j.bjao.2026.100531_bib22","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.bja.2023.10.032","article-title":"The effect of sugammadex on patient morbidity and quality of recovery after general anaesthesia: a systematic review and meta-analysis","volume":"132","author":"Olesnicky","year":"2024","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.bjao.2026.100531_bib23","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/ALN.0000000000000334","article-title":"Prospective external validation of a predictive score for postoperative pulmonary complications","volume":"121","author":"Mazo","year":"2014","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bjao.2026.100531_bib24","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.amjmed.2010.09.013","article-title":"Smoking cessation reduces postoperative complications: a systematic review and meta-analysis","volume":"124","author":"Mills","year":"2011","journal-title":"Am J Med"},{"key":"10.1016\/j.bjao.2026.100531_bib25","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1097\/ALN.0b013e318293065c","article-title":"Development and validation of a score for prediction of postoperative respiratory complications","volume":"118","author":"Brueckmann","year":"2013","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bjao.2026.100531_bib26","doi-asserted-by":"crossref","first-page":"847","DOI":"10.7326\/0003-4819-135-10-200111200-00005","article-title":"Development and validation of a multifactorial risk index for predicting postoperative pneumonia after major noncardiac surgery","volume":"135","author":"Arozullah","year":"2001","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.bjao.2026.100531_bib27","doi-asserted-by":"crossref","first-page":"3555","DOI":"10.1007\/s00464-013-2949-9","article-title":"Impact of operative duration on postoperative pulmonary complications in laparoscopic versus open colectomy","volume":"27","author":"Owen","year":"2013","journal-title":"Surg Endosc"},{"key":"10.1016\/j.bjao.2026.100531_bib28","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.jclinepi.2016.12.023","article-title":"Series: pragmatic trials and real world evidence: paper 1. Introduction","volume":"88","author":"Zuidgeest","year":"2017","journal-title":"J Clin Epidemiol"},{"key":"10.1016\/j.bjao.2026.100531_bib30","series-title":"Miller's Anesthesia","first-page":"832","article-title":"Reversal (antagonism) of neuromuscular blockade","author":"Murphy","year":"2019"},{"key":"10.1016\/j.bjao.2026.100531_bib31","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1097\/EJA.0000000000001769","article-title":"Peri-operative management of neuromuscular blockade: a guideline from the European Society of Anaesthesiology and Intensive Care","volume":"40","author":"Fuchs-Buder","year":"2023","journal-title":"Eur J Anaesthesiol"},{"key":"10.1016\/j.bjao.2026.100531_bib32","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/ALN.0000000000004379","article-title":"2023 American Society of Anesthesiologists Practice Guidelines for Monitoring and Antagonism of Neuromuscular Blockade: a report by the American Society of Anesthesiologists Task Force on Neuromuscular Blockade","volume":"138","author":"Thilen","year":"2023","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bjao.2026.100531_bib33","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1016\/j.bja.2018.02.007","article-title":"A systematic review and consensus definitions for standardised end-points in perioperative medicine: pulmonary complications","volume":"120","author":"Abbott","year":"2018","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.bjao.2026.100531_bib34","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1177\/0310057X20978986","article-title":"Survey of attitudes towards a randomised trial about sugammadex, neostigmine and pulmonary complications","volume":"49","author":"Story","year":"2021","journal-title":"Anaesth Intensive Care"},{"key":"10.1016\/j.bjao.2026.100531_bib35","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1186\/s40814-021-00942-9","article-title":"Sugammadex, neostigmine and postoperative pulmonary complications: an international randomised feasibility and pilot trial","volume":"7","author":"Leslie","year":"2021","journal-title":"Pilot Feasibility Stud"},{"key":"10.1016\/j.bjao.2026.100531_bib36","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2024-081477","article-title":"SPIRIT 2025 statement: updated guideline for protocols of randomised trials","volume":"389","author":"Chan","year":"2025","journal-title":"BMJ"},{"key":"10.1016\/j.bjao.2026.100531_bib37","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1097\/ALN.0b013e318289b84b","article-title":"Development and psychometric evaluation of a postoperative quality of recovery score: the QoR-15","volume":"118","author":"Stark","year":"2013","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bjao.2026.100531_bib38","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1016\/j.bja.2022.03.009","article-title":"Measurement of quality of recovery after surgery using the 15-item quality of recovery scale: a systematic review and meta-analysis","volume":"128","author":"Myles","year":"2022","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.bjao.2026.100531_bib39","series-title":"Methods for analysing and reporting EQ-5D data","author":"Devlin","year":"2020"},{"key":"10.1016\/j.bjao.2026.100531_bib40","first-page":"489","article-title":"A global clinical measure of fitness and frailty in elderly people","volume":"173","author":"Rockwood","year":"2005","journal-title":"Can J Anaesth"},{"key":"10.1016\/j.bjao.2026.100531_bib41","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.ajic.2008.03.002","article-title":"CDC\/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting","volume":"36","author":"Horan","year":"2008","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.bjao.2026.100531_bib42","first-page":"2526","article-title":"Acute respiratory distress syndrome: the Berlin Definition","volume":"307","author":"Ranieri","year":"2012","journal-title":"JAMA"},{"key":"10.1016\/j.bjao.2026.100531_bib43","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.1016\/S0140-6736(14)60893-X","article-title":"The safety of addition of nitrous oxide to general anaesthesia in at-risk patients having major non-cardiac surgery (ENIGMA-II): a randomised, single-blind trial","volume":"384","author":"Myles","year":"2014","journal-title":"Lancet"},{"key":"10.1016\/j.bjao.2026.100531_bib44","article-title":"CONSORT 2025 statement: updated guideline for reporting randomised trials","volume":"389","author":"Hopewell","year":"2025","journal-title":"BMJ"}],"container-title":["BJA Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2772609626000055?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2772609626000055?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T22:35:27Z","timestamp":1784586927000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2772609626000055"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":43,"alternative-id":["S2772609626000055"],"URL":"https:\/\/doi.org\/10.1016\/j.bjao.2026.100531","relation":{},"ISSN":["2772-6096"],"issn-type":[{"value":"2772-6096","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Sugammadex, neostigmine, and postoperative pulmonary complications: protocol of the SNaPP multicentre randomised controlled trial","name":"articletitle","label":"Article Title"},{"value":"BJA Open","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.bjao.2026.100531","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Published by Elsevier Ltd on behalf of British Journal of Anaesthesia.","name":"copyright","label":"Copyright"}],"article-number":"100531"}}