Resumen
El objetivo de este artículo es revisar la importancia del síndrome de apnea-hipopnea obstructiva del sueño (SAHOS) en la población que va a ser llevada a cirugía y cómo detectar en el preoperatorio a pacientes con riesgo elevado de complicaciones en el perioperatorio mediante el cuestionario STOP-BANG. Para lo anterior, se realizó una búsqueda en las bases Pubmed, Science y SciELO. El SAHOS es un problema médico importante con prevalencia variable (hasta el 26 % en la población general dependiendo del centro donde se evalúe). Es una enfermedad de inicio insidioso y progresivo, en la que hay episodios recurrentes de apneas o hipopneas causadas por obstrucción de la vía aérea superior durante el sueño que produce un deterioro significativo de la calidad de vida. Se quiere evaluar si el cuestionario STOP-BANG es útil para identificar, en el preoperatorio, a pacientes que tengan complicaciones perioperatorias, probablemente porque identifica pacientes con SAHOS no diagnosticado.
Abrishami A, Khajehdehi A, Chung F. A systematic review of screening questionnaires for obstructive sleep apnea. Can J Anaesth. 2010;57(5):423-38.
Young T, Hutton R, Finn L, Badr S, Palta M. The gender bias in sleep apnea diagnosis. Are women missed because they have different symptoms? Arch Intern Med. 1996;156:2445-51.
Young T, Evans L, Finn L, Palta M. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep. 1997;20:705-6.
Rodríguez JL, Calle M, Álvarez-Sala JL. Apnea obstructiva del sueño. Medicine. 2006;9(68):4376-84.
Punjabi N M. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc. 2008;5:136-43.
Chang ET, Yang MC, Wang HM, Lai HL. Snoring in a sitting position and neck circumference are predictors of sleep apnea in Chinese patients. Sleep Breath. 2014;18(1):133-6. doi: 10.1007/s11325-013-0860-1.
De Backer W. Obstructive sleep apnea/hypopnea syndrome. Panminerva Med. 2013 Jun;55(2):191-5.
Yaggi HK, Strohl KP. Adult obstructive sleep apnea/hypopnea syndrome: definitions, risk factors, and pathogenesis. Clin Chest Med. 2010;31(2):179-86.
Ferré A, V ila J, Arcalís N . [Usefulness of the basic exploration of the upper airways and neighbor structures in patients with adult obstructive sleep apneahypopnea syndrome]. Med Clin (Barc). 2014;142(7):310-6.
Remmers JE, Degroot WJ, Sauerland EK, Anch AM. Pathogenesis of upper airway oclussion durimg sleep. J Appl Physiol. 1978;44:931-8.
Sullivan CS, Issa FG, Berthon-Jones M, Saunders MA, et al. Pathophysiology of sleep apnea. In: Saunders N A, Sullivan CE, editors. Sleep and breathing. New York: Marcel Dekker; 1984. p. 299-363.
Barral A, Tufik S, Moura SM. Physiopathology of obstructive sleep apnea hypopnea syndrome. J Bras Pneumol. 2007; 33(1):93-100.
Degache F, Sforza E, Dauphinot V , Celle S, Garcin A, Collet P, Pichot V , Barthélémy JC, Roche F; PROOF Study Group. Relation of central fat mass to obstructive sleep apnea in the elderly. Sleep. 2013 Apr 1;36(4):501-7.
Arnaud C, Dematteis M, Pepin JL, Baquet JP, Lèvy P. Obstructive sleep apnea, immuno-inflammation, and atherosclerosis. Semin Immunopathol. 2009;31(1):113-25.
Kallianos A, Trakada G, Papaioannou T, N ikolopouloss I, Mitrako u A, Manios E, Kostopoulos K, Kostopoulos C, Zakopoulos N . Glucose and arterial blood pressure variability in obstructive sleep apnea syndrome. Eur Rev Med Pharmacol Sci. 2013 Jul;17(14):1932-7.
Kanbay A, Tutar N , Kaya E, Buyukoglan H, Ozdogan N , Oymak FS, Gulmez I, Demir R. Mean platelet volume in patients with obstructive sleep apnea syndrome and its relationship with cardiovascular diseases. Blood Coagul Fibrinolysis. 2013 Jul;24(5):532-6.
Karakaş MS, Altekin RE, Baktır AO, Küçük M, Cilli A, Yalçınkaya S. Association between mean platelet volume and severity of disease in patients with obstructive sleep apnea syndrome without risk factors for cardiovascular disease. Turk Kardiyol Dern Ars. 2013 Jan;41(1):14-20.
Ahbab S, Ataoğlu HE, Tuna M, Karasulu L, Cetin F, Temiz LU, Yenigün M. N eck circumference, metabolic syndrome and obstructive sleep apnea syndrome; evaluation of possible linkage. Med Sci Monit. 2013 Feb 13;19:111-7.
Arik B, Inci MF, Gumus C, V arol K, Ege MR, Dogan OT, Zorlu A. Advanced age and apnea-hypopnea index predict subclinical atherosclerosis in patients with obstructive sleep apnea syndrome. Multidiscip Respir Med. 2013 Feb 6;8(1):9.
Selim B, Won C, Yaggi HK. Cardiovascular consequences of sleep apnea. Clin Chest Med. 2010;31:203-20.
Palma JA, Urrestarazu E, López-Azcárate J, Alegre M, Fernández S, Artieda J, Iriarte J. Increased sympathetic and decreased parasympathetic cardiac tone in patients with sleep related alveolar hypoventilation. Sleep. 2013 Jun 1;36(6): 933-40.
Ahn SH, Kim JH, Kim DU, Choo IS, Lee HJ, Kim HW. Interaction between sleepdisordered breathing and acute ischemic stroke. J Clin N eurol. 2013 Jan;9(1):9-13.
Spiegel K, Leproult R, V an Cauter E. Impact of sleep debt on metabolic and endocrine function. Lancet. 1999;354(9188):1435-9.
Brown LK. Hypoventilation syndromes. Clin Chest Med. 2010;31(2):249-70.
Lesser DJ, Bhatia R, Tran WH, Oliveira F, Ortega R, Keens TG, et al. Sleep fragmentation and intermittent hypoxemia are associated with decreased insulin sensitivity in obese adolescent Latino males. Pediatr Res. 2012 Sep;72(3):293-8.
Trombetta IC, Sommers V K, Maki-Nunes C, Drager L. Consequences of comorbid sleep apnea in the metabolic syndrome, implications for cardiovascular risk. Sleep. 2010;33(9):1193-99.
Yaggi HK, Araujo AB, McKinlay JB. Sleep duration as a risk factor for the development of type 2 diabetes. Diabetes Care. 2006;29(3):657-61.
Young T, Evans L, Finn L, Palta M. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep. 1997;20:705-6.
Ancoli-Israel S, Kripke DF, Klauber MR, Mason WJ, Fell R, Kaplan O. Sleep-disordered breathing in community-dwelling elderly. Sleep. 1991;14(6):486-95.
Kaw R, Pasupuleti V , Walker E, et al. Postoperative complications in patients with obstructive sleep apnea. Chest. 2012;141(2):436-41.
Chung SA, Yuan H, Chung F. A systemic review of obstructive sleep apnea and its implications for anesthesiologists. Anesth Analg. 2008;107(5):1543-63.
Vasu TS, Doghramji K, Cavallazzi R, et al. Obstructive sleep apnea syndrome and postoperative complications: clinical use of the STOP-BANG questionnaire. Arch Otolaryngol Head N eck Surg. 2010;136(10):1020-4.
Kaw R, Golish J, Ghamande S, et al. Incremental risk of obstructive sleep apnea on cardiac surgical outcomes. J Cardiovasc Surg (Torino). 2006;47:683-9.
Memtsoudis S, Liu SS, Ma Y, et al. Perioperative pulmonary outcomes in patients with sleep apnea after noncardiac surgery. Anesth Analg. 2011;112:113-21.
Kaw R, Chung F, Pasupuleti V , et al. Meta-analysis of the association between obstructive sleep apnoea and postoperative outcome. Br J Anaesth. 2012;109(6):897-906.
Vasu TJ, Grewal R, Doghkramji K, et al. Obstructive sleep apnea syndrome and perioperative complications:a systematic review of the literature. J Clin Sleep Med. 2012;8(2):199-207.
Gupta RM, Parvizi J, Hanssen AD, et al. Postoperative complications in patients with obstructive sleep apnea syndrome undergoing hip or knee replacement: a case-control study. Mayo Clin Proc. 2001;76:897-905.
Vasu TJ, Doghkramji K, Cavallaz R, Grewal R, Hiromi A. Obstructive sleep apnea syndrome and postoperative complications. Arch Otolaryngol Head N eck Surg. 2010;136(10):1020-4.
Liao P, Yegneswaran B, V airavanathan S, et al. Postoperative complications in patients with obstructive sleep apnea:a retrospective matched cohort study. Can J Anaesth. 2009;56:819-28.
Chia P, Seet E, Macachor JD, et al. The association of pre-operative STOP-BANG scores with postoperative critical care admission. Anaesthesia. 2013;68(9):950-2.
Loomis AL, Harvey N , Hobart GA. Cerebral states during sleep, as studied by human brain potentials. J Exp Psychol. 1937;21:127-44.
Iber C, Ancoli-Israel S, Chambers M, et al. The new sleep scoring manual: the evidence behind the rules. J Clin Sleep Med. 2007;3:107.
Iber C, Ancoli-Israel S, Chesson A, et al. The AASM manual for the scoring of sleep and associated events—rules, terminology and technical specifications. 1st ed. Westchester (IL): American Academy of Sleep Medicine; 2007.
Jafari B, Mohsenin V . Polysomnography. Clin Chest Med. 2010;31(2):287-97.
ASDA Standards of Practice. Portable recording in the assessment of sleep. Sleep. 1994;17:378-92.
Kushida CA, Littner MR, Morgenthaler T, et al. Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep. 2005;28(4):499-521.
Chung F, Yegneswaran B, Liao P, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008;108:812-21.
Chung F, Yang Y, Liao P. Predictive performance of the STOP-Bang score for identifying obstructive sleep apnea in obese patients. Obes Surg. 2013; 23(12):2050-7.
Chung F, Subramanyam R, Liao P, Sasaki E. High STOP-Bang score indicates a high probability of obstructive sleep apnea. Br J Anaesth. 2012;108(5):768-75.
Chung F, Chau E, Yang Y, et al. Serum bicarbonate level improves specificity of STOP-Bang screening for obstructive sleep apnea. Chest. 2013;143(5):1284-93.
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