jueves, 13 de abril de 2017

Apnea del sueño y anestesia / Sleep apnea and anaesthesia

Abril 13, 2017. No. 2658

Examen preoperatorio de la apnea obstructiva del sueño.
Pre-operative screening for obstructive sleep apnoea.
Eur Respir Rev. 2017 Jan 3;26(143). pii: 160012. doi: 10.1183/16000617.0012-2016. Print 2017 Jan.
Sleep disordered breathing, especially obstructive sleep apnoea (OSA), has a high and increasing prevalence. Depending on the apnoea and hypopnoea scoring criteria used, and depending on the sex and age of the subjects investigated, prevalence varies between 3% and 49% of the general population. These varying prevalences need to be reflected when considering screening for OSA. OSA is a cardiovascular risk factor and patients are at risk when undergoing medical interventions such as surgery. Screening for OSA before anaesthesia and surgical interventions is increasingly considered. Therefore, methods for screening and the rationale for screening for OSA are reviewed in this study.

Manejo anestésico de los adultos con apnea del sueño.
Anaesthetic management of sleep-disordered breathing in adults.
Respirology. 2017 Feb;22(2):230-239. doi: 10.1111/resp.12967. Epub 2016 Dec 17.
Anaesthesia and sleep are different states of unconsciousness with considerable physiological common ground. Because of their shared depressant effects on muscle activation and ventilatory drive, patients with anatomically compromised airways will tend to obstruct in either state and those with impaired ventilatory capacity will tend to hypoventilate. Breathing behaviour in one state is predictive of that in the other. An essential difference is that while arousal responses are preserved during sleep, they are depressed during sedation and abolished by anaesthesia. This renders patients with sleep-related breathing disorders vulnerable to hypoventilation and asphyxia when deeply sedated. Addressing this vulnerability requires a systematic approach to identification of patients and circumstances that magnify this risk, and methods of managing it that seek to reconcile the need for safety with cost-effective use of resources.
KEYWORDS: anaesthesia; obstructive sleep apnoea; perioperative management; sleep; sleep-disordered breathing

Una actualización de las diversas aplicaciones prácticas del cuestionario STOP-Bang en anestesia, cirugía y medicina perioperatoria.
An update on the various practical applications of the STOP-Bang questionnaire in anesthesia, surgery, and perioperative medicine.
Curr Opin Anaesthesiol. 2017 Feb;30(1):118-125. doi: 10.1097/ACO.0000000000000426.
PURPOSE OF REVIEW: The present review aims to provide an update on the various practical applications of the STOP-Bang questionnaire in anesthesia, surgery, and perioperative medicine. RECENT FINDINGS: The STOP-Bang questionnaire was originally validated as a screening tool to identify surgical patients who are at high-risk of obstructive sleep apnea (OSA). 
SUMMARY: STOP-Bang at least 3 was recommended previously to identify the suspected or undiagnosed OSA. To reduce the false positive cases and to improve its specificity, a stepwise stratification is recommended to identify the patients at high risk of moderate-to-severe OSA. Because of its practical application, STOP-Bang is a useful screening tool for patients with suspected or undiagnosed OSA.

Vacante para Anestesiología Pediátrica
El Hospital de Especialidades Pediátricas de León, Guanajuato México 
ofrece un contrato laboral en el departamento de anestesiología 
Informes con la Dra Angélica García Álvarez 
angy.coachanestped@gmail.com o al teléfono 477 101 8700 Ext 1028
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Anestesiología y Medicina del Dolor

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