Jeff Halonen, DO
Article
Obstructive Sleep Apnea Predicts Adverse Perioperative
Outcome
Bateman, Brian MD and Eikermann, Matthias MD, PhD,
Anesthesiology, April 2012- Vol 116- Number 4, p 753-755.
Summary
OSA is an important risk factor for cardiovascular disease,
myocardial infarction, stroke and perhaps has an association with postoperative
delirium (POD). The definition for this review of delirium is an acute,
fluctuating impairment in attention and cognition. OSA, independent of obesity,
has been shown by most studies to be an independent risk of Perioperative
complications. These complications may be from drug side effects, inflammation
and hypercoaguability.
While this study can not link OSA and PoD directly, they do
make some interesting speculations. Frequent episodes of airway collapse in OSA
lead to hypoxia, disrupted sleep, sleep inertia, daytime sleepiness and
increased arousal threshold from sleep, all of which may be consider as
potential precipitating and/or augmenting factors of delirium. These are all
associated with inflammation and OSA is also, in part, an inflammatory
disease. From this, the associated
observed between OSA and POd should be considered "hypothesis-generating"
rather than "proven."
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