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Distúrbios respiratórios do sono em transplante pulmonar - revisão sistemática
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Abstract(s)
Introdução: O transplante pulmonar é realizado em pacientes com insuficiência respiratória crónica com terapêutica médica otimizada, para os quais não existe outra terapêutica alternativa, possibilitando aumentar a sua qualidade de vida e sobrevivência. Segundo a International Society for Heart and Lung Transplantation, a patologia cardiovascular representa 4,5% das causas de morte após o primeiro ano da realização do transplante pulmonar. A Síndrome de Apneia do Sono constitui um problema de saúde pública, sendo considerada um fator de risco para a ocorrência de eventos cardiovasculares.
Objetivo: Realizar revisão sistemática incluindo artigos que versem sobre distúrbios respiratórios do sono em indivíduos que realizaram transplante pulmonar, averiguando quais os distúrbios respiratórios do sono mais prevalentes nesta população e, também, sugerir oportunidades de melhoria para estudos futuros.
Metodologia: Foram utilizadas diferentes combinações de palavras-chave para pesquisa de artigos nos motores de pesquisa Pubmed e Cochrane Library (última pesquisa realizada em fevereiro 2025). Como critérios de inclusão refere-se realização de polissonografia depois da realização de transplante pulmonar, sem utilização de ventilação (continuous positive airway pressure, auto-continuous positive airway pressure, bilevel positive airway pressure), artigos publicados entre 2000 e 2024 e de livre acesso. O critério de exclusão utilizado foi artigos redigidos em outras línguas que não português, inglês e espanhol.
Resultados: A pesquisa obteve 1974 resultados dos quais apenas 8 foram considerados elegíveis para a elaboração da revisão sistemática. Globalmente, obteve-se uma amostra total constituída por 448 indivíduos, dos quais 106 apresentavam resultados de polissonografia antes do transplante pulmonar. Foram, também, obtidos resultados para a escala de sonolência de Epworth, pressão de dióxido de carbono através de avaliação transcutânea, medicação e tratamento dos distúrbios respiratórios do sono.
Conclusão: Os distúrbios respiratórios do sono são prevalentes no transplante pulmonar, tendo-se verificado uma prevalência mínima de 36%. A apneia obstrutiva do sono é o principal distúrbio respiratório do sono encontrado nesta revisão sistemática. Pelo número limitado de artigos, sugere-se realização de mais estudos com amostras de maiores dimensões e com seguimento das mesmas.
Introduction: Lung transplantation is performed on patients with chronic respiratory failure who are receiving optimized medical therapy and for whom there is no other alternative therapy, increasing their quality of life and survival. According to the International Society for Heart and Lung Transplantation, cardiovascular disease accounts for 4.5% of the causes of death after the first year of lung transplantation. Sleep apnea syndrome is a public health problem and is considered a risk factor for the occurrence of cardiovascular events. Objective: To conduct a systematic review of articles about sleep-related breathing disorders in individuals who underwent lung transplantation, to determine which sleep- related breathing disorders are most prevalent in this population and to suggest opportunities for improvement in future studies. Methodology: Different combinations of keywords were used to search for articles in the Pubmed and Cochrane Library search engines (last search conducted in February 2025). Inclusion criteria were polysomnography after lung transplantation, without use of ventilation (continuous positive airway pressure, auto-continuous positive airway pressure, bilevel positive airway pressure), articles published between 2000 and 2024 and with open access. The exclusion criterion used was articles written in languages other than Portuguese, English and Spanish. Results: The research obtained 1974 results, of which only 8 were considered eligible for the elaboration of the systematic review. Overall, a total sample of 448 individuals was obtained, of which 106 had polysomnography results before lung transplantation. Results were also obtained for the Epworth Sleepiness Scale, carbon dioxide pressure through transcutaneous assessment, medication and treatment of sleep- disordered breathing. Conclusion: Sleep-disordered breathing is prevalent in lung transplantation, with a minimum prevalence of 36%. Obstructive sleep apnea is the main sleep-disordered breathing found in this systematic review. Due to the limited number of articles, it is suggested that further studies be carried out with larger samples and with follow-up.
Introduction: Lung transplantation is performed on patients with chronic respiratory failure who are receiving optimized medical therapy and for whom there is no other alternative therapy, increasing their quality of life and survival. According to the International Society for Heart and Lung Transplantation, cardiovascular disease accounts for 4.5% of the causes of death after the first year of lung transplantation. Sleep apnea syndrome is a public health problem and is considered a risk factor for the occurrence of cardiovascular events. Objective: To conduct a systematic review of articles about sleep-related breathing disorders in individuals who underwent lung transplantation, to determine which sleep- related breathing disorders are most prevalent in this population and to suggest opportunities for improvement in future studies. Methodology: Different combinations of keywords were used to search for articles in the Pubmed and Cochrane Library search engines (last search conducted in February 2025). Inclusion criteria were polysomnography after lung transplantation, without use of ventilation (continuous positive airway pressure, auto-continuous positive airway pressure, bilevel positive airway pressure), articles published between 2000 and 2024 and with open access. The exclusion criterion used was articles written in languages other than Portuguese, English and Spanish. Results: The research obtained 1974 results, of which only 8 were considered eligible for the elaboration of the systematic review. Overall, a total sample of 448 individuals was obtained, of which 106 had polysomnography results before lung transplantation. Results were also obtained for the Epworth Sleepiness Scale, carbon dioxide pressure through transcutaneous assessment, medication and treatment of sleep- disordered breathing. Conclusion: Sleep-disordered breathing is prevalent in lung transplantation, with a minimum prevalence of 36%. Obstructive sleep apnea is the main sleep-disordered breathing found in this systematic review. Due to the limited number of articles, it is suggested that further studies be carried out with larger samples and with follow-up.
Description
Keywords
sleep disordered breathing” “sleep apnea” “sleep” “lung transplant” “polysomnography”