Artigo Original / Original Article
Papel da oximetria nocturna no rastreio da síndroma de apneia-hipopneia obstrutiva do sono*
The role of nocturnal oximetry in obstructive sleep apnoea-hypopnoea syndrome screening*
Celestina Ventura1, Ana Sofia Oliveira2, Rita Dias3, Joana Teixeira3, Cristina Canhão3, Odete Santos4, Paula Pinto5, Cristina Bárbara6
1 Assistente Graduada de Medicina Familiar, Centro de Saúde de Grândola. / General Practice Specialist Consultant, Grândola Health Centre.
2 Interna do Internato Complementar de Pneumologia do Hospital de Pulido Valente. / Pulmonology Resident, Hospital Pulido Valente.
3 Técnica de Cardiopneumologia do Hospital de Pulido Valente. / Cardiopulmonology Technician, Hospital Pulido Valente.
4 Assistente Hospitalar Graduada do Hospital de Pulido Valente. / Specialist Consultant, Hospital Pulido Valente.
5 Assistente Hospitalar de Pneumologia do Hospital de Pulido Valente. Assistente Convidada de Pneumologia da Faculdade de Ciências Médicas da Universidade Nova de Lisboa. / Pulmonology Consultant, Hospital Pulido Valente. Guest Pulmonolgy Consultant, Nova University School of Medical Sciences.
6 Coordenadora da Unidade de Fisiopatologia Respiratória do Hospital de Pulido Valente. Professora Auxiliar de Pneumologia da Faculdade de Ciências Médicas da Universidade Nova de Lisboa. / Coordinator, Respiratory Physiopathology Unit, Hospital Pulido Valente. Assistant Pulmonology Professor, Nova University School of Medical Sciences.
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"etiqueta" => "1" "identificador" => "af0005" ] 1 => array:3 [ "entidad" => "Interna do Internato Complementar de Pneumologia do Hospital de Pulido Valente. / Pulmonology Resident, Hospital Pulido Valente." "etiqueta" => "2" "identificador" => "af0010" ] 2 => array:3 [ "entidad" => "Técnica de Cardiopneumologia do Hospital de Pulido Valente. / Cardiopulmonology Technician, Hospital Pulido Valente." "etiqueta" => "3" "identificador" => "af0015" ] 3 => array:3 [ "entidad" => "Assistente Hospitalar Graduada do Hospital de Pulido Valente. / Specialist Consultant, Hospital Pulido Valente." "etiqueta" => "4" "identificador" => "af0020" ] 4 => array:3 [ "entidad" => "Assistente Hospitalar de Pneumologia do Hospital de Pulido Valente. Assistente Convidada de Pneumologia da Faculdade de Ciências Médicas da Universidade Nova de Lisboa. / Pulmonology Consultant, Hospital Pulido Valente. Guest Pulmonolgy Consultant, Nova University School of Medical Sciences." "etiqueta" => "5" "identificador" => "af0025" ] 5 => array:3 [ "entidad" => "Coordenadora da Unidade de Fisiopatologia Respiratória do Hospital de Pulido Valente. Professora Auxiliar de Pneumologia da Faculdade de Ciências Médicas da Universidade Nova de Lisboa. / Coordinator, Respiratory Physiopathology Unit, Hospital Pulido Valente. Assistant Pulmonology Professor, Nova University School of Medical Sciences." "etiqueta" => "6" "identificador" => "af0030" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "The role of nocturnal oximetry in obstructive sleep apnoea-hypopnoea syndrome screening<a class="elsevierStyleCrossRef" href="#fn0005">*</a>" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-01-06" "fechaAceptado" => "2007-02-22" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec570343" "palabras" => array:2 [ 0 => "Síndroma de apneia/hipopneia obstrutiva do sono" 1 => "oximetria nocturna" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec570344" "palabras" => array:2 [ 0 => "Obstructive sleep apnoea hypopnoea syndrome" 1 => "nocturnal oximetry" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Objectivo</span>: Foi objectivo deste estudo determinar a sensibilidade e a especificidade da oximetria nocturna (ON) como método de <span class="elsevierStyleItalic">screening</span> diagnóstico para a síndroma de apneia-hipopneia obstrutiva do sono (SAHOS), utilizando como método de referência a polissonografia (PSG).</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Metodologia</span>: Foram incluídos 63 doentes com sus-peita clínica de SAHOS e exclusão de doença respiratória, sendo submetidos a uma PSG completa, incluin-do ON. Posteriormente, foram determinados: a sensibilidade, a especificidade e os valores preditivos positivo (VPP) e negativo (VPN) da ON.</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Resultados</span>: A SAHOS foi diagnosticada em 47 doentes com uma média etária de 54 anos. Verificaram-se diferenças significativas na avaliação da percentagem do tempo total de sono (TTS) com dessaturação de O<span class="elsevierStyleInf">2</span> abaixo de 90% entre doentes com SAHOS (25,4 29,7%) e sem SAHOS (1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1,5%), p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,001. A fim de avaliar a sensibilidade, a especificidade, o VPP e o VPN, utilizámos dois pontos de corte baseados na gravidade da dessaturação. Com o primeiro ponto de corte considerámos positivos para o diagnóstico da SAHOS todos os doentes que apresentassem valores de dessaturação (saturação de O<span class="elsevierStyleInf">2</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>90%)<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>a 1% do TTS, tendo-se obtido para a ON uma sensibilidade de 76,6%, uma especificidade de 75%, um VPP de 90% e um VPN negativo de 52,2%. Utili-zando o segundo ponto de corte, foram considerados positivos todos os doentes que apresentassem valores de dessaturação<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>a 5% do TTS, tendo-se obtido uma sensibilidade de 65,9%, uma especificidade de 100%, um VPP de 100% e um VPN de 50%.</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclusões</span>: A ON é um bom teste de <span class="elsevierStyleItalic">screening</span> diagnóstico da SAHOS, desde que seja excluída patologia respiratória.</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2007; XIII (4): 525-551</span></p></span>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Aim:</span> The aim of our study was to evaluate the sensitivity and specificity of Nocturnal Oximetry (NO) as a diagnostic screening tool for obstructive sleep apnoea hypopnoea syndrome (OSAHS), compared with polysomnography (PSG) as the gold standard.</p><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Methodology:</span> 63 patients with clinical suspicion of OSAHS and exclusion of respiratory disease under-went PSG and NO. We then determined NO sensitivity, specificity, positive (PPV) and negative predictive values (NPV).</p><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Results:</span> OSAHS was diagnosed in 47 patients with a mean age of 54 years. In the evaluation of the percentage of Total Sleep Time (TST) with oxygen desaturation below 90%, we found significant differences between patients with OSAHS (25.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>29.7%) and without OSAHS (1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.5%), p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,001. We used two cutoff points to evaluate sensitivity, specificity, positive (PPV) and negative predictive values (NPV), based on the severity of O<span class="elsevierStyleInf">2</span> desaturation (StO<span class="elsevierStyleInf">2</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>90%). Using the first cutoff point we diagnosed with NO as positive all the patients with TST desaturation values ≥<span class="elsevierStyleHsp" style=""></span>1% of the TST. Under these circumstances we found a sensitivity of 76.6%, a specificity of 75%, a PPV of 90% and an NPV value of 52.2% for our screening test (NO). Using the second cutoff point, we diagnosed with NO as positive all the patients with TST desaturation values ≥<span class="elsevierStyleHsp" style=""></span>5% of the TST. With this method we found a sensitivity of 65.9%, a specificity of 100%, a PPV of 100% and an NPV of 50%.</p><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclusion:</span> NO is a useful screening test for the diagnosis of OSAHS in patients without respiratory disease.</p><p id="sp0050" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2007; XIII (4): 525-551</span></p></span>" ] ] "NotaPie" => array:1 [ 0 => array:3 [ "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara" id="np0005">Estudo efectuado no âmbito de um mestrado em Patologia Respiratória da Faculdade de Ciências Médicas de Lisboa. / Study undertaken as part of an MSc in Respiratory Pathology, Lisbon University School of Medical Sciences.</p>" "identificador" => "fn0005" ] ] "lecturaRecomendada" => array:1 [ 0 => array:3 [ "vista" => "all" "titulo" => "<span class="elsevierStyleSectionTitle" id="st0025">Bibliografia / Bibliography</span>" "seccion" => array:1 [ 0 => array:2 [ "vista" => "all" "bibliografiaReferencia" => array:31 [ 0 => array:3 [ "identificador" => "bb0005" "etiqueta" => "1." 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"referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sleep 3: Clinical presentation and diagnosis of the obstructive sleep apnoea hypopnoea syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D. Schlosshan" 1 => "M.W. Elliott" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "2004" "volumen" => "59" "paginaInicial" => "347" "paginaFinal" => "352" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15047962" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bb0025" "etiqueta" => "5." 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Article information
ISSN: 08732159Original language: Portuguese
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| 2018 October | 9 | 0 | 9 |
| 2018 September | 13 | 6 | 19 |
| 2018 August | 48 | 21 | 69 |
| 2018 July | 32 | 24 | 56 |
| 2018 June | 34 | 16 | 50 |
| 2018 May | 44 | 30 | 74 |
| 2018 April | 47 | 41 | 88 |
| 2018 March | 42 | 29 | 71 |
| 2018 February | 34 | 4 | 38 |
| 2018 January | 35 | 12 | 47 |
| 2017 December | 54 | 11 | 65 |
| 2017 November | 42 | 21 | 63 |
| 2017 October | 31 | 22 | 53 |
| 2017 September | 36 | 11 | 47 |
| 2017 August | 32 | 12 | 44 |
| 2017 July | 23 | 8 | 31 |
| 2017 June | 21 | 9 | 30 |
| 2017 May | 34 | 5 | 39 |
| 2017 April | 9 | 2 | 11 |
| 2017 March | 18 | 2 | 20 |
| 2017 February | 14 | 4 | 18 |
| 2017 January | 15 | 3 | 18 |
| 2016 December | 18 | 4 | 22 |
| 2016 November | 8 | 5 | 13 |
| 2016 October | 10 | 4 | 14 |
| 2016 September | 2 | 0 | 2 |
| 2016 August | 2 | 4 | 6 |
| 2016 July | 4 | 4 | 8 |
| 2016 May | 1 | 5 | 6 |
| 2016 April | 1 | 10 | 11 |
| 2016 March | 3 | 8 | 11 |
| 2016 February | 2 | 13 | 15 |
| 2016 January | 8 | 10 | 18 |
| 2015 December | 7 | 1 | 8 |
| 2015 November | 3 | 3 | 6 |
| 2015 October | 4 | 2 | 6 |
Show all
