The impact of unilateral diaphragmatic paralysis on sleep-disordered breathing : a scoping review
BACKGROUND: Unilateral diaphragm paralysis (UDP) may potentially worsen sleep-disordered breathing (SDB). Unilateral diaphragm paralysis has been associated with proximal brachial plexus blockade, such as interscalene and supraclavicular block. The impact of UDP in patients with SDB is not known in this context. The objectives of this scoping review were to explore the associations between UDP and worsening SDB severity, oxygenation, and pulmonary function.
METHODS: A systematic search was developed, peer-reviewed, and applied to Embase, Medline, CINAHL, and Cochrane databases to include studies involving adult patients (≥ 18 yr) with SDB, where the effects of UDP on SDB severity, oxygenation, and pulmonary function were examined.
RESULTS: Six studies (n = 100 patients) with UDP and SDB were included. The sample population was derived exclusively from respirology-sleep clinics, and none were surgical patients. Compared with control (no UDP), UDP was associated with an increased respiratory disturbance index, most pronounced during rapid eye movement (REM) sleep and supine sleep. Supine and REM sleep were associated with obstructive and mixed (both obstructive and central) events, respectively. Compared with control, UDP was associated with a lower mean and minimum oxygen saturation and arterial oxygen tension during all sleep stages and in all body positions. The majority of UDP patients were found to have clinically significant reductions in mean forced expiratory volume in one second and forced vital capacity values, consistent with restrictive ventilatory pattern.
CONCLUSION: We observed an association between UDP and increasing SDB severity, particularly during REM sleep and while sleeping in the supine position. Although we identified weaknesses in study design and lack of perioperative data, anesthesiologists should be aware of this association when considering proximal brachial plexus blockade in patients with SDB.
| Errataetall: | |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:68 |
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| Enthalten in: |
Canadian journal of anaesthesia = Journal canadien d'anesthesie - 68(2021), 7 vom: 16. Juli, Seite 1064-1076 |
| Sprache: |
Französisch |
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| Weiterer Titel: |
L’impact de la paralysie diaphragmatique unilatérale sur les troubles respiratoires du sommeil : une revue exploratoire |
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| Beteiligte Personen: |
Singh, Mandeep [VerfasserIn] |
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| Links: |
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| Themen: |
Diaphragm palsy |
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| Anmerkungen: |
Date Completed 22.06.2021 Date Revised 31.07.2021 published: Print-Electronic ErratumIn: Can J Anaesth. 2021 Apr 7;:. - PMID 33829392 Citation Status MEDLINE |
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| doi: |
10.1007/s12630-021-01970-y |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM322819601 |
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| 100 | 1 | |a Singh, Mandeep |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The impact of unilateral diaphragmatic paralysis on sleep-disordered breathing |b a scoping review |
| 246 | 3 | 3 | |a L’impact de la paralysie diaphragmatique unilatérale sur les troubles respiratoires du sommeil : une revue exploratoire |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 22.06.2021 | ||
| 500 | |a Date Revised 31.07.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ErratumIn: Can J Anaesth. 2021 Apr 7;:. - PMID 33829392 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Unilateral diaphragm paralysis (UDP) may potentially worsen sleep-disordered breathing (SDB). Unilateral diaphragm paralysis has been associated with proximal brachial plexus blockade, such as interscalene and supraclavicular block. The impact of UDP in patients with SDB is not known in this context. The objectives of this scoping review were to explore the associations between UDP and worsening SDB severity, oxygenation, and pulmonary function | ||
| 520 | |a METHODS: A systematic search was developed, peer-reviewed, and applied to Embase, Medline, CINAHL, and Cochrane databases to include studies involving adult patients (≥ 18 yr) with SDB, where the effects of UDP on SDB severity, oxygenation, and pulmonary function were examined | ||
| 520 | |a RESULTS: Six studies (n = 100 patients) with UDP and SDB were included. The sample population was derived exclusively from respirology-sleep clinics, and none were surgical patients. Compared with control (no UDP), UDP was associated with an increased respiratory disturbance index, most pronounced during rapid eye movement (REM) sleep and supine sleep. Supine and REM sleep were associated with obstructive and mixed (both obstructive and central) events, respectively. Compared with control, UDP was associated with a lower mean and minimum oxygen saturation and arterial oxygen tension during all sleep stages and in all body positions. The majority of UDP patients were found to have clinically significant reductions in mean forced expiratory volume in one second and forced vital capacity values, consistent with restrictive ventilatory pattern | ||
| 520 | |a CONCLUSION: We observed an association between UDP and increasing SDB severity, particularly during REM sleep and while sleeping in the supine position. Although we identified weaknesses in study design and lack of perioperative data, anesthesiologists should be aware of this association when considering proximal brachial plexus blockade in patients with SDB | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a diaphragm palsy | |
| 650 | 4 | |a hypoxemia | |
| 650 | 4 | |a interscalene block | |
| 650 | 4 | |a obstructive sleep apnea | |
| 650 | 4 | |a shoulder surgery | |
| 650 | 4 | |a sleep-disordered breathing | |
| 700 | 1 | |a Mejia, Jorge M |e verfasserin |4 aut | |
| 700 | 1 | |a Auckley, Dennis |e verfasserin |4 aut | |
| 700 | 1 | |a Abdallah, Faraj |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Kumar, Vivek |e verfasserin |4 aut | |
| 700 | 1 | |a Englesakis, Marina |e verfasserin |4 aut | |
| 700 | 1 | |a Brull, Richard |e verfasserin |4 aut | |
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