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se ha relacionado de forma directamente proporcional con la gravedad del SAHS<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a>&#46; El RDW est&#225; siendo estudiado como biomarcador proinflamatorio &#40;no solamente en enfermedad cardiovascular&#41;&#44; elev&#225;ndose probablemente por estr&#233;s oxidativo e inflamaci&#243;n cr&#243;nica&#44; que causan la liberaci&#243;n de citoquinas que podr&#237;an actuar sobre la m&#233;dula &#243;sea y alterar la eritropoyesis<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a>&#46; Tambi&#233;n se cree que podr&#237;an influir est&#237;mulos neurohormonales<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">En la literatura pedi&#225;trica se ha estudiado la presencia de alteraciones metab&#243;licas&#44; como la elevaci&#243;n de la hemoglobina glucosilada en pacientes con SAHS&#44; postul&#225;ndose como marcador de gravedad &#40;independiente de la edad y el peso&#41;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a>&#59; pero&#44; los datos sobre la serie roja no est&#225;n bien descritos&#46; Por ello hemos realizado un estudio para evaluar si las alteraciones hematol&#243;gicas propias del adulto con SAHS grave se reflejan en ni&#241;os&#44; para identificar nuevas herramientas de cribado y as&#237; priorizar la realizaci&#243;n de estudios de sue&#241;o&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">&#201;ste estudio es retrospectivo&#44; con revisi&#243;n de historias cl&#237;nicas y anal&#237;ticas preoperatorias de pacientes intervenidos de SAHS grave entre los a&#241;os 2012-2016 en nuestro centro&#44; as&#237; como controles de ni&#241;os&#44; de similar edad&#44; operados por otros motivos&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se ha definido como SAHS grave la presencia de un &#237;ndice de apneas&#47;hipopneas &#40;IAH&#41;<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>10 en el estudio de sue&#241;o&#46; Las variables analizadas han sido&#58; edad&#44; IAH o IAH obstructivas&#44; &#237;ndice de desaturaciones &#40;IDO&#41;&#44; nadir&#44; tiempo de saturaci&#243;n de ox&#237;geno menor al 90&#37; &#40;T90&#41;&#44; <span class="elsevierStyleItalic">arousals</span>&#44; tiempo total de sue&#241;o&#44; eficiencia de sue&#241;o&#44; porcentaje de sue&#241;o profundo y fase de sue&#241;o r&#225;pido &#40;REM&#41; y datos de la serie roja &#40;hemoglobina&#44; hematocrito&#44; HCM&#44; VCM y RDW&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Se obtuvo una muestra de 87 ni&#241;os con SAHS grave &#40;edad media&#58; 4&#44;30<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;27&#41;&#44; 78 diagnosticados con polisomnograf&#237;a y 9 con poligraf&#237;a y 88 controles &#40;edad media&#58; 6&#44;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;68&#41;&#46; El IAH medio del grupo de SAHS era de 21&#44;34<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#44;80 apneas&#47;h&#46; El resto de valores poligr&#225;ficos&#47;polisomnogr&#225;ficos quedan reflejados en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Comparando la media de hemoglobina en el grupo de SAHS &#40;12&#44;92<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;92&#41;&#44; no se han encontrado diferencias significativas con el grupo control &#40;13&#44;09<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;99&#41;&#44; ni tampoco en el resto de valores hematol&#243;gicos &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Dada la diferencia significativa de edad entre ambos grupos&#44; y por las diferencias en valores hematol&#243;gicos en las distintas etapas de la infancia&#44; se decidi&#243; reanalizar por subgrupos de edad &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#44; sin encontrarse diferencias significativas en valores de hemoglobina ni hematocrito&#46; En nuestro estudio los menores de 6 a&#241;os con SAHS presentan un mayor n&#250;mero de eritrocitos&#44; pero parad&#243;jicamente&#44; en mayores de 6 a&#241;os esta tendencia no solo no se mantiene&#44; sino que se observa que los del grupo control tienen mayor n&#250;mero de eritrocitos&#44; por lo que no se pueden establecer conclusiones a este respecto&#46; Por otra parte&#44; en referencia al RDW&#44; los mayores de 6 a&#241;os sin SAHS parecen tenerlo ligeramente aumentado con respecto al grupo con SAHS&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Por tanto&#44; a diferencia de la poblaci&#243;n adulta&#44; no encontramos diferencias significativas entre los valores de la serie roja de ni&#241;os operados por SAHS comparados con ni&#241;os de edad similar intervenidos por otras causas&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Probablemente se deba a un menor grado de hipoxia &#40;T90 en muchas ocasiones del 0&#37; 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          "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">DT&#58; desviaci&#243;n t&#237;pica&#59; IAH&#58; &#237;ndice de apnea-hipopnea&#59; IDO&#58; &#237;ndice de desaturaciones&#59; N3&#58; fase de sue&#241;o lento profundo&#59; REM&#58; fase de sue&#241;o r&#225;pido &#171;rapid eye movement&#187;&#59; SAHS&#58; s&#237;ndrome de apnea-hipopnea del sue&#241;o&#59; T90&#58; tiempo de saturaci&#243;n de ox&#237;geno &#60;<span class="elsevierStyleHsp" style=""></span>90&#37;&#59; TST&#58; tiempo total de sue&#241;o&#46;</p>"
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          "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis descriptivo del grupo de pacientes con SAHS grave&#44; con medidas de tendencia central y de dispersi&#243;n</p>"
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          "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">N&#250;mero total de 175 pacientes&#58; 87 con SAHS grave &#40;69 menores de 6 a&#241;os y los 18 restantes mayores&#41; y 88 controles &#40;48 por debajo de 6 a&#241;os y 40 por encima&#41;&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Eritrocitos &#40;&#215;10<span class="elsevierStyleSup">6</span>&#47;&#956;l&#41;&#59; Hb&#58; hemoglobina &#40;g&#47;dl&#41;&#59; HCM&#58; hemoglobina corpuscular media &#40;pg&#41;&#59; Hto&#58; hematocrito&#59; RDW&#58; ancho de distribuci&#243;n eritrocitaria&#59; SAHS&#58; s&#237;ndrome de apnea-hipopnea del sue&#241;o&#59; VCM&#58; volumen corpuscular medio &#40;fl&#41;&#46;</p>"
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                  \t\t\t\t">4&#44;82<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;35&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#44;80<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;41&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12&#44;92<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;914&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13&#44;09<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;99&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">38&#44;46<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#44;24<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VCM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">79&#44;40<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">81&#44;52<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HCM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">26&#44;87<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;59&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">27&#44;32<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;11&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">RDW&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">13&#44;69<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;14&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13&#44;75<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;44&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>6 a&#241;os &#40;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>117&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12&#44;74<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Hto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">38&#44;08<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;93&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;74&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">VCM&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">HCM&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Hb&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13&#44;52<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;87&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">39&#44;27<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;18&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">40&#44;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;71&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">VCM&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">80&#44;26<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#44;22&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">82&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;22&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">HCM&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">27&#44;65<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">RDW&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12&#44;79<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;68&nbsp;\t\t\t\t\t\t\n
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Carta científica
Análisis de la serie roja en niños con síndrome de apnea-hipopnea del sueño
Analysis of red blood cells in children diagnosed with obstructive sleep apnoea syndrome
Jesús Rodríguez-Catalána,
Autor para correspondencia
jesusrodricatalan@gmail.com

Autor para correspondencia.
, Juan López Carneroa, Gloria Pérez Tejerizob, Paula Rodríguez Rodríguezc,d, Genoveva del-Río Camachoa,d
a Servicio de Pediatría, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
b Servicio de Cirugía Pediátrica, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
c Servicio de Neumología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
d Unidad Multidisciplinar del Sueño, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
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siendo menos frecuentes la somnolencia diurna o la morbilidad cardiovascular&#44; m&#225;s propias del adulto&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Entre los hallazgos hematol&#243;gicos&#44; ha sido descrito en adultos el aumento de hemoglobina<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">4&#44;5</span></a> llegando en ocasiones al rango de policitemia<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a>&#44; consider&#225;ndose estas alteraciones secundarias al aumento de secreci&#243;n de eritropoyetina por la hipoxia recurrente durante el sue&#241;o&#46; Si bien &#250;ltimamente se est&#225; analizando la influencia de otros factores<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a>&#44; dado que no todo paciente con SAHS grave desarrolla estos cambios&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Asimismo&#44; el aumento del ancho de distribuci&#243;n eritrocitaria &#40;RDW&#41; se ha relacionado de forma directamente proporcional con la gravedad del SAHS<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a>&#46; El RDW est&#225; siendo estudiado como biomarcador proinflamatorio &#40;no solamente en enfermedad cardiovascular&#41;&#44; elev&#225;ndose probablemente por estr&#233;s oxidativo e inflamaci&#243;n cr&#243;nica&#44; que causan la liberaci&#243;n de citoquinas que podr&#237;an actuar sobre la m&#233;dula &#243;sea y alterar la eritropoyesis<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a>&#46; Tambi&#233;n se cree que podr&#237;an influir est&#237;mulos neurohormonales<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">En la literatura pedi&#225;trica se ha estudiado la presencia de alteraciones metab&#243;licas&#44; como la elevaci&#243;n de la hemoglobina glucosilada en pacientes con SAHS&#44; postul&#225;ndose como marcador de gravedad &#40;independiente de la edad y el peso&#41;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a>&#59; pero&#44; los datos sobre la serie roja no est&#225;n bien descritos&#46; Por ello hemos realizado un estudio para evaluar si las alteraciones hematol&#243;gicas propias del adulto con SAHS grave se reflejan en ni&#241;os&#44; para identificar nuevas herramientas de cribado y as&#237; priorizar la realizaci&#243;n de estudios de sue&#241;o&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">&#201;ste estudio es retrospectivo&#44; con revisi&#243;n de historias cl&#237;nicas y anal&#237;ticas preoperatorias de pacientes intervenidos de SAHS grave entre los a&#241;os 2012-2016 en nuestro centro&#44; as&#237; como controles de ni&#241;os&#44; de similar edad&#44; operados por otros motivos&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se ha definido como SAHS grave la presencia de un &#237;ndice de apneas&#47;hipopneas &#40;IAH&#41;<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>10 en el estudio de sue&#241;o&#46; Las variables analizadas han sido&#58; edad&#44; IAH o IAH obstructivas&#44; &#237;ndice de desaturaciones &#40;IDO&#41;&#44; nadir&#44; tiempo de saturaci&#243;n de ox&#237;geno menor al 90&#37; &#40;T90&#41;&#44; <span class="elsevierStyleItalic">arousals</span>&#44; tiempo total de sue&#241;o&#44; eficiencia de sue&#241;o&#44; porcentaje de sue&#241;o profundo y fase de sue&#241;o r&#225;pido &#40;REM&#41; y datos de la serie roja &#40;hemoglobina&#44; hematocrito&#44; HCM&#44; VCM y RDW&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Se obtuvo una muestra de 87 ni&#241;os con SAHS grave &#40;edad media&#58; 4&#44;30<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;27&#41;&#44; 78 diagnosticados con polisomnograf&#237;a y 9 con poligraf&#237;a y 88 controles &#40;edad media&#58; 6&#44;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;68&#41;&#46; El IAH medio del grupo de SAHS era de 21&#44;34<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#44;80 apneas&#47;h&#46; El resto de valores poligr&#225;ficos&#47;polisomnogr&#225;ficos quedan reflejados en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Comparando la media de hemoglobina en el grupo de SAHS &#40;12&#44;92<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;92&#41;&#44; no se han encontrado diferencias significativas con el grupo control &#40;13&#44;09<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;99&#41;&#44; ni tampoco en el resto de valores hematol&#243;gicos &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Dada la diferencia significativa de edad entre ambos grupos&#44; y por las diferencias en valores hematol&#243;gicos en las distintas etapas de la infancia&#44; se decidi&#243; reanalizar por subgrupos de edad &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#44; sin encontrarse diferencias significativas en valores de hemoglobina ni hematocrito&#46; En nuestro estudio los menores de 6 a&#241;os con SAHS presentan un mayor n&#250;mero de eritrocitos&#44; pero parad&#243;jicamente&#44; en mayores de 6 a&#241;os esta tendencia no solo no se mantiene&#44; sino que se observa que los del grupo control tienen mayor n&#250;mero de eritrocitos&#44; por lo que no se pueden establecer conclusiones a este respecto&#46; Por otra parte&#44; en referencia al RDW&#44; los mayores de 6 a&#241;os sin SAHS parecen tenerlo ligeramente aumentado con respecto al grupo con SAHS&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Por tanto&#44; a diferencia de la poblaci&#243;n adulta&#44; no encontramos diferencias significativas entre los valores de la serie roja de ni&#241;os operados por SAHS comparados con ni&#241;os de edad similar intervenidos por otras causas&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Probablemente se deba a un menor grado de hipoxia &#40;T90 en muchas ocasiones del 0&#37; pese a SAHS significativo&#41;&#44; as&#237; como a menos tiempo de evoluci&#243;n&#44; as&#237;&#44; considerando nuestro estudio&#44; no supone una herramienta &#250;til de cribado&#46; No obstante&#44; consideramos necesaria la realizaci&#243;n de m&#225;s estudios al respecto&#44; aumentando el tama&#241;o muestral&#44; equiparando mejor las edades de ambos grupos y estudiando m&#225;s comorbilidades y par&#225;metros &#40;no solo hematol&#243;gicos&#44; tambi&#233;n antropom&#233;tricos-metab&#243;licos&#41;&#44; que pudieran asimismo afectar a la serie roja&#46;</p></span>"
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          "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">DT&#58; desviaci&#243;n t&#237;pica&#59; IAH&#58; &#237;ndice de apnea-hipopnea&#59; IDO&#58; &#237;ndice de desaturaciones&#59; N3&#58; fase de sue&#241;o lento profundo&#59; REM&#58; fase de sue&#241;o r&#225;pido &#171;rapid eye movement&#187;&#59; SAHS&#58; s&#237;ndrome de apnea-hipopnea del sue&#241;o&#59; T90&#58; tiempo de saturaci&#243;n de ox&#237;geno &#60;<span class="elsevierStyleHsp" style=""></span>90&#37;&#59; TST&#58; tiempo total de sue&#241;o&#46;</p>"
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                  \t\t\t\t">40&#44;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">REM&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">14&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">14&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">11&#44;00&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Eficiencia&#44; &#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">86&#44;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">7&#44;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">88&#44;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">83&#44;65&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab2284912.png"
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          "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis descriptivo del grupo de pacientes con SAHS grave&#44; con medidas de tendencia central y de dispersi&#243;n</p>"
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      1 => array:8 [
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        "tipo" => "MULTIMEDIATABLA"
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            "rol" => "short"
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          "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">N&#250;mero total de 175 pacientes&#58; 87 con SAHS grave &#40;69 menores de 6 a&#241;os y los 18 restantes mayores&#41; y 88 controles &#40;48 por debajo de 6 a&#241;os y 40 por encima&#41;&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Eritrocitos &#40;&#215;10<span class="elsevierStyleSup">6</span>&#47;&#956;l&#41;&#59; Hb&#58; hemoglobina &#40;g&#47;dl&#41;&#59; HCM&#58; hemoglobina corpuscular media &#40;pg&#41;&#59; Hto&#58; hematocrito&#59; RDW&#58; ancho de distribuci&#243;n eritrocitaria&#59; SAHS&#58; s&#237;ndrome de apnea-hipopnea del sue&#241;o&#59; VCM&#58; volumen corpuscular medio &#40;fl&#41;&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Total &#40;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>175&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#44;30<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;27&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#44;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;68&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Eritrocitos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;82<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;35&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;80<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;41&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hb&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;92<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;914&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;09<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;24&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#44;46<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#44;24<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VCM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79&#44;40<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#44;52<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HCM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#44;87<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;32<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">RDW&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;69<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;75<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>6 a&#241;os &#40;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>117&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#44;85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;37&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#44;67<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;38&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12&#44;81<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;94&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">38&#44;26<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;67&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">27&#44;65<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;27&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudio comparativo del grupo de pacientes con SAHS grave y los controles&#44; tanto de forma global&#44; como subestratificados por edades</p>"
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                    0 => array:2 [
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Información del artículo
ISSN: 16954033
Idioma original: Español
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