title: Obstructive Sleep Apnea and Smoking as a Risk Factor for Venous Thromboembolism Events: Review of the Literature on the Common Pathophysiological Mechanisms.
abstract: Venous thromboembolism events (VTE) are a common and preventable cause of postoperative complications. Interestingly, smoking and obstructive sleep apnea syndrome (OSA) affecting a large part of our population (and especially obese patients) are two underestimated predisposing factors of VTE. Many coagulation disorders favoring thromboembolism have been identified in the case of OSA and smoking and are reviewed in this article. They can be divided into two entities: endothelial dysfunction and hemostasis disorders. Interestingly OSA and smoking share common pathways to the prothrombotic state. The interactions with others comorbidities will also be discussed. This article provides pathophysiological mechanisms of the increased risk of thromboembolism in OSA patients and smokers, which should help manage these patients more adequately during the perioperative period.
authors.affiliation: Department of Anesthesia, Clinique Saint-Luc of Bouge & Cabinet Medical ASTES & University of Liege, Chaussee de Tongres, 29, 4000, Liege-Rocourt, Belgium. eric.deflandre@gmail.com.|Cabinet Medical ASTES, Jambes, Belgium. eric.deflandre@gmail.com.
authors.forename: Eric
authors.initials: E
authors.lastname: Deflandre
authors.affiliation: Cabinet Medical ASTES, Jambes, Belgium. contact@astes.be.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Degey
authors.affiliation: Catholic University of Louvain, Louvain, Belgium. natacha.opsomer@hotmail.be.
authors.forename: Natacha
authors.initials: N
authors.lastname: Opsomer
authors.affiliation: Department of Anesthesia CHU de Liege, University of Liege, Liege, Belgium. jfbrichant@chu.ulg.ac.be.
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Brichant
authors.affiliation: Department of Anesthesia CHU de Liege, University of Liege, Liege, Belgium. jean.joris@chu.ulg.ac.be.
authors.forename: Jean
authors.initials: J
authors.lastname: Joris
mesh_terms: D006801:Humans; D009767:Obesity, Morbid / Q000150:complications*; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications*; D012907:Smoking / Q000009:adverse effects*; D054556:Venous Thromboembolism / Q000209:etiology*
keywords: Obstructive sleep apnea; Perioperative management; Thromboembolism; Thrombophilia; Tobacco smoking; Vascular endothelium