Point-of-Care Ultrasound for Obstructive Sleep Apnea Screening: Are We There Yet? A Systematic Review and Meta-Analysis

Perioperative diagnosis of OSA has important resource implications because screening questionnaires are overly sensitive, and sleep studies are expensive and time-consuming. The objective of this systematic review was to evaluate the correlation of surface ultrasound images with OSA diagnosis and to determine whether a point-of-care ultrasound (PoCUS) for OSA screening may help improve perioperative screening. A search of all electronic databases including Medline, Embase, and Cochrane Database of Systematic Reviews was conducted from database inception to September 2017. Inclusion criteria were observational cohort studies and randomized controlled trials of known or suspected OSA patients undergoing surface ultrasound assessment. Of the initial 3865 screened articles, 21 studies (7 airway and 14 non-airway) evaluating 3339 patients were included. Airway US parameters with moderate to good correlation with OSA were distance between lingual arteries, resting tongue thickness, tongue base thickness during Muller maneuver (MM), and a combination of neck circumference and retropalatal (RP) diameter shortening during MM. Non-airway US parameters with low to moderate correlation with OSA were carotid intimal thickness and plaque presence. In conclusion, a number of airway and non-airway parameters were identified with moderate to good correlation with OSA. Future studies should elucidate the utility of PoCUS for perioperative OSA screening.