Journal Information
Vol. 26. Issue 8.
Pages 356-359 (November - December 1990)
Share
Share
Download PDF
More article options
Vol. 26. Issue 8.
Pages 356-359 (November - December 1990)
Full text access
Detección del umbral de la disnea ocasionado por cargas resistivas añadidas en asmáticos y pacientes con enfermedad pulmonar obstructiva crónica
Detection of the dyspnea threshold created by added resistive loads in patients with asthma and chronic obstructive lung disease
Visits
3468
A. Pereira Vega, J. Castillo Gómez, F. Rodriguez Panadero, F. Capote Gil, P. Alberich Sotomayor, R. Sánchez Gil
Servicio de Neumología. Hospital Virgen del Rocío. Sevilla
This item has received
Article information

Hemos estudiado en 24 sujetos (13 asmáticos y 11 pacientes con EPOC) la presión muscular inspiratoria necesaria para ventilar a volumen corriente (PI), la presión muscular inspiratoria máxima medida a capacidad residual funcional FRC-(PI max), el cociente PI/PI max y el índice tensióntiempo inspiratorio (ITT), tanto de forma basal como una vez conseguido el umbral de la disnea mediante la aplicación de una carga resistiva externa, con el objeto de analizar las posibles diferencias entre asmáticos y EPOC con similares edades, peso y resistencias basales de la vía aérea (Raw). Nuestro estudio mostró que los pacientes con EPOC tenían de forma basal unos valores de PI, PI/PI max e ITT superiores (p<0,01, p<0,01 y p<0,02, respectivamente) a los de los asmáticos. No hubo diferencias significativas en la resistencia añadida necesaria para alcanzar el umbral de la disnea entre los dos grupos. En el umbral, los pacientes con EPOC mostraron de nuevo valores superiores de PI, PI/PI max e ITT que los asmáticos (p<0,05, p<0,001 y p<0,01, respectivamente). Concluimos que no encontramos una respuesta mitigada para la detección de cargas resistivas en pacientes con EPOC; sin embargo, estos pacientes presentaron un mayor ITT que los asmáticos en las dos situaciones estudiadas con lo que podrían alcanzar más fácilmente la fatiga muscular y secundariamente hipoventilar.

In 24 subjects (13 with asthma and 11 with chronic obstructive lung disease (COLD), we evaluated the inspiratory muscular pressure required for ventilation at tidal volume (IP), the maximum inspiratory muscle pressure measured at the functional residual capacity, FRC (IPmax), the IP/IPmax ratio and the inspiratory tension-time index (TTI), both in the baseline and when the dyspnea threshold was achieved by the application of an external resistive load so as to evaluate the possible differences between patients with asthma and COLD with similar age, weight and baseline airway resistance (Raw). Our study showed that COLD patients had baseline values of IP, IP/IPmax and TTI higher (p < 0,01, p < 0,01, and p < 0,02, respectively) than those in patients with asthma. There were no significant differences in the added resistance required to achieve the dyspnea threshold between the two groups. In the threshold, the COLD patients had again higher values of IP, IP/IPmax and TTI than patients with asthma (p < 0,05, p < 0,01, and p < 0,01, respectively). We conclude that we did not find an attenuated response for the detection of resistive loads in COLD patients; however, these patients had a higher TTI than patients with asthma in the two investigated situations, which might lead them more easily to muscle fatigue and secondary hyperventilation.

Full text is only aviable in PDF
Bibliografía
[1.]
M.D. Altose, W.C. McCauley, S.G. Kelsen, N.S. Cherniak.
Effects of hipercapnia and inspiratory flow-resistive loading on respiratory activity in chronic airways obstruction.
J Clin Invest, 59 (1977), pp. 500-507
[2.]
S.G. Kelsen, B. Fleegles, M.D. Altose.
The respiratory neuromuscular response to hipoxia, hipercapnia, and obstruccion to airflow in asthma.
Am Rev Respir Dis, 120 (1979), pp. 517-527
[3.]
E. Rodriguez Becerra, et al.
Hipoventilación alveolar en estenosis alta.
Arch Bronconeumol., 17 (1981), pp. 287-289
[4.]
N.S. Cherniak, M.D. Altose.
Mechanisms of dyspnea.
Clin Chest Med, 8 (1987), pp. 207-214
[5.]
S.B. Gottfried, M.D. Altose, S.G. Kelsen, N.S. Cherniak.
Perception of changes in airflow resistance in obstructive pulmonary disorders.
Am Rev Respir Dis, 124 (1981), pp. 566-570
[6.]
S.B. Gottfried, S. Redline, M.D. Altose.
Respiratory sensation in chronic obstructive pulmonary disease.
Am Rev Respir Dis, 132 (1985), pp. 954-959
[7.]
M.E. Ward, D.G. Stubbing.
Effect of chronic lung disease on the perception of added inspiratory loads.
Am Rev Respir Dis, 132 (1985), pp. 652-656
[8.]
D.A. Mahler, R.A. Rosiello, A. Harver, et al.
Comparison of clinical dyspnea ratings and psychophysical measurements of respiratory sensation in obstructive airway disease.
Am Rev Respir Dis, 135 (1987), pp. 1229-1233
[9.]
F. Bellemare, A. Grassino.
Effect of pressure and timing of contraction on human diaphragm fatigue.
J Appl Physiol, 53 (1982), pp. 1190-1195
[10.]
F. Bellemare, A. Grassino.
Evaluation of human diaphragm fatigue.
J Appl Physiol, 53 (1982), pp. 1196-1206
[11.]
F. Bellemare, A. Grassino.
Force reserve of the diaphragm in patients with chronic obstructive pulmonary disease.
J Appl Physiol, 55 (1983), pp. 8-15
[12.]
G.S. Supinski, S.J. Clary, H. Bark, S.G. Kelsen.
Effect of inspiratory muscle fatigue on perception of effort during loaded breathing.
J Appl Physiol, 62 (1987), pp. 300-307
[13.]
T.D. Bradley, D.A. Chartrand, J.W. Fitting, K.J. Killian, A. Grassino.
The relation of inspiratory effort sensation to fatiguing patterns of the diaphragm.
Am Rev Respir Dis, 134 (1986), pp. 1119-1124
[14.]
J.W. Fitting, D.A. Chartrand, T.D. Bradley, K.J. Killian, A. Grassino.
Effect of thoracoabdominal breathing patterns on inspiratory effort sensation.
J Appl Physiol, 62 (1987), pp. 1665-1670
[15.]
Normativa para la práctica de la espirometría forzada.
Grupo de Trabajo de la SEPAR.
Arch Bronconeumol, 24 (1989), pp. 132-141
[16.]
K.J. Killian, D.D. Bucens, E.J.M. Campbell.
Effect of breathing patterns on the perceived magnitude of added loads to breathing.
J Appl Physiol, 52 (1982), pp. 578-584
Copyright © 1990. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?