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Vol. 26. Issue 8.
Pages 356-359 (November - December 1990)
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Vol. 26. Issue 8.
Pages 356-359 (November - December 1990)
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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
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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
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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.

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Copyright © 1990. Sociedad Española de Neumología y Cirugía Torácica
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