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Vol. 31. Issue 1.
Pages 18-22 (January 1995)
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Vol. 31. Issue 1.
Pages 18-22 (January 1995)
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Efectos de la presión positiva continua nasal (CPAPn) sobre la función pulmonar en pacientes con síndrome de apnea obstructiva del sueño (SAOS)
Effects of nasal continuous positive airways pressure on lung function in patients with obstructive sleep apnea syndrome
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R. Vázquez Oliva*, S. Cano Gómez, F. Capote Gil, M.A. Sánchez Armengol, C. Carmona Bernal, J. Castillo Gómez
Servicio de Neumología. Hospital Universitario Virgen del Rocío. Sevilla
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Sesenta y un pacientes con síndrome de apnea obstructiva del sueño (SAOS), veintiséis de los cuales tenían enfermedad pulmonar obstructiva crónica (EPOC) asociada, recibieron tratamiento con presión positiva continua nasal (CPAPn). Para evaluar los efectos de este dispositivo sobre la función pulmonar diurna se analizaron los tests de función pulmonar practicados antes del tratamiento con CPAPn y tras un período medio de seguimiento de 12 meses (valores extremos: 222 meses). En el grupo de pacientes con SAOS y EPOC existió un descenso significativo de la PaC02 (p < 0,007), de la resistencia de la vía aérea (Raw) (p < 0,002) y del volumen residual (RV) (p < 0,01), y un incremento de la capacidad vital forzada (FVC) (p < 0,04) y de la presión inspiratoria máxima (PIM) (p < 0,02). No encontramos cambios manifiestos en la función pulmonar de pacientes con SAOS aislado. En los 15 pacientes inicialmente hipoxémicos la PaO2 se incrementó tras el seguimiento (p < 0,001). Concluimos que tras tratamiento con CPAPn los mayores cambios en la función respiratoria se producen en el grupo de pacientes con SAOS y EPOC asociada, en el que también se produce una ligera disminución del peso corporal. Los cambios en este grupo podrían deberse a un descenso de la auto-PEEP y a una disminución del peso.

Palabras clave:
SAOS
EPOC
CPAPn

Sixty-one patients with obstructive sleep apnea syndrome (OSAS), 26 of whom also had chronic obstructive pulmonary disease (COPD), received treatment by nasal continuous positive airways pressure (nCPAP). To evalúate the effects of this device on daytime lung function, we analyzed pulmonary function tests before treatment with nCPAP and after a mean follow-up period of 12 months (range: 2-22 months). In patients with both OSAS and COPD, we observed a significant decrease in PaCO2 (p < 0.007), in airways resistance (p < 0.002) and in residual volume (p < 0.01); for these same patients we recorded increases in forced vital capacity (p < 0.04) and maximum inspiratory pressure (p < 0.02). We saw no change in lung function in patients with OSAS only. PaO2 increased after treatment in the 15 patients who were initially hypoxemic (p < 0.001). We conclude that after treatment with nCPAP, the greatest changes in respiratory function occur in patients with both OSAS and COPD, who also experience slight decrease in body weight. These changes may be explained by a decrease in auto-PEEP and weight loss.

Key words:
Obstructive sleep apnea syndrome
Chronic obstructive pulmonary disease
Nasal continuous positive airways pressure
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Copyright © 1995. Sociedad Española de Neumología y Cirugía Torácica
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