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Vol. 27. Issue 5.
Pages 193-196 (June - July 1991)
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Vol. 27. Issue 5.
Pages 193-196 (June - July 1991)
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El patrón ventilatorio en la limitación crónica al flujo aéreo
The ventilatory pattern in chronic airflow limitation
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E. García Pachón, P. Casan, M. González, R. Miralda, J. Sanchis
Unitat de Funció Pulmonar. Hospital de la Santa Creu i de Sant Pau. Barcelona
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Para analizar las posibles diferencias en el patrón ventilatorio (PV) relacionadas con la retención de C02 en pacientes con limitación crónica al flujo aéreo (LCFA), hemos estudiado el PV en 30 pacientes, divididos en dos grupos de 15, aparejados por características físicas y grado de alteración epiromé-trica, de volúmenes pulmonares y resistencias de vías aéreas, uno con PaCO2 > 45 mmHg y otro con PaCO245mmHg. Los hipercápnicos presentaban menor ventilación (V’E) que los normocápnicos (11,6 vs 13,3 lmin-1; p<0,05) y menor volumen circulante (0,67 vs 0,83 1; p<0,025). También presentaban valores significativamente inferiores en el flujo medio espiratorio y en el flujo máximo inspiratorio y espiratorio del PV. La presión de oclusión era mayor en los hipercápnicos (2,63 vs 2,11 hPa; p<0,05). La retención de C02 no se debió a disminución de V’E por reducción del impulso central sino que estaba relacionada con el aumento de la “impedancia efectiva” y probablemente, de la relación VD/VT.

In order to study the possible differences in the ventilatory pattern related to C02 retention in patients with chronic air flow limitation, we analyzed the ventilatory pattern in 30 patients divided in two groups of 15 according to the presence of arterial pCO2 greater or lower than 45mmHg. In both groups the patients were matched by physical characteristics and degree of spirometric alteration as well as by pulmonary volumes and airway resistence. Patients with high pCO2 had a lower ventilation (V’E) than patients with normal pCO2 (11.6 vs 13.3 lmin-1; p<0.05) and lower tidal volume (0.67 vs 0.83 l, p<0.025). They also presented significantly lower values of mean expiratory flow and maximal inspiratory and expiratory flow. The closing pressure was higher in patients with hypercapnia (2.63 vs 2.11 hPa; p<0.05). Retention of C02 was not due to a decrease in V’E induced by a central impulse. Instead, it was related to an increase in “effective impedance” and, probably, to an increase in VD/VT relation.

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Copyright © 1991. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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