Ventilación no invasiva en cifoescoliosis. Estudio comparativo entre respirador volumétrico y soporte de presión (BIPAP)
Non-invasive ventilation in kyphoscoliosis. A comparison of a volumetric ventilator and a BIPAP support pressure device
E. Laserna
, E. Barrot, A. Belaustegui, E. Quintana, A. Hernández, J. Castillo
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Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Hospital Universitario Virgen del Rocío. Sevilla. España
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Estudio comparativo entre respirador volumétrico y soporte de presión (BIPAP)" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "13" "paginaFinal" => "18" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "E. Laserna, E. Barrot, A. Belaustegui, E. Quintana, A. Hernández, J. Castillo" "autores" => array:6 [ 0 => array:4 [ "nombre" => "E." "apellidos" => "Laserna" "email" => array:1 [ 0 => "elena_laserna@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Barrot" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Belaustegui" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Quintana" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Hernández" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Castillo" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Hospital Universitario Virgen del Rocío. Sevilla. España" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Sinaí, 14, 2.° A. 41007 Sevilla. España" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Non-invasive ventilation in kyphoscoliosis. A comparison of a volumetric ventilator and a BIPAP support pressure device" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2002-01-28" "fechaAceptado" => "2002-05-08" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec190536" "palabras" => array:3 [ 0 => "Ventilación no invasiva" 1 => "Soporte de presión" 2 => "Ci-foescoliosis" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec190535" "palabras" => array:3 [ 0 => "Non-invasive ventilation" 1 => "Pressure support" 2 => "Kyphos-coliosis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El tratamiento de elección de los pacientes con insuficien-cia respiratoria crónica secundaria a cifoescoliosis grave es la administración de ventilación no invasiva domiciliaria</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El propósito de nuestro estudio ha sido comparar, en un es-tudio prospectivo, cruzado y aleatorizado, la evolución clíni-ca, gasométrica y funcional tras un mes de tratamiento domi-ciliario con los dos tipos de respirador, así como evaluar las alteraciones que presentan durante el sueño estos enfermos</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Para ello hemos incluido en el estudio a 10 pacientes con insuficiencia respiratoria crónica secundaria a afección res-trictiva por cifoescoliosis</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se asignó a cada paciente el primer dispositivo de manera aleatoria y tras un mes de tratamiento en su domicilio se reali-zó una nueva evaluación clínica, funcional y polisomnográfica con el respirador. El mismo protocolo se aplicó con el segundo dispositivo, dejando entre uno y otro 10 días de descanso</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">En la polisomnografía basal observamos un sueño fragmen-tado, con disminución de las fases profundas de sueño NREM y de sueño REM, así como un patrón respiratorio con frecuencias muy elevadas que coincidían con importantes desaturaciones</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">En todos los enfermos se objetivó una mejoría clínica y gasométrica con ambos dispositivos, sin diferencias estadís-ticas entre ellos. En los registros polisomnográficos se obser-vó una disminución significativa en el porcentaje de tiempo transcurrido con saturación de oxígeno por debajo del 90% con ambos respiradores respecto al registro basal</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">En nueve de los 10 pacientes se observó una mejor adap-tación y tolerancia a la presión de soporte respecto al respi-rador volumétrico</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">En conclusión, en nuestra experiencia la ventilación no in-vasiva en los pacientes con insuficiencia respiratoria crónica secundaria a cifoescoliosis es igualmente efectiva adminis-trada con respirador volumétrico o con soporte de presión (BIPAP). La respuesta subjetiva y la adaptación al dispositi-vo parece ligeramente superior para el BIPAP</p>" ] "en" => array:1 [ "resumen" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Non-invasive intermittent positive pressure ventilation (NIPPV) at home is the treatment of choice for patients with chronic respiratory insufficiency secondary to severe kyp-hoscoliosis. Our aim was to compare clinical course, blood gases and lung function after one month of domiciliary NIPPV with two types of ventilator and to assess sleep pat-tern changes in patients enrolled in a prospective, randomi-zed crossover study. Ten patients with chronic respiratory insufficiency due to kyphoscoliosis were enrolled and ran-domly assigned to the first device. After one month of use, the patients underwent clinical and functional examinations and polysomnographic studies while using the ventilator. The same protocol was applied with the second device after a ten-day washout period. Baseline polysomnographs sho-wed fragmented sleep with low percentages of deep non-REM sleep and of REM sleep, as well as respiratory pat-terns characterized by very high frequencies coinciding with significant desaturations. In all cases symptoms and arterial blood gas improvements were significant, with no differen-ces between the two treatment periods. The percentages of time spent with SaO<span class="elsevierStyleInf">2</span>below 90% of reference in sleep stu-dies were significantly lower than baseline with both ventila-tors. All but one patient had better tolerance of the bilevel positive airway pressure (BIPAP) support mode than of the volumetric ventilator. Our study shows that NIPPV is equally effective for patients with kyphoscoliosis whether administered with a volumetric ventilator or a BIPAP devi-ce. Subjective response and tolerance seem to be slightly better with BIPAP</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Noninvasive ventilation, does it work, for whom, and how?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "N.S. Hill" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm/147.4.1050" "Revista" => array:6 [ "tituloSerie" => "Am Rev Respir Dis" "fecha" => "1993" "volumen" => "147" "paginaInicial" => "1050" "paginaFinal" => "1055" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8466105" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 10 | 3 | 13 |
| 2024 October | 41 | 26 | 67 |
| 2024 September | 52 | 23 | 75 |
| 2024 August | 64 | 42 | 106 |
| 2024 July | 45 | 22 | 67 |
| 2024 June | 68 | 36 | 104 |
| 2024 May | 68 | 37 | 105 |
| 2024 April | 63 | 30 | 93 |
| 2024 March | 63 | 38 | 101 |
| 2024 February | 44 | 36 | 80 |
| 2024 January | 0 | 2 | 2 |
| 2023 December | 0 | 2 | 2 |
| 2023 November | 0 | 6 | 6 |
| 2023 October | 0 | 7 | 7 |
| 2023 September | 0 | 11 | 11 |
| 2023 August | 10 | 2 | 12 |
| 2023 July | 0 | 23 | 23 |
| 2023 May | 0 | 1 | 1 |
| 2023 March | 3 | 3 | 6 |
| 2023 February | 22 | 28 | 50 |
| 2023 January | 31 | 45 | 76 |
| 2022 December | 40 | 22 | 62 |
| 2022 November | 54 | 33 | 87 |
| 2022 October | 32 | 29 | 61 |
| 2022 September | 25 | 23 | 48 |
| 2022 August | 38 | 45 | 83 |
| 2022 July | 44 | 43 | 87 |
| 2022 June | 39 | 33 | 72 |
| 2022 May | 37 | 34 | 71 |
| 2022 April | 41 | 30 | 71 |
| 2022 March | 35 | 29 | 64 |
| 2022 February | 33 | 36 | 69 |
| 2022 January | 26 | 29 | 55 |
| 2021 December | 27 | 43 | 70 |
| 2021 November | 34 | 51 | 85 |
| 2021 October | 40 | 53 | 93 |
| 2021 September | 28 | 46 | 74 |
| 2021 August | 31 | 37 | 68 |
| 2021 July | 20 | 43 | 63 |
| 2021 June | 29 | 37 | 66 |
| 2021 May | 24 | 37 | 61 |
| 2021 April | 51 | 88 | 139 |
| 2021 March | 45 | 28 | 73 |
| 2021 February | 39 | 20 | 59 |
| 2021 January | 31 | 25 | 56 |
| 2020 December | 28 | 29 | 57 |
| 2020 November | 19 | 26 | 45 |
| 2020 October | 27 | 10 | 37 |
| 2020 September | 22 | 16 | 38 |
| 2020 August | 24 | 6 | 30 |
| 2020 July | 21 | 19 | 40 |
| 2020 June | 35 | 13 | 48 |
| 2020 May | 22 | 17 | 39 |
| 2020 April | 35 | 9 | 44 |
| 2020 March | 25 | 21 | 46 |
| 2020 February | 29 | 33 | 62 |
| 2020 January | 62 | 28 | 90 |
| 2019 December | 38 | 32 | 70 |
| 2019 November | 17 | 36 | 53 |
| 2019 October | 28 | 41 | 69 |
| 2019 September | 32 | 53 | 85 |
| 2019 August | 23 | 31 | 54 |
| 2019 July | 29 | 39 | 68 |
| 2019 June | 25 | 43 | 68 |
| 2019 May | 27 | 40 | 67 |
| 2019 April | 59 | 53 | 112 |
| 2019 March | 29 | 18 | 47 |
| 2019 February | 22 | 24 | 46 |
| 2019 January | 12 | 14 | 26 |
| 2018 December | 23 | 29 | 52 |
| 2018 November | 31 | 25 | 56 |
| 2018 October | 34 | 38 | 72 |
| 2018 September | 19 | 13 | 32 |
| 2018 May | 14 | 1 | 15 |
| 2018 April | 10 | 7 | 17 |
| 2018 March | 11 | 5 | 16 |
| 2018 February | 9 | 14 | 23 |
| 2018 January | 16 | 17 | 33 |
| 2017 December | 14 | 13 | 27 |
| 2017 November | 8 | 14 | 22 |
| 2017 October | 14 | 19 | 33 |
| 2017 September | 12 | 19 | 31 |
| 2017 August | 11 | 19 | 30 |
| 2017 July | 9 | 10 | 19 |
| 2017 June | 15 | 34 | 49 |
| 2017 May | 16 | 32 | 48 |
| 2017 April | 22 | 22 | 44 |
| 2017 March | 14 | 45 | 59 |
| 2017 February | 9 | 11 | 20 |
| 2017 January | 17 | 16 | 33 |
| 2016 December | 20 | 16 | 36 |
| 2016 November | 41 | 38 | 79 |
| 2016 October | 46 | 41 | 87 |
| 2016 September | 32 | 24 | 56 |
| 2016 August | 43 | 21 | 64 |
| 2016 July | 51 | 22 | 73 |
| 2016 June | 36 | 20 | 56 |
| 2016 May | 39 | 24 | 63 |
| 2016 April | 24 | 2 | 26 |
| 2016 March | 25 | 3 | 28 |
| 2016 February | 29 | 4 | 33 |
| 2016 January | 43 | 18 | 61 |
| 2015 December | 46 | 18 | 64 |
| 2015 November | 48 | 14 | 62 |
| 2015 October | 126 | 2 | 128 |
| 2015 September | 116 | 0 | 116 |
| 2015 August | 75 | 0 | 75 |
| 2015 July | 94 | 0 | 94 |
| 2015 June | 81 | 0 | 81 |
| 2015 May | 130 | 0 | 130 |
| 2015 April | 92 | 0 | 92 |
| 2015 March | 98 | 0 | 98 |
| 2015 February | 101 | 0 | 101 |
| 2015 January | 90 | 0 | 90 |
| 2014 December | 80 | 0 | 80 |
| 2014 November | 86 | 0 | 86 |
| 2014 October | 143 | 0 | 143 |
| 2014 September | 102 | 0 | 102 |
| 2014 August | 92 | 0 | 92 |
| 2014 July | 107 | 0 | 107 |
| 2014 June | 98 | 0 | 98 |
| 2014 May | 99 | 0 | 99 |
| 2014 April | 94 | 0 | 94 |
| 2014 March | 111 | 0 | 111 |
| 2014 February | 98 | 0 | 98 |
| 2014 January | 85 | 0 | 85 |
| 2013 December | 104 | 0 | 104 |
| 2013 November | 80 | 0 | 80 |
| 2013 October | 114 | 0 | 114 |
| 2013 September | 70 | 0 | 70 |
| 2013 August | 77 | 0 | 77 |
| 2013 July | 95 | 0 | 95 |
| 2013 June | 81 | 0 | 81 |
| 2013 May | 62 | 0 | 62 |
| 2013 April | 51 | 0 | 51 |
| 2013 March | 16 | 0 | 16 |
| 2000 January | 5306 | 0 | 5306 |
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