Actividad de la musculatura espiratoria abdominal en pacientes con enfermedad pulmonar obstructiva crónica estable
Abdominal respiratory muscle activity in patients with stable chronic obstructive pulmonary disease
Servicios de Neumología, Hospital Universitario Virgen del Rocío. Sevilla
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Comparación con controles históricos" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "18" "paginaFinal" => "22" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Diseases diagnosed in a respiratory unit with integrated health care. Comparison with historical records" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "P. Martín Escribano, A. López Encuentra, I. Martín García, M.I. Cienfuegos Agustín, C. Caballero Borda" "autores" => array:5 [ 0 => array:2 [ "nombre" => "P." "apellidos" => "Martín Escribano" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "López Encuentra" ] 2 => array:2 [ "nombre" => "I." "apellidos" => "Martín García" ] 3 => array:2 [ "nombre" => "M.I." "apellidos" => "Cienfuegos Agustín" ] 4 => array:2 [ "nombre" => "C." "apellidos" => "Caballero Borda" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615308334?idApp=UINPBA00003Z" "url" => "/03002896/0000003200000001/v1_201506230031/S0300289615308334/v1_201506230031/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Actividad de la musculatura espiratoria abdominal en pacientes con enfermedad pulmonar obstructiva crónica estable" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "23" "paginaFinal" => "28" ] ] "autores" => array:2 [ 0 => array:4 [ "autoresLista" => "F. Ortega Ruiz, H. Sánchez Riera, J. Fernández Guerra, T. Elías Hernández, T. Montemayor Rubio" "autores" => array:5 [ 0 => array:3 [ "nombre" => "F." "apellidos" => "Ortega Ruiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "H." "apellidos" => "Sánchez Riera" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Fernández Guerra" ] 3 => array:2 [ "nombre" => "T." "apellidos" => "Elías Hernández" ] 4 => array:2 [ "nombre" => "T." "apellidos" => "Montemayor Rubio" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicios de Neumología, Hospital Universitario Virgen del Rocío. Sevilla" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia: Avda. Reina Mercedes, 51, l.° B. 41012 Sevilla." ] ] ] 1 => array:3 [ "autoresLista" => "J. Madrazo Osuna, E. Olloqui Martín" "autores" => array:2 [ 0 => array:3 [ "nombre" => "J." "apellidos" => "Madrazo Osuna" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] 1 => array:3 [ "nombre" => "E." "apellidos" => "Olloqui Martín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicios de Neurofisiología, Hospital Universitario Virgen del Rocío. Sevilla" "etiqueta" => "*" "identificador" => "aff0010" ] 1 => array:3 [ "entidad" => "Servicios de Radiodiagnóstico. Hospital Universitario Virgen del Rocío. Sevilla" "etiqueta" => "**" "identificador" => "aff0015" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Abdominal respiratory muscle activity in patients with stable chronic obstructive pulmonary disease" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1995-05-11" "fechaAceptado" => "1995-07-26" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec546056" "palabras" => array:3 [ 0 => "Enfermedad pulmonar obstructiva crónica" 1 => "Músculos respiratorios" 2 => "Electromiograma" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec546055" "palabras" => array:3 [ 0 => "Chronic obstructive pulmonary disease" 1 => "Respiratory muscles" 2 => "Electromyogram" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Con el objetivo de valorar el patrón de actividad de la musculatura espiratoria abdominal en pacientes con enfermedad pulmonar obstructiva crónica (EPOC) estable, hemos estudiado el electromiograma (EMG) de los músculos recto abdominal (RA), oblicuo externo (OE) y transverso (MT) en 14 pacientes con diferentes grados de obstrucción en vías aéreas (FEV<span class="elsevierStyleInf">1</span>: 41<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>12%; FEV<span class="elsevierStyleInf">1</span>/FVC: 45<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10%; RV: 198<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>38%; PaO<span class="elsevierStyleInf">2</span>: 75,8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>12 y PaCO<span class="elsevierStyleInf">2</span>: 41,4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5,7<span class="elsevierStyleHsp" style=""></span>mmHg). El EMG era recogido mediante la inserción de electrodos bipolares, realizando previamente una ecografía de pared abdominal para la localización de los músculos. Las medidas se registraron en decúbito supino durante: <span class="elsevierStyleItalic">a)</span> respiración a volumen corriente; <span class="elsevierStyleItalic">b)</span> espiración lenta hasta RV; <span class="elsevierStyleItalic">c)</span> con carga de flujo inspiratorio; <span class="elsevierStyleItalic">d)</span> con carga de flujo espiratorio, y <span class="elsevierStyleItalic">e)</span> respiración tranquila con elevación de brazos. A 10 pacientes se les registró también las mismas maniobras en posición sentada. Ocho de los enfermos presentaron actividad fásica espiratoria durante la respiración tranquila (actividad del MT solo o acompañado del OE). No existían diferencias significativas en el grado de hiperinsuflación ni en los gases arteriales entre los pacientes que presentaban actividad fásica espiratoria y los que no la presentaban. Sí existían diferencias significativas entre ambos grupos en el grado de obstrucción de las vías aéreas, tanto en el FEV<span class="elsevierStyleInf">1</span>, en valores absolutos (p < 0,001) como en porcentaje (p < 0,004) en el FEV<span class="elsevierStyleInf">1</span>/FVC (p < 0,02) y en las Raw (p < 0,04). La espiración lenta hasta RV provocaba actividad muscular en 13 pacientes, aunque ios músculos no operaban como una unidad, activándose el MT y posteriormente el resto de la musculatura abdominal. El patrón de activación también se encontraba con la colocación de cargas inspiratorias y espiratorias, aunque en este caso, cuando los tres músculos se activaban, lo hacían de forma simultánea. Durante el registro con los brazos elevados en sólo 2 casos se obtuvo actividad fásica, observándose una mayor actividad tónica de los músculos. El patrón de actividad fásica de los músculos recogido en posición sentado era esencialmente similar a la obtenida en posición supina. En resumen, algunos pacientes con EPOC estable presentan en reposo actividad fásica espiratoria de la musculatura abdominal. Estos músculos no parecen actuar como una unidad y esta actividad espiratoria fásica está relacionada con la severidad de la obstrucción de la vía aérea.</p></span>" ] "en" => array:1 [ "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">With the purpose of defining the pattern of abdominal respiratory muscle activity in patients with chronic obstructive pulmonary disease (COPD), we studied the electromyogram of the rectus abdominis (RA), the external oblique (EO) and transversus (TM) muscles in 14 patients with different degrees of airways obstruction (FEV<span class="elsevierStyleInf">1</span>: 41<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>12%; FEV<span class="elsevierStyleInf">1</span>/FVC: 45<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10%; RV: 198<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>38%; PaO<span class="elsevierStyleInf">2</span>: 75.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>12 y PaCO<span class="elsevierStyleInf">2</span>: 41.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.7<span class="elsevierStyleHsp" style=""></span>mmHg). The EMG was obtained by insertion of bipolar electrodes guided by an ultrasound image of the abdominal wall to locate the position of the muscles. The measurements were recorded in supine decubitus position in 5 situations: <span class="elsevierStyleItalic">a)</span> breathing at tidal volume; <span class="elsevierStyleItalic">b)</span> slow expiration until RV; <span class="elsevierStyleItalic">c)</span> with inspiratory load; <span class="elsevierStyleItalic">d)</span> with expiratory load, and <span class="elsevierStyleItalic">e)</span> during relaxed breathing with the arms raised. Recordings were also made in the same situations with 10 patients sitting. Eight patients presented phasic expiratory activity during relaxed breathing (TM activity alone or accompanied by EO). We found no significant differences in degree of hyperinflation or in arterial gases between patients with phasic expiratory activity and those without. There were significant differences between these 2 groups, however, as to degree of airways obstruction, for absolute values of FEV<span class="elsevierStyleInf">1</span> (p < 0.02) and in raw values (p < 0.04). Slow breathing until RV recruited muscular activity in 13 patients; the muscles did not operate in union, however, with TM acting first. Recruitment was also observed when inspiratory and expiratory loads were placed, although in this case the 3 muscles acted simultaneously. Phasic activity was observed in only 2 patients forrecordings made with arms raised, at which time there was greater tonic muscle activity. The phasic activity pattern recorded when patients were sitting was very similar to that obtained in supine position. In summary, some patients with stable COPD have phasic expiratory activity of the abdominal muscles when resting. These muscles do not appear to act as a unit and this phasic expiratory activity is related to severity of upper airways obstruction.</p></span>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The respiratory muscles in chronic obstructive pulmonary disease (COPD)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D.F. Rochester" 1 => "N.S. Arora" 2 => "N.M.T. Braun" 3 => "S.K. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 10 | 1 | 11 |
| 2024 October | 86 | 18 | 104 |
| 2024 September | 66 | 10 | 76 |
| 2024 August | 74 | 29 | 103 |
| 2024 July | 63 | 28 | 91 |
| 2024 June | 68 | 21 | 89 |
| 2024 May | 58 | 22 | 80 |
| 2024 April | 34 | 26 | 60 |
| 2024 March | 41 | 25 | 66 |
| 2024 February | 31 | 34 | 65 |
| 2024 January | 0 | 6 | 6 |
| 2023 November | 0 | 2 | 2 |
| 2023 October | 0 | 3 | 3 |
| 2023 August | 0 | 3 | 3 |
| 2023 July | 0 | 5 | 5 |
| 2023 May | 0 | 1 | 1 |
| 2023 April | 0 | 4 | 4 |
| 2023 March | 8 | 7 | 15 |
| 2023 February | 38 | 30 | 68 |
| 2023 January | 25 | 19 | 44 |
| 2022 December | 39 | 27 | 66 |
| 2022 November | 39 | 25 | 64 |
| 2022 October | 36 | 26 | 62 |
| 2022 September | 28 | 22 | 50 |
| 2022 August | 31 | 47 | 78 |
| 2022 July | 32 | 30 | 62 |
| 2022 June | 25 | 22 | 47 |
| 2022 May | 32 | 28 | 60 |
| 2022 April | 42 | 25 | 67 |
| 2022 March | 35 | 26 | 61 |
| 2022 February | 36 | 25 | 61 |
| 2022 January | 29 | 31 | 60 |
| 2021 December | 23 | 32 | 55 |
| 2021 November | 22 | 32 | 54 |
| 2021 October | 60 | 34 | 94 |
| 2021 September | 18 | 38 | 56 |
| 2021 August | 23 | 38 | 61 |
| 2021 July | 14 | 28 | 42 |
| 2021 June | 24 | 42 | 66 |
| 2021 May | 18 | 25 | 43 |
| 2021 April | 33 | 28 | 61 |
| 2021 March | 34 | 25 | 59 |
| 2021 February | 52 | 15 | 67 |
| 2021 January | 31 | 17 | 48 |
| 2020 December | 31 | 14 | 45 |
| 2020 November | 36 | 5 | 41 |
| 2020 October | 17 | 0 | 17 |
| 2020 September | 39 | 7 | 46 |
| 2020 August | 44 | 16 | 60 |
| 2020 July | 34 | 14 | 48 |
| 2020 June | 22 | 10 | 32 |
| 2020 May | 38 | 12 | 50 |
| 2020 April | 41 | 6 | 47 |
| 2020 March | 35 | 16 | 51 |
| 2020 February | 28 | 14 | 42 |
| 2020 January | 48 | 23 | 71 |
| 2019 December | 30 | 25 | 55 |
| 2019 November | 27 | 8 | 35 |
| 2019 October | 40 | 13 | 53 |
| 2019 September | 24 | 14 | 38 |
| 2019 August | 18 | 10 | 28 |
| 2019 July | 17 | 28 | 45 |
| 2019 June | 20 | 20 | 40 |
| 2019 May | 26 | 23 | 49 |
| 2019 April | 40 | 17 | 57 |
| 2019 March | 17 | 13 | 30 |
| 2019 February | 7 | 9 | 16 |
| 2019 January | 15 | 7 | 22 |
| 2018 December | 7 | 20 | 27 |
| 2018 November | 11 | 19 | 30 |
| 2018 October | 15 | 9 | 24 |
| 2018 September | 7 | 6 | 13 |
| 2018 May | 2 | 1 | 3 |
| 2018 April | 12 | 12 | 24 |
| 2018 March | 9 | 9 | 18 |
| 2018 February | 4 | 12 | 16 |
| 2018 January | 7 | 6 | 13 |
| 2017 December | 6 | 11 | 17 |
| 2017 November | 8 | 8 | 16 |
| 2017 October | 11 | 11 | 22 |
| 2017 September | 7 | 7 | 14 |
| 2017 August | 5 | 7 | 12 |
| 2017 July | 5 | 5 | 10 |
| 2017 June | 12 | 13 | 25 |
| 2017 May | 12 | 17 | 29 |
| 2017 April | 10 | 8 | 18 |
| 2017 March | 7 | 10 | 17 |
| 2017 February | 6 | 9 | 15 |
| 2017 January | 4 | 10 | 14 |
| 2016 December | 11 | 12 | 23 |
| 2016 November | 30 | 20 | 50 |
| 2016 October | 34 | 22 | 56 |
| 2016 September | 32 | 19 | 51 |
| 2016 August | 26 | 3 | 29 |
| 2016 July | 38 | 7 | 45 |
| 2016 June | 25 | 5 | 30 |
| 2016 May | 26 | 3 | 29 |
| 2016 April | 17 | 0 | 17 |
| 2016 March | 18 | 0 | 18 |
| 2016 February | 27 | 0 | 27 |
| 2016 January | 36 | 8 | 44 |
| 2015 December | 45 | 24 | 69 |
| 2015 November | 48 | 13 | 61 |
| 2015 October | 12 | 2 | 14 |
| 2015 September | 1 | 0 | 1 |
| 2015 June | 1 | 0 | 1 |
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