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Vol. 20. Issue 6.
Pages 248-252 (November - December 1984)
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Vol. 20. Issue 6.
Pages 248-252 (November - December 1984)
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Estudio comparativo de la evolucion radiologica y del recambio de gases en la neumonia bacteriana
Comparative study of the radiological evolution and gas interchange during bacterial pneumonia
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P. Morales Marin, R. Navarro Ivañez, V. Marco Martinez, D. Nauffal Manzur, F. Planas Comerma, B. Agüera Perez, E. Benlloch Garcia
Servicio de Neumología. Departamento de Medicina Interna. Ciudad Sanitaria La Fe. Valencia
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En 25 pacientes con neumonía bacteriana no complicada, se ha estudiado la correlación entre la extensión radiológica inicial determinada por planimetría y la alteración del recambio gaseoso. La extensión radiológica de la neumonía (x¯±sd) fue 19,5±12,6%: la PaCO2 74,0±9,8 torr y la PA(A-a)O2 36,1±9,9 torr. No encontramos una correlación significativa entre la afectación radiológica inicial y el deterioro del recambio gaseoso; sin embargo, tomando como línea de separación de los casos analizados la mediana de la distribución de la extensión radiológica (17%), vemos que el gradiente alvéolo-arterial era significativamente mayor (p < 0,05) en aquellos sujetos con afectación radiológica ≥ 17%. En controles seriados de ambos parámetros llevados a cabo a los dos días, una semana, dos semanas, un mes y posteriormente cada mes hasta su normalización, la resolución radiológica precedió a la normalización gasométrica significativamente (p < 0,01). No se observó por otro lado relación entre el grado de extensión radiológica de la neumonía y el tiempo de resolución (r = 0,25).

La existencia de zonas dispersas de inflamación y microatelectasias no visibles radiológicamente, justificarían estos hallazgos contribuyendo a la persistencia de alteraciones del intercambio gaseoso en el pulmón, en ausencia de condensación radiológica.

The correlation between (he initial radiological extension and gas interchange alterations was studied in 25 patients with non-complicated bacterial pneumonia. Radiological extension was determined through planimetry.

Radiological extension was (x¯±SD) 19.5±12.6%; PaCO2 was 74.0±9.8 torr and P(A-a)O2 36.1±9.9 torr. We did not find any significant correlation between the initial radiological affectation and the deterioration in gas interchange; however, if the mean distribution of the radiological extension (17%) is taken as the dividing line, the alveolo-arterial gradient was significantly higher in patients with radiological affectation (p < 0.05) (≥ 17%). In seried Controls of both parameters taken over a two day period, one week, two weeks and one month, followed by a one-monthly control until normal levells were reached, radiological normalization took place before the gas interchange returned to normal (p < 0.01).

No relationship was observed between the radiological extension of the pneumonia and the tome before interval before a return to normal (r = 0.25).

The presence of dispersed areas of inflammation and microatelectasia which could not be radiologically detected, justifies these findings and would contribute to the persistence of the alterations in gas interchange in the absence of radiological condensation.

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Copyright © 1984. Sociedad Española de Neumología y Cirugía Torácica
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