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Journal Information
Vol. 18. Issue 5.
Pages 221-225 (September - October 1982)
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Vol. 18. Issue 5.
Pages 221-225 (September - October 1982)
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Hallazgos y complicaciones en cien punciones transtraqueales
Aspects and complications of percutaneous transtracheal puncture biopsy
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J.L. Alcazar Serrano*, C. Alvarez Alvarez*, E.G. Diego Gonzalez*, D. Escribano Sevillano*, M.aJ. Ferreiro Alvarez*, G. Gea Laurila*, J. Hitado Garcia*, J.L. Menendez Del Campo*, A. Roman Rojo*, M.A. Cabezudo Hernandez**, A. Mendez Lanza**, J.A. Muñoz Martinez**, J. Sala Felis**, J. Mosquera Pestaña***
* Medico Adjunto. Servicio de Neumología. Instituto Nacional de Silicosis. Servicio de Neumología. Instituto Nacioal de Silicosis. Oviedo
** Jefe Clínico. Servicio de Neumología. Instituto Nacional de Silicosis. Servicio de Neumología. Instituto Nacioal de Silicosis. Oviedo
*** Jefe Servicio. Servicio de Neumología. Instituto Nacional de Silicosis, Servicio de Neumología. Instituto Nacioal de Silicosis. Oviedo
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Resumen

Se realiza un estudio prospectivo de la punción transtraqueal (PTT) efectuada en 100 pacientes, cuya edad oscilaba entre 25 y 85 años. La indicación fue en 43 casos por neumonía cavitada, en 13 casos por cavitación reciente de masas neumoconióticas, en 1 caso por patrón nodular difuso y en los 43 restantes por neumonía no cavitada. Crecieron gérmenes en el 77 % de las muestras, siendo los anaerobios los gérmenes más frecuentemente hallados. El estudio gasométrico en conjunto, no evidenció cambios significativos de la Pa 02, Pa CO2 y pH (p > 0,05), sin embargo la mitad de los casos presentaron hipoxemia y un tercio hipoventilación sin que pudiera predecirse con claridad qué tipo de pacientes iban a realizar estas alteraciones. Los cambios electrocardiográficos carecieron de interés. En 15 casos ocurrieron otro tipo de complicaciones, siendo la hemoptisis y el enfisema subcutáneo las más frecuentes. No hubo exitus.

La PTT es una técnica idónea para la obtención de muestras bacteriológicas no contaminadas en la orofaringe, aunque sus potenciales complicaciones restringen su uso a un medio hospitalario.

Summary

Percutaneous transtracheal puncture biopsy (PTT) was prospectively studied in a series of 100 patients aged between 25 and 85. Indications for the biopsy included: cavity pneumonia in 43 cases; recent pneumoconiotic cavitation in 13; diffuse nodular patterns in 1 and non-cavitating pneumonia in the remaining 43. Cultures were positive in 77 % and anaerobes were the most frequently encountered organisms. Although gasometric studies did not show any significant changes in Pa Co2; Pa 02 and pH (p > 0.05) half of all patients presented hypoxemia and a third hypoventilation without the possibility of predicting which of the patient would present these alterations. ECG alterations were not significant. Other complications such as hemoptysis and subcutaneous emphysema were the most frequently seen ones. Mortality rate was nil.

PTT is the technique of choice for obtaining noncontaminated bacteriologic semples form the oropharyngeal space, although possible complications restrict their use in the hospital environment.

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Bibliografia
[1.]
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Sputum or Spit?.
Chest, 76 (1979), pp. 498-500
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Transtracheal aspiration complicated by fatal endotracheal hemorrage.
N Engl J Med, 295 (1976), pp. 488-490
Copyright © 1982. Sociedad Española de Neumología y Cirugía Torácica
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