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Vol. 32. Issue 6.
Pages 267-270 (June - July 1996)
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Vol. 32. Issue 6.
Pages 267-270 (June - July 1996)
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Programa de detección precoz de insuficiencia respiratoria en la enfermedad de Duchenne: resultados preliminares
Early detection program for respiratory insufficiency in Duchenne's disease: preliminary results
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S. Díaz Lobato1, F.J. Gómez de Terreros, M.T. García Tejero, C. Villasante
Servicio de Neumología. Hospital La Paz. Madrid
J. Corral*, C. Vázquez*, M.A. Redondo*, C. Echavarri*, J. Martínez*
* Colegio Público de Educación Especial y Reeducación de Inválidos (CPEERI). Madrid
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La ventilación mecánica no invasiva, realizada a través de una mascarilla nasal, es una técnica recientemente incorporada al arsenal terapéutico, que ha supuesto un notable avance en el tratamiento domiciliario de los pacientes con insuficiencia respiratoria secundaria a fallo de la bomba ventilatoria. Presentamos los resultados preliminares de un programa de detección precoz de insuficiencia respiratoria en pacientes afectados de enfermedad de Duchenne. En el período comprendido entre enero de 1994 y enero de 1995, hemos valorado a 16 casos con enfermedad de Duchenne. Edad: 15,8 años; CVF: 1.440 ml (46,7%); PO2: 87,3 mmHg; PCO2: 40,8 mmHg; PIM: 40,1 cmH2O(30,6%); PEM: 41 cmH,:0 (25%). Dos pacientes mostraron pulsioximetría nocturna y gasometría diurna patológicas, iniciándose ventilación mecánica por mascarilla nasal. Estos 2 enfermos fueron de mayor edad, con menor CVF, más hipoxémicos e hi-percápnicos, y con un mayor deterioro de las presiones musculares inspiratorias y espiratorias.

Palabras clave:
Enfermedad de Duchenne
Ventilación mecánica domiciliaria
Mascarilla nasal
Insuficiencia respiratoria

Non invasive mechanical ventilation through a nasal mask is a recently introduced therapeutic tool that represents a noteworthy advance in home treatment for patients with respiratory insufficiency secondary to ventilatory pump fai-lure. We present the preliminary results of a program for early detection of respiratory insufficiency in patients with Duchenne's disease. Sixteen patients (mean age 15.8 years) with this disease were evaluated between January 1994 and January 1995. Mean lung function parameters were FVC 1,440 ml (46.7%), PO2 87.3 mmHg, PCO2 40.8 mmHg, PIM 40.1 cmH2O (30.6%), and PEM 41 cmH2O(25%). Two patients had abnormal pulse oximetry readings at night and abnormal gasometric readings during the day and were started on mechanical ventilation through nasal masks. These 2 patients were older, more hypoxemic and hypercapnic, had lower FVC values and showed greater deterioration of inspiratory and expiratory muscle pressures.

Key words:
Duchenne's disease
Home mechanical ventilation
Nasal mask
Respiratory insufficiency
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Trabajo subvencionado parcialmente por la Beca FIS 94/0347.

Copyright © 1996. Sociedad Española de Neumología y Cirugía Torácica
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