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Vol. 36. Issue 5.
Pages 286-289 (May 2000)
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Vol. 36. Issue 5.
Pages 286-289 (May 2000)
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Tratamiento con Bi-PAP en pacientes con parálisis diafragmática bilateral
Bi-PAP treatment of patients with bilateral diaphragmatic paralysis
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J. de Miguel Díez*, B. Jara Chinarro, J.A. Hermida Gutiérrez, M.A. Juretschke Moragues
Servicio de Neumología. Hospital Universitario de Getafe. Madrid
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Se describen los casos de 2 pacientes que presentaron una parálisis diafragmática bilateral (PDB). En el primer caso fue secundaria a cirugía cardíaca abierta y en el segundo a un politraumatismo. Ambos fueron tratados con presión positiva intermitente de la vía aérea a dos niveles (Bi-PAP) con buenos resultados.

La PDB puede ser secundaria a diversos procesos, aunque también existen formas idiopáticas. Su diagnóstico puede ser difícil y requiere un alto grado de sospecha clínica. El tratamiento y el pronóstico están determinados por la enfermedad subyacente. En algunos casos puede requerirse la instauración de soporte ventilatorio nocturno. La asistencia ventilatoria no invasiva tipo Bi-PAP puede proporcionar a los pacientes una importante mejoría clínica, permitiéndoles llevar una vida independiente.

Palabras clave:
Parálisis diafragmática
Ventilación mecánica no invasiva Bi-PAP

Two patients with bilateral diaphragmatic paralysis are described. The first case occurred secondary to open chest surgery; the second occurred in a polytraumatized patient. Both were successfully treated with intermittent bi-level positive airway pressure (Bi-PAP).

Bilateral diaphragmatic paralysis can be related to a variety of processes, although idiopathic forms also occur. Diagnosis can be difficult and should involve a high level of clinical suspicion. Treatment and prognosis are determined by the underlying disease. Some cases may require the establishment of nighttime support ventilation. Techniques for non-invasive ventilatory assistance such as Bi-PAP can improve symptoms markedly and allow patients to live independently.

Key words:
Diaphragmatic paralysis
Non-invasive mechanical ventilation
Bi-PAP
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Copyright © 2000. Sociedad Española de Neumología y Cirugía Torácica
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