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Vol. 30. Issue 4.
Pages 202-206 (April 1994)
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Vol. 30. Issue 4.
Pages 202-206 (April 1994)
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Reclutamiento alveolar por insuflación transpulmonar a alta presión. Estudio morfométrico experimental
Alveolar recruitment during inflation at high transpulmonary pressure: An experimental morphometric study
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J.D. Escolar Castellón*, C. Tejero Juste, M.A. Escolar Castellón
Departamento de Ciencias Morfológicas. Universidad de Zaragoza
B. Gallego Carrión*
* Servicio de Neumología. Hospital Miguel Servet. Zaragoza
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Se presenta un estudio experimental en el que se cuestionan, utilizando técnicas morfométricas, los conceptos tradicionales sobre el comportamiento del alveolo ante los cambios de presión.

El incremento de la presión de insuflación pulmonar produce reclutamiento alveolar (aumento en el número de los espacios aéreos distales) por desplegamiento de sus paredes.

Para demostrar la hipótesis se han perfundido pulmones de rata a 25 y 35 cm de presión de agua. Los perfundidos a mayor presión deberán presentar: disminución del tamaño de los alveolos, con adelgazamiento de sus paredes, aumento del perímetro alveolar interno, sin que varíe la cantidad de tejido. El estudio ha sido morfométrico, realizado en un sistema informático. Los resultados se han contrastado con tests estadísticos.

Se han utilizado 10 ratas Wistar. Sus pulmones se procesaron para microscopia de luz. Se cuantificaron las siguientes variables: índice de intersección lineal media (Lm), cuerda alveolar, grosor de pared, perímetro alveolar interno y porcentaje de tejido.

La disminución del Lm en los pulmones perfundidos a 35 cm de presión de agua, nos hace considerar que el número de alveolos aumentó; la disminución del Lm y de la cuerda alveolar indican reducción del tamaño de los alveolos; la pared alveolar disminuyó de grosor; el perímetro alveolar interno aumentó. Todas estas diferencias fueron estadísticamente significativas (p < 0,001), siendo el porcentaje de tejido la única variable que no sufrió variación significativa.

Todos estos resultados nos hacen considerar que el aumento de la presión de insuflación pulmonar produce reclutamiento alveolar por desplegamiento de sus paredes.

We describe an experimental study in which morphometric techniques are used to question traditional conceptions about the behavior of the alveolus under changes in pressure.

An increase in inflation pressure in the lung results in alveolar recruitment (an increase in distal air spaces) due to stretching of its walls.

To test this hypothesis, the lungs of rats were filled to 25 to 35 cm water pressure. Lungs filled to a higher pressure were expected to present a decrease in alveolar size along with thinning of its walls, and an increase of internal perimeter of the alveolus with no change in amount of tissue. Morphometric data were processed by Computer and results were analyzed by statistical tests.

The lungs of 10 Wistar rats were examined under light microscope. The following variables were recorded: mean linear intersection (Lm), alveolar cord, wall thickness, internal alveolar perimeter and tissue percentage.

Lower Lm in lungs filled to 35 cm water pressure allows us to consider that the number of alveoli increased; lower Lm and alveolar cord indícate that alveolar size is smaller; alveolar wall thickness decreased; internal alveolar perimeter increased. All these differences were statistically significant (p < 0.001), tissue percentage being the only variable that did not change significantly.

All results lead us to consider that an increase in lung inflation pressure leads to alveolar recruitment and stretching of its walls.

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Copyright © 1994. Sociedad Española de Neumología y Cirugía Torácica
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