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Hipoxemia transitoria durante el sueño en bronquitis crónica y enfisema
Lancet (London, England)
|January 6, 1979
Resumen
Los pacientes con bronquitis crónica y enfisema experimentan hipoxemia transitoria durante el sueño. Estos episodios, particularmente durante el sueño REM, pueden contribuir a la hipertensión pulmonar y la policitemia en individuos "azules e hinchados".
Área de la Ciencia:
- Medicina Pulmonar La medicina pulmonar es el tratamiento de las enfermedades pulmonares.
- Medicina del sueño Medicina del sueño.
- Fisiología de las vías respiratorias.
Sus antecedentes:
- La bronquitis crónica y el enfisema son las principales causas de enfermedades respiratorias.
- Los pacientes con estas afecciones a menudo exhiben fenotipos clínicos distintos, como "azul y hinchado" o "rosa y hinchado".
Objetivo del estudio:
- Para investigar la oxigenación arterial y los patrones de respiración durante el sueño en pacientes con bronquitis crónica y enfisema.
- Para comparar los parámetros respiratorios relacionados con el sueño entre pacientes "azulados e hinchados", pacientes "rosados e hinchados" y sujetos sanos.
Principales métodos:
- La polisomnografía se utilizó para monitorear el electroencefalograma, los patrones de respiración y la saturación de oxígeno arterial durante el sueño.
- Se realizó un monitoreo continuo de la saturación arterial de oxígeno en pacientes con bronquitis crónica y enfisema y controles sanos.
Principales resultados:
- Todos los 10 pacientes "azulados e hinchados" experimentaron episodios de hipoxemia transitoria (disminución de la saturación de oxígeno >10%) durante el sueño, que duraron de 1 a 100 minutos.
- No se observaron tales eventos de desaturación en los 2 pacientes "rosados y hinchados" o en los 4 sujetos sanos.
- Los episodios de hipoxemia ocurrieron predominantemente durante la etapa de movimiento rápido de los ojos (REM) del sueño.
Conclusiones:
- La hipoxemia transitoria durante el sueño es un hallazgo significativo en pacientes "azules e hinchados" con bronquitis crónica y enfisema.
- Es probable que estos episodios de hipoxemia sean causados por una combinación de hipoventilación y desajuste de ventilación / perfusión (V / Q).
- La hipoxemia relacionada con el sueño puede ser un factor que contribuye al desarrollo de la hipertensión pulmonar y la policitemia secundaria característica del fenotipo "azul e hinchado".
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