RESUMEN
BACKGROUND: The ventilatory mechanics of patients with COPD and obesity-hypoventilation syndrome (OHS) are changed when there is air trapping and auto-PEEP, which increase respiratory effort. P0.1 measures the ventilatory drive and, indirectly, respiratory effort. The aim of the study was to measure P0.1 in subjects with COPD or OHS on treatment with positive pressure and to analyze their changes in P0.1 after treatment. METHODS: With a prospective design, subjects with COPD and OHS were studied in whom positive airway pressure was applied in their treatment. P0.1 was determined at study inclusion and after 6 months of treatment. RESULTS: A total of 88 subjects were analyzed: 56% were males, and the mean age of 65 ± 9 y old. Fifty-four (61%) had OHS, and 34 (39%) had COPD. Fifty (56%) had air trapping, with an initial P0.1 value of 3.0 ± 1.3 cm H2O compared with 2.1 ± 0.7 cm H2O for subjects who did not have air trapping (P = .001). After 6 months of treatment, subjects who had air trapping had similar P0.1 as those who did not: 2.3 ± 1.1 and 2.1 ± 1 cm H2O, respectively (P = .53). In subjects with COPD, initial P0.1 was 2.9 ± 1.4 cm H2O and at 6 months 2.2 ± 1.1 cm H2O (P = .02). In subjects with OHS, initial P0.1 was 2.4 ± 1.1 cm H2O and at 6 months 2.2 ± 1.0 cm H2O (P = .28). CONCLUSIONS: COPD and air trapping were associated with greater P0.1 as a marker of respiratory effort. A decrease in P0.1 indicates less respiratory effort after treatment.
RESUMEN
La inmunoterapia con el bacilo Calmette-Guérin (BCG) es el agente intravesical más efectivo para el tratamiento de carcinoma vesical in situ tras la resección transuretral del tumor. Pese a ser un agente seguro y las complicaciones sistémicas son infrecuentes, las complicaciones locales leves son frecuentes. La afectación pulmonar es inusual (< 1%) suele ser grave, en forma de patrón micronodulillar y su mecanismo etiopatológico es controvertido. Se presenta el caso clínico de un varón con afectación pulmonar micronodulillar secundaria a instilaciones de BCG intravesical (AU)
Immunotherapy with Calmette-Guérin bacillus (BCG) is the most effective intravesical treatment of in situ bladder carcinoma besides the transurethral resection. Tough its known to be secure, and systemic complications are very rare, mild local complications are frequents. The lung involvement is unusual (< 1%), normally severe, with a micronodular pattern, and its etiopathogenic mechanism is a controversial issue. We present a case of a man with micronodular pattern secondary to intravesical BCGs instillations (AU)
Asunto(s)
Humanos , Masculino , Anciano , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Carcinoma in Situ/tratamiento farmacológico , Vacuna BCG/efectos adversos , Neumonía/inducido químicamente , Neumonía/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
No disponible