[Treatment with Bi-PAP in patients with bilateral diaphragm paralysis]. / Tratamiento con Bi-PAP en pacientes con parálisis diafragmática bilateral.

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.

[Functional laryngeal obstruction]. / Obstrucción laríngea funcional.

We describe 4 patients with reversible obstruction of the upper airways, a condition that usually presents with crises of dyspnea and respiratory sounds. No organic cause could be identified and the symptoms were initially confused with those of bronchial asthma. During episodes, the flow-volume curve suggested obstruction of the upper airways with poor reproducibility and repeatedly normal resistance values. Fiberoptic bronchoscopy allowed us to confirm the functional nature of the obstruction in these cases.