Publication: Valoración de la pequeña vía aérea en niños asmáticos mediante Oscilometría de Impulso. ¿Alternativa a la Espirometría Forzada?
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2018-04-10
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Universidad Complutense de Madrid
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Abstract
La alteración funcional básica en el asma es la obstrucción al flujo aéreo, causada por una disminución del calibre de la vía aérea. Esta obstrucción puede ocurrir en cualquier nivel del árbol traqueobronquial, pero la vía aérea periférica (VAP) parece ser el principal sitio de obstrucción. El término de vía aérea periférica engloba a aquellos conductos del árbol respiratorio de calibre interno inferior a 2 mm. En los últimos años se han desarrollado técnicas que permiten evaluar la afectación de estas vías periféricas. La oscilometría de impulso (IOS), es una modalidad de la técnica de oscilación forzada que está adquiriendo cada vez más relevancia. El asma es una enfermedad inflamatoria crónica, total o parcialmente reversible de las vías respiratorias. Presenta diversos fenotipos clínicos de similares características clínicas pero etiologías diferentes. Los niños asmáticos muestran hiperreactividad bronquial (HRB) en un amplio porcentaje. Y aunque esta hiperrespuesta puede aparecer en otros procesos, es bastante sugerente de asma. La vía aérea pequeña de los pacientes asmáticos presenta similar infiltrado inflamatorio al que aparece en las vías aéreas centrales, siendo incluso más intenso en los casos de asma grave y en ciertos fenotipos asmáticos. Al ser el asma una enfermedad poligénica, su desarrollo va a depender de factores genéticos aunque también de la exposición e interacción con factores externos ambientales. El asma provoca cambios estructurales en las vías aéreas proximales y periféricas...
The basic functional alteration in asthma is the obstruction of the airflow. This is caused by a decrease in the airway calibre. This obstruction can occur at any level of the tracheobronchial tree, but the peripheral airway seems to be the main site of obstruction. The term peripheral airway includes those ducts of the respiratory tree of internal calibre of less than 2 mm. In recent years, techniques have been developed to assess the involvement of these peripheral pathways. Impulse oscillometry system (IOS) is a type of the forced oscillation technique that is becoming more relevant. Asthma is a chronic, totally or partially reversible inflammatory disease of the respiratory tract. It presents diverse clinical phenotypes of similar clinical characteristics but different aetiologies. Asthmatic children show bronchial hyperresponsiveness (BHR) by a large percentage. And although this hyperresponsiveness may appear in other processes, it is quite suggestive of asthma. The small airway of asthmatic patients has a similar inflammatory infiltrate that appears in the central airways, being even more intense in cases of severe asthma and in certain asthmatic phenotypes. Asthma is a polygenic disease. Its development will depend on genetic factors but also on exposure and interaction with external environmental factors. Asthma causes structural changes in the proximal and peripheral airways...
The basic functional alteration in asthma is the obstruction of the airflow. This is caused by a decrease in the airway calibre. This obstruction can occur at any level of the tracheobronchial tree, but the peripheral airway seems to be the main site of obstruction. The term peripheral airway includes those ducts of the respiratory tree of internal calibre of less than 2 mm. In recent years, techniques have been developed to assess the involvement of these peripheral pathways. Impulse oscillometry system (IOS) is a type of the forced oscillation technique that is becoming more relevant. Asthma is a chronic, totally or partially reversible inflammatory disease of the respiratory tract. It presents diverse clinical phenotypes of similar clinical characteristics but different aetiologies. Asthmatic children show bronchial hyperresponsiveness (BHR) by a large percentage. And although this hyperresponsiveness may appear in other processes, it is quite suggestive of asthma. The small airway of asthmatic patients has a similar inflammatory infiltrate that appears in the central airways, being even more intense in cases of severe asthma and in certain asthmatic phenotypes. Asthma is a polygenic disease. Its development will depend on genetic factors but also on exposure and interaction with external environmental factors. Asthma causes structural changes in the proximal and peripheral airways...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Pediatría, leída el 28/06/2017