Mónica Gutiérrez C

Proposición de nuevas ecuaciones para calcular valores espirométricos de referencia en población chilena adulta: Sociedad Chilena de Enfermedades Respiratorias (SER)

BACKGROUND To correctly interpret spirometric results, reference values should come from the same population. Current spirometric reference equations have been under scrutiny due to deficiencies to fit adequately for Chilean population, specially, for those aged over 65 years old. AIM To develop new spirometric reference values for Chilean adults, based on national studies in which spirometries were performed in healthy non-smoker adults. MATERIAL AND METHODS A standardized database of spirometric values was developed combining spirometric data collected from five population-based studies, in which healthy nonsmoker adults participated. Spirometries from 448 males aged 19 to 84 years and from 726 females aged 19 to 94 years, obtained according to guidelines from the American Thoracic and European Respiratory Societies, were analyzed. Using multiple regression models, which included height, gender, and age, the theoretical value and inferior limits of normality were calculated for 1st second (FEV1), forced vital capacity (FVC), FEV1/FVC, and forced mid-expiratory flow rate (FEF25-75). RESULTS Reference values and lower limits of normality (LLN) were constructed for Chilean adults of both genders. The new proposed set of equations had a better fit, when compared with the current reference values used in Chile. CONCLUSIONS The new spirometric references values derived from this study, fit better than currently used ones. Therefore, they should be used as new references values for Chilean adults.

Guía para realizar oximetría de pulso en la práctica clínica

Se presenta una guia practica resumida para efectuar la oximetria de pulso en la practica clinica. Esta guia fue redactada por la Comision de Funcion Pulmonar de la Sociedad Chilena de Enfermedades Respiratorias. Se describen resumidamente los aspectos basicos para aplicar esta medicion no invasiva a adultos y a ninos y tambien se consideran las precauciones que se deben tener presente al interpretar los resultados de esta medicion.

Nomogramas de ecuaciones de referencia espirométrica SER 2009

Resumen La actual disponibilidad de programas de deteccion y tratamiento de enfermedades respiratorias en Chile ha determinado una mayor utilizacion de la espirometria en el diagnostico de dichas enferme-dades. La adecuada interpretacion de los resultados de la espirometria requiere disponer de patrones de referencia idealmente originados en la misma poblacion en la cual se utilizaran. Para facilitar el uso y aplicacion de nuevas ecuaciones de referencia espirometricas recientemente modeladas en poblacion adulta chilena, se presentan nomogramas disenados para cada uno de los parametros en base al genero, edad y talla para sujetos entre 19 y 50 anos y en mayores de 51 anos. Estas ecuaciones derivan de 5 estudios nacionales que incluyeron poblacion que cumplio criterios universales para de-terminar valores de referencia, (1.174 sujetos, 19 a 94 anos), que efectuaron espirometrias siguiendo recomendaciones internacionales (ATS). Palabras clave: Espirometria, valores de referencia, nomogramas.

Flujometría en la práctica de atención primaria

La medicion del fujo espiratorio maximo (FEM) con el mini-fujometro de Wright se usa ampliamente en la practica clinica para evaluar pacientes con obstruccion de las vias aereas. Este documento redactado por la Comision de Funcion Pulmonar de la Sociedad Chilena de Enfermedades Respiratorias, proporciona una guia practica para efectuar esta medicion en pacientes adultos. En este articulo se describen resumidamente las indicaciones, la tecnica y la evaluacion de la obstruccion de las vias aereas a traves de la medicion del FEM con el mini-fujometro de Wright.

Insuficiencia renal aguda secundaria a rabdomiólisis de esfuerzo: Report of three cases

Renal failure secondary to effort rhabdomyolysis is uncommon. We report three males age 28, 37 (military sportsmen) and 44 years (sedentary obese), with this condition. Episodes occurred after a training session to run a triathlon, during the course of a mini marathon and during a rescue attempt of a drowning person. All three subjects experienced intense muscle symptoms, hemoglubinuria, oliguria, rise of blood urea nitrogen and a significant rise in muscle enzymes. Creatinekinase reached a maximum of 41 times normal, aspartate aminotransferase a maximum 35 times normal and lactacte dehydrogenase a maximum of 11 times normal. There was a rapid elevation of serum creatinine, reaching values of 6.6 and 9.8 mg/dl on the third day after the physical effort. This parameter had a disproportionate elevation in relation to urea nitrogen, in two subjects. All subjects were managed with saline hydration, sodium bicarbonate and furosemide. Only one required hemodialysis for two days. All normalized their renal function 18 to 48 days after the physical exertion. No subject had other predisposing conditions for acute renal failure.Renal failure secondary to effort rhabdomyolysis is uncommon. We report three males age 28, 37 (military sportsmen) and 44 years (sedentary obese), with this condition. Episodes occurred after a training session to run a triathlon, during the course of a mini marathon and during a rescue attempt of a drowning person. All three subjects experienced intense muscle symptoms, hemoglubinuria, oliguria, rise of blood urea nitrogen and a significant rise in muscle enzymes. Creatinekinase reached a maximum of 41 times normal, aspartate aminotransferase a maximum 35 times normal and lactacte dehydrogenase a maximum of 11 times normal. There was a rapid elevation of serum creatinine, reaching values of 6.6 and 9.8 mg/dl on the third day after the physical effort. This parameter had a disproportionate elevation in relation to urea nitrogen, in two subjects. All subjects were managed with saline hydration, sodium bicarbonate and furosemide. Only one required hemodialysis for two days. All normalized their renal function 18 to 48 days after the physical exertion. No subject had other predisposing conditions for acute renal failure