RESUMEN

La prueba de desaturación de oxígeno y la prueba de titulación de oxígeno suplementario son realizadas con fines diagnósticos, pronósticos y terapéuticos. Con el propósito de incrementar la precisión y la exactitud de los resultados, nos dimos a la tarea de optimizar el proceso técnico que se lleva a cabo durante la ejecución de las pruebas. Los diagramas de flujo que proponemos en este manuscrito facilitan la toma de decisiones durante la realización de las pruebas y recomendamos que la pertinencia de cada prueba sea evaluada a la luz del estado físico del paciente. La utilidad práctica de dichos diagramas la hemos confirmado durante las actividades cotidianas de nuestro laboratorio; sin embargo, su aplicabilidad en otros laboratorios de función pulmonar debe de ser explorada. Aunque ha sido diseñado como una estrategia de control de calidad de nuestro laboratorio, los autores creemos que este informe podría ser de utilidad para otros centros interesados en realizar estas pruebas.

PALABRAS CLAVE

Estandarización, prueba de desaturación de oxígeno, titulación de oxígeno suplementario, ejercicio, función respiratoria.

REFERENCIAS

1. Miller MR, Hankinson J, Brusasco V, et al. Standardization of spirometry. Eur Respir J 2005; 26: 319-338.

2. Miller MR, Crapo R, Hankinson J, et al. General considerations for lung function testing. Eur Respir J 2005; 26: 153-161.

3. Wanger J, Clausen JL, Coates A, et al. Standardization of the measurement of lung volumes. Eur Respir J 2005; 26: 511-522.

4. Macintyre N, Crapo RO, Viegi G, et al. Standardization of the single-breath determination of carbon monoxide uptake in the lung. Eur Respir J 2005; 26: 720-735.

5. Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests. Eur Respir J 2005; 26: 948-968.

6. Wanger J CR, Irvin C. Pulmonary Function Laboratory Management and Procedure Manual. A project of the American Thoracic Society. Pulse Oximetry with Exercise: Assessment of desaturation, oxygen titration and distance walked. American Thoracic Society, American Lung Association. Chapter 17. 2000.

7. Palange P, Ward SA, Carlsen KH, et al. Recommendations on the use of exercise testing in clinical practice. Eur Respir J 2007; 29: 185-209.

8. Casanova C, Cote C, Marin JM, et al. Distance and oxygen desaturation during the 6-min walk test as predictors of long-term mortality in patients with COPD. Chest 2008; 134: 746-752.

9. Sandland CJ, Morgan MD, Singh SJ. Detecting oxygen desaturation in patients with COPD: incremental versus endurance shuttle walking. Respir Med 2008; 102: 1148-1152

10. Garcia-Talavera I, Garcia CH, Macario CC, et al. Time to desaturation in the 6-min walking distance test predicts 24-hour oximetry in COPD patients with a PO2 between 60 and 70 mmHg. Respir Med 2008; 102: 1026-1032.

11. Takigawa N, Tada A, Soda R, et al. Distance and oxygen desaturation in 6-min walk test predict prognosis in COPD patients. Respir Med 2007; 101: 561-567.

12. Christensen CC, Ryg MS, Edvardsen A, et al. Relationship between exercise desaturation and pulmonary haemodynamics in COPD patients. Eur Respir J 2004; 24: 580-586.

13. Brunelli A, Al Refai M, Monteverde M, et al. Predictors of exercise oxygen desaturation following major lung resection. Eur J Cardiothorac Surg 2003; 24: 145-148.

14. Hadeli KO, Siegel EM, Sherrill DL, et al. Predictors of oxygen desaturation during submaximal exercise in 8,000 patients. Chest 2001; 120: 88-92.

15. Paciocco G, Martinez FJ, Bossone E, et al. Oxygen desaturation on the six-minute walk test and mortality in untreated primary pulmonary hypertension. Eur Respir J 2001; 17: 647-652.

16. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002; 166: 111-117.

17. ATS/ACCP Statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med 2003; 167: 211-277.

18. Poulain M, Durand F, Palomba B, et al. 6-minute walk testing is more sensitive than maximal incremental cycle testing for detecting oxygen desaturation in patients with COPD. Chest 2003; 123: 1401-1407.

19. Perez Padilla JR, Vazquez Garcia JC. [Estimation of gasometric values at different altitudes above sea level in Mexico]. Rev Invest Clin 2000; 52: 148-155.

20. Torre-Bouscoulet L, Chavez-Plascencia E, Vazquez-Garcia JC, et al. [Precision and accuracy of “a pocket” pulse oximeter in Mexico City]. Rev Invest Clin 2006; 58: 28-33.

21. Escourrou PJ, Delaperche MF, Visseaux A. Reliability of pulse oximetry during exercise in pulmonary patients. Chest 1990; 97: 635-638.

22. Celli BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 2004; 350: 1005-1012.

23. Reesink HJ, van der Plas MN, Verhey NE, et al. Six-minute walk distance as parameter of functional outcome after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. J Thorac Cardiovasc Surg 2007; 133: 510-516.

24. Verrill D, Barton C, Beasley W, et al. The effects of short-term and long-term pulmonary rehabilitation on functional capacity, perceived dyspnea, and quality of life. Chest 2005; 128: 673-683.

25. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982; 14: 377-381.