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Vol. 18. Issue 2.
Pages 96-108 (June 2011)
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Vol. 18. Issue 2.
Pages 96-108 (June 2011)
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Test de respiración única para la capacidad de difusión de monóxido de carbono (DLCO) y su interpretación en enfermedades autoinmunes. Aplicación en la práctica clínica -Segunda Parte-
Single breath carbon monoxide diffusing capacity (DLCO) test and its interpretation in autoimmune diseases. Application in clinical practice - Part II -
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Sergio Alexander Mora Alfonso1,
Corresponding author
sergiomora3@hotmail.com

Correspondencia: Unidad de Reumatología – Medicina Interna, Hospital Universitario de La Samaritana Piso 5, carrera 8 No 0-55, Bogotá, Colombia.
, Juan Manuel Bello Gualtero1, John Londoño2, Rafael Raúl Valle-Oñate3, Gerardo Quintana4
1 Médico Internista, Reumatólogo, Universidad Militar Nueva Granada. Hospital Militar Central y Hospital Universitario de La Samaritana (E.S.E)
2 Médico Internista, Reumatólogo, Servicio Reumatología. Hospital Militar Central. Universidad de la Sabana, Grupo de Investigación de Espondiloartropatías
3 Médico Internista, Reumatólogo, Profesor titular de Reumatología Universidad Militar Nueva Granada, Jefe servicio de Reumatología Hospital Militar Central, Bogotá
4 Médico Internista, Reumatólogo y Epidemiólogo Clínico, Departamento de Medicina, Facultad de Medicina, Universidad Nacional de Colombia y Universidad de los Andes, y Servicio de Reumatología, Fundación Santa Fe de Bogotá
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Resumen

El test de respiración única ha probado por si mismo ser una parte esencial del tamizaje de rutina de la función pulmonar, y de igual valor que la espirometría. A pesar de 100 años de investigación, aún no existe certeza sobre la relativa importancia de las membranas alveolo-capilares vs los eritrocitos como los pasos que sean delimitantes en el transporte global del monóxido de carbono del gas hacia la sangre, pero esto es solo un problema cuantitativo. La naturaleza esencial del test de DLCO ya ha sido elucidada, siendo F.J.W. Roughton y R.E. Forster los mayores protagonistas en esta descripción.

La interpretación de la DLCO, en conjunto con la espirometría y los volúmenes pulmonares, pueden contribuir en la evaluación de enfermedades pulmonares subyacentes y, en el campo reumatológico es esencial su conocimiento puesto que ofrece la posibilidad de establecer un diagnóstico diferencial y un seguimiento cercano de los pacientes con enfermedades autoinmunes con manifestaciones pulmonares. El test de espiración única para la capacidad de difusión de monóxido de carbono, la espirometría y los gases arteriales son los test de función pulmonar más ampliamente utilizados para la evaluación y tratamiento de pacientes.

Palabras clave:
intercambio de gases
membrana
difusión
test de respiración única para la capacidad de difusión de monóxido de carbono
(DLCO)
pruebas de función pulmonar
enfermedades autoinmunes
Summary

The single breath DLCO (TLCO) has proved as an essential part of the routine pulmonary function screen, similar to spirometry. In spite of nearly 100 years research, there is still concern over the relative importance of the alveolarcapillary membranes versus the red cells as rate limiting steps in the overall transfer of carbon monoxide from gas to blood, but this is only a quantitative problem. The essential nature of the DLCO has already been elucidated by F.J.W. Roughton and R.E. Forster having played the major roles.

Interpreting the DLCO, in conjunction with spirometry and lung volumes assessment, may assist in diagnosing the underlying disease and in the Rheumatology field it is essential it’s knowledge because it offers the possibility of establish the differential diagnosis and a close follow-up of the patients with pulmonary manifestations in autoimmune diseases.

Key words:
gas exchange
pulmonary
membrane
diffusion
single-breath carbon monoxide diffusing capacity
(DLCO)
pulmonary function tests
autoimmune diseases
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