Efecto de los cambios posturales en las crepitaciones de pacientes con fibrosis quística versus fibrosis pulmonar. Comunicación preliminar

Abstract

Position dependence of crackles is noticed in patients with interstitial pulmonary fibrosis (IPF). In the lateral decubitus position (LDP), crackles may diminish in the upper lung or increase in the dependent lung. We hypothesized that different crackle mechanisms would lead to position dependence in IPF but not in Cystic Fibrosis (CF). We investigated this clinical finding by computerized sound analysis. Lung sounds over corresponding sites of the left and right lower lobes were recorded in 14 patients, 7 with CF and 7 with IPF, first in the sitting position, then the left and right LDP and again in the sitting position. In CF unilateral position dependence was observed in three patients. In IPF, position dependence was found in six patients, bilateral in four and unilateral in two. Our results suggest that position dependence is common in IPF but not in CF. This may be explained by different mechanism of crackle generation, i.e. increased lung recoil in IPF versus increased airway secretions in CF