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Sueño normal
La ventilación se ve afectada por el sueñ Se ha descrito una
reducción significativa del VC y del impulso inspiratorio, y la ven-
tilación minuto disminuye aproximadamente un 5-16%, depen-
diendo de la fase del sueño, de modo que la disminución más
marcada se produce durante el sueño de movimientos oculares
rápidos (REM). El volumen pulmonar también se reduce durante
el sueño, y se manifiesta como disminución de la CR La dismi-
nución más marcada se produce durante el sueño REM, momento
durante el cual la disminución es de aproximadamente 0,3 l, o el
10% del valor despiert .
La disminución de la CRF durante el sueño se acompaña de
una disminución de la aireación de las regiones pulmonares infe-
riores, como se demostró en un estudio con TC en voluntarios
sano La pérdida de la aireación era tan marcada como en
pacientes anestesiados que respiraban gas con una concentración
moderada de oxígeno (Fio2 de 0,3). Cuando se cambió a los pacien-
tes anestesiados a O2 al 100% aparecieron rápidamente atelecta-
sia Es tentador asumir que el sueño normal mientras se respira
oxígeno puro también puede llevar a la formación de atelectasias.
Bibliografía
Fisiología respiratoria 155 5
Seccíon I
Fisiología y anestesia
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