Effects of noninvasive ventilation on dynamic hiperinflation of patients with COPD during activities of daily living with upper limbs.
Background: Patients with chronic obstructive pulmonary disease (COPD) complain of dyspnea on activities of daily living (ADLs) with the upper limbs. Dynamic hyperinflation (DH) is one of the ventilatory mechanisms that may contribute towards dyspnea. To minimize the DH it is indicated the use of no...
| Publicado en: | Brazilian Journal of Physical Therapy Vol. 16; no. 1; pp. 61 - 68 |
|---|---|
| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Elsevier B.V.
jan/fev2012
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=73793789&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 73793789 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14133555 1FEL jtl: Brazilian Journal of Physical Therapy issn: 14133555 maglogo: N pubinfo: dt: jan/fev2012 vid: 16 iid: 1 pid: 82545 pub: Elsevier B.V. place: Philadelphia, Pennsylvania artinfo: ui: 73793789 73793789 104540532 73793789 ppf: 61 ppct: 7 formats: tig: atl: Effects of noninvasive ventilation on dynamic hiperinflation of patients with COPD during activities of daily living with upper limbs. aug: au: Sclauser Pessoa, Isabela M. B. Costa, Dirceu Velloso, Marcelo Mancuzo, Eliane Reis, Marco A. S. Parreira, Verônica F. affil: Physical Therapy Department, Universidade Católica de Minas Gerais (PUC/Minas), Belo Horizonte, MG, Brazil sug: subj: Pulmonary Disease, Chronic Obstructive Therapy Respiration, Artificial Adverse Effects Activities of Daily Living Upper Extremity Human Dyspnea Risk Factors Middle Age Aged Aged, 80 and Over Descriptive Statistics Scales Pulmonary Disease, Chronic Obstructive Physiopathology Spirometry Body Mass Index Male Female Paired T-Tests Wilcoxon Rank Sum Test Data Analysis Software Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Background: Patients with chronic obstructive pulmonary disease (COPD) complain of dyspnea on activities of daily living (ADLs) with the upper limbs. Dynamic hyperinflation (DH) is one of the ventilatory mechanisms that may contribute towards dyspnea. To minimize the DH it is indicated the use of noninvasive ventilation (NIV). Objectives: To verify whether there is DH and dyspnea during the performance of ADL with the upper limbs with and without the use of NIV. Methods: 32 patients with moderate-to-severe COPD, aged 54 to 87 years (mean 69.4, SD 7.4) were evaluated. The subjects lift up containers weighing between 0.5 and 5.0 kg over a five-minute period, starting from the waist level and putting them onto a shelf located above head height, with and without the use of NIV (BiPAP®; IPAP 10cmH2O; EPAP 4 cmH2O). The inspiratory capacity (IC) and dyspnea (Borg scale) were evaluated on all the patients. The IC was measured before and after simulation of the ADL. In order to analyze the data, Student's t test for dependent samples and the Wilcoxon test were used. Results: There were statistically significant reductions in IC after the ADL with and without NIV (p=0.01). The dyspnea increased after the ADL with and without the NIV, however between both interventional procedures protocols no between-group difference was observed. Conclusions: The simulation of an ADL with the upper limbs resulted in an increase in DH and dyspnea. The NIV supplied with pre-established pressure was not enough to prevent the DH and dyspnea. Contextualização: Pacientes com doença pulmonar obstrutiva crônica (DPOC) queixam-se de dispneia nas atividades de vida diária (AVD) com os membros superiores (MMSS). A hiperinsuflação dinâmica (HD) é um dos mecanismos ventilatórios que contribuem para a dispneia. Para minimizar a HD, propõe-se a utilização de sistemas de ventilação não-invasiva (VNI). Objetivos: Verificar se existe HD e dispneia durante a realização de uma AVD com os MMSS com e sem o uso da VNI. Métodos: Participaram 32 pacientes com DPOC de moderada a muito grave, com idades entre 54 a 87 anos (69,4±7,4). Os pacientes elevaram potes com pesos de 0,5 a 5 kg durante 5 minutos, iniciando a elevação a partir da cintura pélvica em direção a uma prateleira localizada acima da cabeça, com e sem o uso da VNI (BiPAP®; IPAP 10 cmH2O; EPAP 4 cmH2O). Foram avaliadas a capacidade inspiratória (CI) e a dispneia (Escala de Borg). A CI foi mensurada antes e após a simulação da AVD. Na análise dos dados foram utilizados o teste t de Student para amostras dependentes e o teste de Wilcoxon. Resultados: Houve redução significativa da CI após a AVD com e sem VNI (p=0,01). A dispneia aumentou após a AVD com e sem a VNI, mas entre ambos os protocolos não houve diferença. Conclusões: A simulação da AVD com os MMSS resultou em aumento da HD e dispneia. A VNI ofertada com pressões preestabelecidas não foi suficiente para evitar a HD e a dispneia. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|