Efeito imediato da pressão positiva continua nas vias aereas não invasiva no volume pulmonar expiratorio final de pacientes com doença pulmonar obstrutiva cronica / Immediate effects of non invasive continuous positive airway pressure in end-expiratory lung volume in chronic obstructive pulmonary disease patients
AUTOR(ES)
Silvia Maria de Toledo Piza Soares
DATA DE PUBLICAÇÃO
2007
RESUMO
Bachground: Flow limitation and dynamic hyperinflation are common findings in COPD patients. Inspiratory capacity (IC) has been proposed as a simple method to assess changes in end-expiratory lung volume (EEL V) and lung hyperinflation. However, few studies verified if the application of continuous positive airway pressure (CP AP) could decrease lung hyperinflation. Objective: To assess the immediate effect of the CP AP in EEL V in stable COPD patients. Method: Prospective study of 21 stable COPD patients, age 63 + ou - 9 years, with forced expiratory volume in first second (FEV1) of 40.7 + ou - 11.7%, who were submitted to the gradual test of CP AP (4, 7 and 11 CmH20 - Drãger - SA VINA ventilator). The IC was measured by spirometry, before and after each CP AP leveI. In patients in whom all three CP AP levels resulted in a decreased IC, an additional CP AP test at 2 cmH20 was conducted. For each patient, a "best" CPAP leveI was defined as the one associated with the greater IC observed. This "best" CP AP leveI was then applied during 10 min and subsequent spirometry was performed. Results: During the gradual test of CP AP, 6 patients (non responder group) did not present any improvement of the IC. When the "best" CPAP was then applied in these cases, a significant worsening of the IC was observed of 83.7 + ou -19.4% to 74 + ou - 22.8% (p = 0.0341). In 15 patients (responder group), the IC increased significantly ITom 68.6 + ou - 17.9% to 75.3 + ou - 18.0% (p = 0.0002). The. slow vital capacity was the only other spirometric parameter that also increased post "best" CP AP in the responder group (240 mL, 7.4% of the predicted value, p <0.01). No significant differences in IC were observed after "best" CP AP in patients with expiratory flow limitation (IC pre CP AP doenças pulmonares ventilação mecanica mechanical ventilation spirometry espirometria pulmonary diseases
ASSUNTO(S)
ACESSO AO ARTIGO
http://libdigi.unicamp.br/document/?code=vtls000432297
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