There was a short-term improvement in the oxygenation of infants who were submitted to the EFIT. Additional studies are necessary to establish the efficacy and effectiveness of this technique.

Objective: To compare spirometry and volumetric capnography (VCap) to determine if the capnographic values add more information about early lung disease in cystic fibrosis (CF) patients.Methods: This was a cross-sectional study involving CF patients: Group I (42 patients, 6-12 years of age); and Group II (22 patients, 13-20 years of age). The corresponding control groups were comprised of 30 and 50 healthy subjects, respectively. Forced vital capacity (FVC), forced expiratory volume in one second (FEV 1 ), and the FEV 1 /FVC ratio was determined by spirometry. Using VCap, we measured peripheral oxygen saturation (SpO 2 ), respiratory rate (RR), inspiratory time (IT), expiratory time (ET), and the phase III slope normalized by expiratory volume (phase III slope/Ve). Results:In comparison with control groups, all CF patients presented higher phase III slope/Ve values (p < 0.001) independent of the pulmonary disease stage. The phase III slope/Ve was significantly higher in the 24 patients who presented normal spirometry results (p = 0.018). The Group II patients showed lower FVC, FEV 1 , FEV 1 /FVC (p < 0.05), and also lower SpO 2 values (p < 0.001) when compared with Group I patients. In comparison with Control Group II, the Group II patients presented higher RR (p < 0.001), and lower IT and ET values (p < 0.001). Conclusions:Compared to the controls, all studied CF patients showed an increase in phase III slope/Ve values. VCap identified the heterogeneity of the ventilation distribution in the peripheral airways of CF patients who presented normal spirometry.J Pediatr (Rio J). 2012;88(6)

Objectives: To study changes in the variables of volumetric capnography in children and adolescents with asthma compared with a control group and to investigate their changes with the use of bronchodilators and bronchial provocation test with methacholine. Methods:One hundred and three patients with controlled persistent asthma and 40 healthy volunteers participated in the study. All of them underwent volumetric capnography and spirometry. All asthmatics repeated the tests after bronchodilator use. Among 103 asthma patients, 33 underwent methacholine challenge test, and measures were recorded on three occasions: before and after methacholine and after bronchodilator use. Results:Compared with the control group, asthmatics had an increase in the slope of phase III normalized by tidal volume and decreases in tidal volume, forced expiratory volume in one second, forced vital capacity, rate of obstruction and forced expiratory flow between 25 to 75% of forced vital capacity. After bronchodilator use, there was an increase in spirometric variables, volume of anatomic dead space, and decrease in the slope of phase II normalized by tidal volume, but the slope of phase III normalized by tidal volume did not change. After methacholine, there was an increase in this variable, which decreased after bronchodilator use. Conclusions:The increase in the slope of phase III normalized by tidal volume in asthma patients suggests that these patients have ventilation inhomogeneity in the distal air spaces, which may reflect chronic structural disorders or reversible acute changes seen on the bronchial provocation test.J Pediatr (Rio J). 2011;87(2):163-168: Capnography, spirometry, pediatrics, asthma. ResumoObjetivos: Estudar alterações nas variáveis de capnografia volumétrica em crianças e adolescentes asmáticos comparados com grupocontrole e investigar suas mudanças com o uso do broncodilatador e do teste de broncoprovocação com metacolina. Métodos:Cento e três pacientes com asma persistente controlada e 40 voluntários saudáveis participaram do estudo. Todos realizaram exames de capnografia volumétrica e espirometria. Todos os asmáticos repetiram os exames após uso do broncodilatador. Dos 103 asmáticos, 33 realizaram teste de broncoprovocação com metacolina, e foram registradas as medidas em três momentos: antes e após metacolina e após broncodilatador. Resultados:Comparados ao grupo-controle, os asmáticos apresentaram aumento do slope da fase III normalizado pelo volume corrente e diminuição do volume corrente, do volume expiratório forçado no primeiro segundo, da capacidade vital forçada, do índice de obstrução e do fluxo expiratório forçado entre 25 a 75% da capacidade vital forçada. Após o broncodilatador, houve aumento das variáveis espirométricas, do volume espaço morto anatômico e diminuição do slope da fase II normalizado pelo volume corrente; porém não houve alteração do slope da fase III normalizado pelo volume corrente. Após a metacolina, houve aumento dessa variável, com diminuição após broncodilatador. Conclus...

In the study population, Vd/Vt not only reflected ventilatory disorders, as is well recognized, but also was associated with disturbances of oxygenation. These results warrant further evaluation of the usefulness of serial measurement of Vd/Vt as a marker of disease severity in severe acute bronchiolitis and other causes of respiratory failure.

The experienced and inexperienced groups were similar in their overall MH performance; the only difference was the observation of the highest PIF in the results from the experienced group.