Respiratory evaluation through volumetric capnography among grade III obese and eutrophic individuals: a comparative study

Modena, Débora Aparecida Oliveira; Moreira, Marcos Mello; Paschoal, Ilma Aparecida; Pereira, Mônica Corso; Martins, Luíz Cláudio; Cazzo, Everton; Chaim, Élinton Adami

doi:10.1590/1516-3180.2017.0085011017

Cited by 6 publications

(7 citation statements)

References 38 publications

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“…We found higher values of Slp3 than those usually seen in normal subjects,[ 41 42 ] and similar to other studies that analysed VCap in patients with COPD. [ 4 41 ]…”

Section: Discussionsupporting

confidence: 91%

Bronchiectasis associated with severe COPD

Pereira¹,

Silva²,

Moreira³

et al. 2022

Lung India

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Background: Bronchiectasis is frequently identified in patients with COPD, especially in severe patients, but the relevance of this finding remains unclear. We aimed to investigate the factors that would increase the chance of having bronchiectasis in patients with severe COPD. Methods: This is an analytical, observational, cross-sectional study. Patients with severe COPD with (BC group) and without bronchiectasis (NBC group) were clinically evaluated and performed spirometry, 6-minute walk test (6MWT), volumetric capnography (VCap) and high resolution computed tomography (CT). CT was scored for the findings, and multiple linear regression was performed to identify variables related to the score's severity and logistic regression in order to identify factors that could be associated with the presence of bronchiectasis. Results: There was no significant difference between BC and NBC groups regarding clinical variables, except in the smoking load, which was lower in the BC group. In functional evaluation, NBC patients walked shorter distances in 6MWT (P < 0.005). In the BC group the distribution of CT findings was mostly bilateral and in lower lobes. Using the multiple linear regression analysis within the BC group, we found that the higher the bronchiectasis score, the higher ?SpO2 during the 6MWT and the lower the FVC. The chance of having bronchiectasis was 4.78 times higher in the presence of positive isolates (sputum) (CI 1.35-16.865; P = 0.023). The higher the distance covered (6MWT) and Slp3 (VCap), (OR 1.01, CI 1.004; 1.0202, P = 0.0036; OR 1.04, CI 1.003; 1.077; P = 0.036), the greater are likelihood of bronchiectasis. Conclusions: In patients with COPD and bronchiectasis, higher CT scores were associated with worse lung function and a greater drop in oxygenation during exercise.

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“…We found higher values of Slp3 than those usually seen in normal subjects,[ 41 42 ] and similar to other studies that analysed VCap in patients with COPD. [ 4 41 ]…”

Section: Discussionsupporting

confidence: 91%

Bronchiectasis associated with severe COPD

Pereira¹,

Silva²,

Moreira³

et al. 2022

Lung India

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“…1 After reviewing the medical records, patients who fulfilled the inclusion criteria of the New York Heart Association (NYHA) Respiratory cycles that had slope 2 (Slp2) and slope 3 (Slp3) equal to zero were excluded. 2,3 The main variables analyzed were EtCO 2 , Slp2, Slp3, inspiratory time (Ti), expiratory time (Te), expiratory volume (Ve) and tidal volume according to anatomical dead space (Vd/Vt aw). Both slopes were calculated using the Analysis Plus software.…”

Section: Methodsmentioning

confidence: 99%

Lung function and stress echocardiography in pulmonary arterial hypertension: a cross-sectional study

Almeida

Pereira²,

Moreira

et al. 2021

Sao Paulo Med. J.

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BACKGROUND: The mechanism of exercise limitation in idiopathic pulmonary arterial hypertension (IPAH) is not fully understood. The role of hemodynamic alterations is well recognized, but mechanical, ventilatory and gasometric factors may also contribute to reduction of exercise capacity in these individuals. OBJECTIVE: To investigate whether there is an association between ventilatory pattern and stress Doppler echocardiography (SDE) variables in IPAH patients. DESIGN AND SETTING: Single-center prospective study conducted in a Brazilian university hospital. METHODS: We included 14 stable IPAH patients and 14 age and sex-matched controls. Volumetric capnography (VCap), spirometry, six-minute walk test and SDE were performed on both the patients and the control subjects. Arterial blood gases were collected only from the patients. The IPAH patients and control subjects were compared with regard to the abovementioned variables. RESULTS: The mean age of the patients was 38.4 years, and 78.6% were women. The patients showed hypocapnia, and in spirometry 42.9% presented forced vital capacity (FVC) below the lower limit of normality. In VCap, IPAH patients had higher respiratory rates (RR) and lower elimination of CO 2 in each breath. There was a significant correlation between reduced FVC and the magnitude of increases in tricuspid regurgitation velocity (TRV). In IPAH patients, VCap showed similar tidal volumes and a higher RR, which at least partially explained the hypocapnia. CONCLUSIONS: The patients with IPAH showed hypocapnia, probably related to their higher respiratory rate with preserved tidal volumes; FVC was reduced and this reduction was positively correlated with cardiac output.

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“…The VCap assesses the concentration of expired CO 2 as a function of expired tidal volume, analyzing the functional components of tidal volume (VC) and dead space; this method enables the determination of the relationship between ventilation and perfusion. 16 , 17 , 18 …”

Section: Methodsmentioning

confidence: 99%

“…In addition, sequences showing phases 2 and 3 slopes equal to zero were eliminated, along with discrepant values. 18 …”

Section: Methodsmentioning

confidence: 99%

Effects of home-based inspiratory muscle training on sickle cell disease (SCD) patients

Galvão

Zanoni

Moreira

et al. 2021

Hematology, Transfusion and Cell Therapy

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Introduction Inspiratory muscle training (IMT) has been shown to be an efficient method of improving exercise tolerance and inspiratory and expiratory muscle strength in several diseases. The effects of IMT on patients with sickle cell anemia (SCD) are relatively unknown. Our study aimed to evaluate the effects of IMT on adult SCD patients, regarding respiratory muscle strength (RMS) variables, lung function, exercise tolerance, blood lactation concentration, limitation imposed by dyspnea during daily activities and impact of fatigue on the quality of life. Methods This was a randomized single-blind study, with an IMT design comprising true load (TG) and sham load (SG) groups. Initial assessment included spirometry, volumetric capnography (VCap) and measurement of RMS by maximal inspiratory and expiratory pressure (PImax and PEmax). The Medical Research Council dyspnea scale and modified fatigue impact scale were also applied and blood lactate concentration was measured before and after the 6-minute walk test. After this initial assessment, the patient used the IMT device at home daily, returning every 6 weeks for RMS reassessment. Both groups used the same device and were unaware of which group they were in. After a period totaling 18 weeks, patients underwent the final evaluation, as initially performed. Results Twenty-five patients in total participated until the end of the study (median age 42 years). There were no significant differences between TG and SG based on age, sex, body mass index or severity of genotype. At the end of the training, both groups showed a significant increase in PEmax and PImax, improvement in Vcap and in exercise tolerance and dyspnea reduction while performing daily life activities. The same was observed in patients grouped according to disease severity (HbSS and HbSβ 0 vs HbSC and HbSβ + ), without differences between groups. Conclusion Home-based inspiratory muscle training benefits outpatients with SCD, including the sham load group. Trial registration http://www.ensaiosclinicos.gov.br ; registration number: RBR-6g8n92.

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Respiratory evaluation through volumetric capnography among grade III obese and eutrophic individuals: a comparative study

Cited by 6 publications

References 38 publications

Bronchiectasis associated with severe COPD

Bronchiectasis associated with severe COPD

Lung function and stress echocardiography in pulmonary arterial hypertension: a cross-sectional study

Effects of home-based inspiratory muscle training on sickle cell disease (SCD) patients

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