Força muscular e mortalidade na lista de espera de transplante de fígado

Abstract

Objective: To evaluate respiratory muscle strength and hand strength in patients on a liver transplant waiting list and to associate these with mortality. Methods: one hundred and thirty-two patients who underwent routine physical therapy evaluation while waiting for liver transplantation were studied retrospectively. Respiratory muscle strength was assessed by measuring the maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP), and upper-limb strength was evaluated by dynamometry. The patients were divided into two groups: group A, consisting of 51 patients (14 females, 50.1±12.3 years) who died while on the waiting list; and group B, consisting of 81 patients (31 females, 45.0±3.8 years) who survived until the time of liver transplant. Student's t test was used with a 5% significance level. Results: The mean MIP values for groups A and B were 65.7±28.0 and 77.5±33.8mmHg (p=0.04), respectively, and the mean MEP values were 72.9±32.9 and 84.4±33.1mmHg (p=0.07), respectively. The mean values for left-hand strength in groups A and B were 18.5±8.1 and 21.5±10.5kgf (p=0.08), and the mean values for right-hand strength were 20.2±9.7 and 23.5±12.5kgf (p=0.10), respectively. Conclusions: MIP was lower in the patients who died while waiting for liver transplantation. In the same group, it was observed that the MEP values and right and left-hand strength were numerically lower, although they did not reach statistically significant differences.Key words: liver transplantation; respiratory muscles; mortality; hand strength; physical therapy. ResumoObjetivo: Avaliar a força de músculos respiratórios e de mão em pacientes na lista de espera para o transplante de fígado e associá- Palavras-chave: transplante de fígado; músculos respiratórios; mortalidade; força da mão; fisioterapia.

Capacidade funcional e força muscular respiratória de candidatos ao transplante hepático

“…Carvalho et al (17) verified that those individuals with higher mortality on the waiting list to undergo an The age, weight, height, BMI and abdominal perimeter variables are described in mean and standarddeviation of the mean, respectively. M/F = male/female; BMI = body mass index; n (number of individuals); Alc Cirrhosis = alcoholic cirrhosis; HCV = hepatitis by virus C; HVB = hepatitis by virus B; ns = not significant.…”

“…It is also believed that due to the presence of ascites (50% to 60% of the cases), a mechanical disadvantage in the diaphragm muscle occurs, which may possibly interfere in the lengthtension of the muscle and, consequently, in the respiratory muscular strength, harming even more the functionality of the individuals (17) . Although there is great variety of studies approaching the hepatic disease and its stages, little is seen on the functional capacity of this population.…”

Level of independence, functional capacity and respiratory muscle strength of patients with mucopolysaccharidosis type VI in the Northeast of Brazil

“…7,16 Limitations in the musculoskeletal tissue also affect the respiratory muscles, harming the mechanic of the respiratory system in patients with MPS. 5,10,11 The analysis on respiratory muscle strength is used as a predictor of morbidity and mortality in various populations, 17,18 however, a medical literature review performed on Pubmed, SciELO and LILACS databases revealed few studies on patients with MPS. 19 The objective of this present study was to assess the level of the functional independence, the functional capacity and the respiratory muscle strength of patients with MPS VI.…”

The influence that hepatic cirrhosis provides in exercise capacity and muscle strength: a review

“…Unfortunately, many patients have to wait on liver transplantation waiting lists, and the number of patients awaiting transplants is greater than the ones receiving (15). Therefore, a relevant alternative to these patients might be to begin physical training and multidisciplinary rehabilitation programs (16,17).…”