Abstract:Fisioter Mov. 2013 jul/set;26(3):525-36 ISSN 0103-5150 Fisioter. Mov., Curitiba, v. 26, n. 3, p. 525-536, jul./set. 2013 Licenciado sob uma Licença Creative Commons doi: [T] Análise de parâmetros funcionais pulmonares e da qualidade de vida na revascularização do miocárdio [I] Analysis of pulmonary functional parameters and health-related quality of life in patients submitted to coronary arterial bypass graft [A] Raquel Annoni [a] , Wilton Rodrigues Silva [b] , Resumo Introdução: A cirurgia de… Show more
“…On the other hand, Annoni et al 17 observed a significant increase in MEP and PEF, which may have been correlated with the small sample size, and collaboration and learning of patients to perform the tests, since they were evaluated daily from the first postoperative period until the day of discharge.…”
Background: The European Heart Surgery Risk Assessment System (EuroSCORE) and InsCor have been used to predict complications of cardiac surgery. However, their application to predict lung function and functionality is still uncertain. Objective: To correlate surgical risk scales with functional independence and pulmonary function in patients undergoing coronary artery bypass grafting. Methods: This was a prospective cohort study. In the preoperative period, the two surgical scales were applied, the maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and peak expiratory flow (PEF) were measured, and functionality was assessed using the functional independence measure (FIM). On the seventh postoperative day, the pulmonary function and functionality variables were reevaluated, compared with the preoperative values (delta) and correlated with the risk scales. Correlations of pulmonary function, functional independence and muscle strength variables with the surgical scales were made by Pearson correlation test. The significance level adopted was 5%. Results: Thirty-one patients were studied; most were male (77%), with a mean age of 56±8 years. Mean EuroSCORE was 2.3±0.5 and mean InsCOR was 1.2±0.5. MIP, MEP, and PEF reduced 30% (p<0.001), 33% (p<0.001) and 10% (p=0.23), respectively. The EuroSCORE correlated with MIP (r-0.78; p = 0.02) and FIM (r-0.79; p <0.01), and the InsCor correlated with MIP (r-0.77), MEP (r-0.73) and MIF (r-0.89; p=0.02). Conclusion: The EuroSCORE showed a strong negative correlation with MIP and FIM, while InsCor had a strong negative correlation with MIP, MEP and FIM.
“…On the other hand, Annoni et al 17 observed a significant increase in MEP and PEF, which may have been correlated with the small sample size, and collaboration and learning of patients to perform the tests, since they were evaluated daily from the first postoperative period until the day of discharge.…”
Background: The European Heart Surgery Risk Assessment System (EuroSCORE) and InsCor have been used to predict complications of cardiac surgery. However, their application to predict lung function and functionality is still uncertain. Objective: To correlate surgical risk scales with functional independence and pulmonary function in patients undergoing coronary artery bypass grafting. Methods: This was a prospective cohort study. In the preoperative period, the two surgical scales were applied, the maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and peak expiratory flow (PEF) were measured, and functionality was assessed using the functional independence measure (FIM). On the seventh postoperative day, the pulmonary function and functionality variables were reevaluated, compared with the preoperative values (delta) and correlated with the risk scales. Correlations of pulmonary function, functional independence and muscle strength variables with the surgical scales were made by Pearson correlation test. The significance level adopted was 5%. Results: Thirty-one patients were studied; most were male (77%), with a mean age of 56±8 years. Mean EuroSCORE was 2.3±0.5 and mean InsCOR was 1.2±0.5. MIP, MEP, and PEF reduced 30% (p<0.001), 33% (p<0.001) and 10% (p=0.23), respectively. The EuroSCORE correlated with MIP (r-0.78; p = 0.02) and FIM (r-0.79; p <0.01), and the InsCor correlated with MIP (r-0.77), MEP (r-0.73) and MIF (r-0.89; p=0.02). Conclusion: The EuroSCORE showed a strong negative correlation with MIP and FIM, while InsCor had a strong negative correlation with MIP, MEP and FIM.
“…Thus, the occurrence of ARDS and sepsis in puerperal women with HELLP syndrome can be associated, which can lead to the worsening of this pathology, making intensive care necessary 4,13 . * Reference values predicted in literature 9,14 In this context, sepsis can manifest itself with signs such as acute pulmonary edema of non-cardiac origin, after hypoxemia; not infrequently, acute lung injury or ARDS is diagnosed. In most of these cases, there is a need for invasive mechanical ventilation (IMV), a protective strategy for the lung, using ventilatory parameters such as driving pressure, which directly interferes with Cst and regional pulmonary ventilation 8,18 .…”
Section: Discussionmentioning
confidence: 99%
“…Another important factor evaluated by EIT is static lung compliance (Cst), facilitating the identification of alveolar collapses, when present, in some regions of the lung (decreased Cst), as well as reduced alveolar hyperdistension in other regions (causing increased Cst), during, for example, decremental titration of positive end-expiratory pressure (PEEP) in patients with ARDS 13,14 .…”
Introdução: As doenças relacionadas à gravidez tem agravado o quadro de puérperas, que acabam fazendo uso de Ventilação Mecânica (VM) quando internadas em Unidades de Terapia Intensiva (UTI). A VM, apesar de trazer benefícios, está associada a efeitos deletérios que podem ser minimizados com o uso da Tomografia por Impedância Elétrica (TIE). Objetivo: Analisar o perfil epidemiológico e parâmetros ventilatórios de puérperas que evoluíram com Síndrome HELLP, Sepse e/ou Síndrome do Desconforto Respiratório Agudo (SDRA), sob VM e monitoradas com a TIE. Métodos: Estudo observacional, transversal retrospectivo e prospectivo, realizado entre março e setembro de 2018, por meio de fichas de coletas preenchidas a partir de banco de dados/prontuários sociodemográficos, obstétricos e ventilatórios de puérperas internadas em UTI. Resultados: Amostra composta por 13 puérperas, oito com Sepse (61,5%), sete com Síndrome HELLP (53,8%) e quatro com SDRA (30,8%), demonstrando que cinco (38,5%) pacientes evoluíram com mais de uma dessas patologias. Acerca dos parâmetros ventilatórios avaliados, observou-se VT 378.9 (± 103.9) e que valores médios encontrados para PEEP 9.8 (±1.9) e driving pressure 11.1 (±1.4) estão abaixo dos preconizados pela literatura, predizendo menores índices de mortalidade e morbidade. Conclusão: Demonstrou-se relevância da avaliação de driving pressure no cenário da VM, parâmetro avaliado por meio da TIE e diretamente relacionado à Cst, PEEP, VT e otimização da ventilação pulmonar regional. Destaca-se a necessidade de pesquisas futuras que apresentem maiores significâncias clínicas voltadas ao perfil de puérperas em relação às doenças cada vez mais frequentes nesta população.
“…The 6MWT is a submaximal test that allows the assessment of the respiratory, cardiac and metabolic tracts, that is widely applied in physical rehabilitation programs and in treatment of patients with cardiopulmonary diseases. [9][10][11][12][13][14] In patients with CF, muscle weakness and functional impairment associated with malnutrition are factors that limit physical capacity. [15][16][17]…”
Objective: To correlate the respiratory muscle strength and functional capacity in patients with CF. Method: Cross-sectional study in adults with cystic fibrosis. Sampling data were cataloged in Microsoft Office Excel 2007 and the variables analyzed by SPSS version 20.0 using the Student t test and the Spearman coefficient. The level of significance adopted was p < 0.05. Results: We assessed 35 patients with cystic fibrosis (44.6 ± 19.0 years), the great majority of patients in FC (n=22) did not present weakness of the inspiratory muscles (MIP-90,7 ± 27.4 cmH2O). It was not found statistically significant differences only between the adult and elderly patients. There was a positive correlation between MIP and MEP and a six-minute walk test (6MWT) in participants with respiratory muscle weakness and in the elderly. There was statistically significant difference between the averages of the distance covered on the 6MWT and the maximal respiratory pressures with the average of what was envisaged for these variables. Conclusion: All groups presented limitation of respiratory strength and functional capacity. The correlations between the respiratory pressures with the 6MWT were low and small in adults and individuals without respiratory muscle weakness; moderate to high in the elderly; small to moderate in women; small and negative in men; and high in patients with respiratory muscle weakness.
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