Efeitos da aplicação da EPAP (Expiratory Positive Airway Pressure) sobre a tolerância ao esforço em pacientes portadores de insuficiência cardíaca

Abstract

Introduction: New therapeutic approaches that aim to improve the sensation of dyspnea and fatigue in patients with heart failure, as the application of expiratory positive airway pressure (EPAP) should be tested in an attempt to improve functional capacity and quality of life. Objective: To evaluate the effects of the use of EPAP during exercise in patients with heart failure functional class II and III (NYHA). Methods: Of 390 patients, 28 were selected with LVEF <40%. The six-minute walk test (6'WT) was performed three times with and without the EPAP, reflecting the greater distance in the analysis. The comparison between the data obtained was performed by paired t test or Wilcoxon test as the normality of the data. Results: The use of EPAP increased volume without significant minutes, but the perceived exertion was higher after the walk with the use of the mask when compared in the absence of a mask. There was significant increase in oxygen saturation compared with the group that did not use the mask. There was no improvement in distance walked in 6'WT with the use of EPAP. Conclusion: Use of EPAP mask increases the perception of ventilatory effort and work, but its applicability in routine cardiac rehabilitation programs based on our preliminary data is questionable.

Pressão positiva expiratória das vias aéreas sobre a oxigenação e hemodinâmica em pacientes submetidos a revascularização do miocárdio

“…Thofehrn et al [17] applied, in patients with congestive insufficiency, the sixminute walk test and 20 cmH2O EPAP, generating changes in hemodynamic variables.…”