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Master's Dissertation
DOI
Document
Author
Full name
Ricardo Grassi Moroli
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2019
Supervisor
Committee
Gastaldi, Ada Clarice (President)
Corso, Simone Dal
Lorenzo, Valeria Amorim Pires Di
Vianna, Elcio dos Santos Oliveira
Title in Portuguese
Efeitos da taquipneia e hiperinsuflação dinâmica sobre a resistência do sistema respiratório em pacientes com bronquiectasias
Keywords in Portuguese
Bronquiectasia hiperinsuflação dinâmica
Exercício
Fisioterapia
Oscilometria de impulso
Abstract in Portuguese
Introdução: Bronquiectasias (BQC) são caracterizadas pela dilatação patológica e irreversível dos brônquios. Nestas situações pode-se observar redução da capacidade de exercício e limitações ao esforço por dispneia, aumento da frequência respiratória e hiperinsuflação dinâmica. Objetivo: Avaliar os efeitos do aumento da demanda ventilatória sobre a mecânica do sistema respiratório, simulando o que acontece no exercício, em indivíduos com BQC e em indivíduos controles. Métodos: Foram avaliados 30 voluntários com BQC (49,47±15,31 anos) e 16 SDP (40,19±15,74 anos). A capacidade vital e inspiratória foram avaliadas pela ventilometria. A resistência a 5 e 20 Hz (R5 e R20) e subtração de R5-R20, reatância a 5 Hz (X5), frequência de ressonância (Fres) e área de reatância (Ax) foram avaliadas pelo sistema de oscilometria de impulso (IOS), com respirações ao volume corrente e frequência respiratória basal (Fb); com aumento da frequência respiratória (F) a 30 e 40 incursões respiratórias por minuto (irpm) (F30 e F40), e hiperinsuflado basal (Hb) e com aumento da F (H30 e H40). Resultados: No IOS, nas comparações entre os grupos, houve diferença (p<0,05) para R5, R5-20, X5, Fres e Ax, apenas R20 não apresentou diferença significativa (p>0,05). No grupo BCQ, quando comparadas as frequências (Fb, F30 e F40) houve diferença para R5, R5-20, X5, Fres e Ax, (p<0,05). Quando comparadas a hiperinsuflação voluntária com aumento de F (Hb, H30 e H40) houve diferença para R5, R5-20, X5 e Ax, (p<0,05). Entre as situações de aumento de F, e, aumento de volume, houve diferença para R5, R20, R5-20, X5, Fres e Ax, (p<0,05). No grupo controle, para a R20, houve diferença entre H30 e H40 com F40. A X5 apresentou diferença entre Hb e as frequencias (Fb, F30 e F40) e aumento volume (H30 e H40), p<0,05. Conclusão: A taquipneia aumentou a resistência total, central e periférica das vias aéreas em indivíduos com BQC e a resistência central no grupo controle. Por outro lado, a hiperinsuflação voluntária promoveu um efeito protetor sobre a resistência, aproximando-a dos valores basais, em ambos os grupos
Title in English
Effects of respiratory rate and dynamic hyperinflation on respiratory system resistance in patients with bronchiectasis
Keywords in English
Bronchiectasis
Dynamic hyperinflation
Exercise
Impulse oscillometry
Physical therapy
Abstract in English
Introduction: Bronchiectasis (NFCB) are characterized by pathological and irreversible bronchial dilation. Reduction of exercise capacity, dyspnea, increased respiratory rate, and dynamic hyperinflation can be observed in patients with this condition. Objective: To evaluate the effects of increased and ventilatory demand and increase of respiratory rate of the respiratory system, during simulation of physical exercise in individuals with NFCB and in control subjects. Methods: Thirty volunteers with NFCB (49.47±15.31 years old) and 16 control (40.19±15.74 years old) were evaluated. The vital and inspiratory capacity was evaluated by ventilometry. Resistance at 5 and 20 Hz (R5 and R20, respectively) and R5-R20, reactance at 5 Hz (X5), resonance frequency (Fres), and reactance area (Ax) were evaluated by impulse oscillometry system (IOS). Measurements included basal tidal volume (TV), basal TV and respiratory rate (R), 30 breaths (RR30) per min (bpm), basal TV and rate 40 (RR40) bpm, basal hyperinflation (bh), hyperinflation and r30 bpm (h30), and hyperinflation and r40bpm (h40). Results: In IOS, the comparisons between groups, there was difference (p<0.05) for R5, R5-20, X5, Fres and Ax, only R20 did not present significant difference (p>0.05). In the BCQ group, when comparing the frequencies (TV, RR30 and RR40) there was difference for R5, R5- 20, X5, Fres and Ax, p <0.05. When comparing the voluntary hyperinflation with increase of F (Hb, HRR30 and HRR40) there was difference for R5, R5-20, X5 and Ax, (p<0.05). Among the situations of increase of R, and increase of volume, there was difference for R5, R20, R5-20, X5, Fres and Ax, (p<0.05). In the control group, for R20, there was a difference between HRR30 and HRR40 with RR40. The X5 presented difference between Hb and the rate (TV, RR30 and RR40) and volume increase (HRR30 and HRR40), p <0.05.Conclusion: Tachypnea increased total, central and peripheral airway resistance in individuals with BQC and central resistance in the control group. And voluntary hyperinflation promoted a protective effect on resistance, approaching baseline values in both groups
 
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Publishing Date
2019-08-14
 
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