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Master's Dissertation
DOI
10.11606/D.5.2007.tde-16082007-151208
Document
Author
Full name
Wellington Pereira dos Santos Yamaguti
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2007
Supervisor
Committee
Carvalho, Celso Ricardo Fernandes de (President)
Marques, Amelia Pasqual
Pitta, Fabio de Oliveira
Title in Portuguese
Mobilidade diafragmática em pacientes com DPOC: avaliação ultra-sonográfica do deslocamento crânio-caudal do ramo esquerdo da veia porta
Keywords in Portuguese
Diafragma
Doença pulmonar obstrutiva crônica
Músculos respiratórios
Testes de função respiratória
Ultra-sonografia
Abstract in Portuguese
O objetivo desse estudo foi avaliar a relação da mobilidade diafragmática com a função pulmonar e a força muscular respiratória em indivíduos com DPOC, utilizando a mensuração ultra-sonográfica do deslocamento crânio-caudal do ramo esquerdo da veia porta. Foram estudados 54 pacientes portadores de DPOC com hiperinsuflação pulmonar e 20 sujeitos saudáveis. Os parâmetros avaliados foram: mobilidade diafragmática, função pulmonar e as pressões respiratórias máximas. Pacientes com DPOC apresentaram menor mobilidade do diafragma (36,46 ± 10,90 mm) quando comparados a indivíduos saudáveis (46,33 ± 9,47) (p = 0,001). Nos indivíduos portadores de DPOC foram verificadas uma forte correlação com os parâmetros da função pulmonar que quantificam o aprisionamento de ar (VR: r = -0,60; p < 0,001; VR/CPT: r = -0,72; p < 0,001), uma moderada correlação com a obstrução de vias aéreas (VEF1: r = 0,55, p < 0,001; resistência das vias aéreas: r = -0,32, p = 0,02) e uma fraca correlação com a hiperinsuflação pulmonar (CPT: r = -0,28, p = 0,04). Não foi observada relação entre a mobilidade do diafragma e a força muscular respiratória (PImax: r = -0,11 e p = 0,43; PEmax: r = 0,03 e p = 0,80). Nossos resultados sugerem que a redução da mobilidade do diafragma em pacientes com DPOC ocorre principalmente devido ao aprisionamento de ar, não sendo influenciada pela hiperinsuflação pulmonar ou pela força muscular respiratória.
Title in English
Diaphragm mobility in COPD patients: ultrasound assessment of the craniocaudal displacement of the left branch of the portal vein
Keywords in English
Chronic obstructive pulmonary disease
Diaphragm
Respiratory function tests
Respiratory muscles
Ultrasound
Abstract in English
The purpose of this study was to use ultrasound to measure the craniocaudal displacement of the left branch of the portal vein in order to evaluate the relationship between pulmonary function and diaphragm mobility, as well as that between respiratory muscle strength and diaphragm mobility, in COPD patients. We studied 54 COPD patients with pulmonary hyperinflation, together with 20 healthy subjects. Pulmonary function, maximal respiratory pressures, and diaphragm mobility were evaluated. COPD patients presented less diaphragm mobility than did healthy individuals (36.46 +/- 10.90 mm vs. 46.33 +/- 9.47 mm, respectively) (p = 0.001). In COPD patients, we found that diaphragm mobility correlated strongly with pulmonary function parameters that quantify air trapping (RV: r = -0.60; p < 0.001; RV/TLC: r = -0.76; p < 0.001), moderately with airway obstruction (FEV1: r = 0.55, p < 0.001; airway resistance: r = -0.32, p = 0.02), and weakly with pulmonary hyperinflation (TLC: r = -0.28, p = 0.04). No relationship was observed between diaphragm mobility and respiratory muscle strength (maximal inspiratory pressure: r = -0.11 and p = 0.43; maximal expiratory pressure: r = 0.03 and p = 0.80). The results of this study suggest that the reduction in diaphragm mobility in COPD patients occurs mainly due to air trapping and is not influenced by respiratory muscle strength or pulmonary hyperinflation.
 
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Publishing Date
2007-08-22
 
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