Navegando por Palavras-chave "Airway obstruction"

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    Efficacy of the FEV1/FEV6 ratio compared to the FEV1/FVC ratio for the diagnosis of airway obstruction in subjects aged 40 years or over
    (Associação Brasileira de Divulgação Científica, 2007-12-01) Rosa, Fernanda Warken [UNIFESP]; Pérez-Padilla, Rogelio; Camelier, Aquiles Assunção [UNIFESP]; Nascimento, Oliver Augusto [UNIFESP]; Menezes, Ana Maria Baptista; Jardim, José Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Católica do Salvador; Faculdade de Tecnologia e Ciências; National Institute of Respiratory Diseases; Universidade Federal da Bahia Disciplina de Pneumologia; Universidade Federal de Pelotas Programa de Pós-graduação em Epidemiologia; PLATINO Group
    The present cross-sectional, population-based study was designed to evaluate the performance of the FEV1/FEV6 ratio for the detection of airway-obstructed subjects compared to the FEV1/FVC <0.70 fixed ratio test, as well as the lower limit of normality (LLN) for 1000 subjects ³40 years of age in the metropolitan area of São Paulo, SP, Brazil. After the exclusion of 37 (3.7%) spirometries, a total of 963 pre-bronchodilator (BD) and 918 post-BD curves were constructed. The majority of the post-BD curves (93.1%) were of very good quality and achieved grade A (762 curves) or B (93 curves). The FEV1/FEV6 and FEV1/FVC ratios were highly correlated (r² = 0.92, P < 0.000). Two receiver operator characteristic curves were constructed in order to express the imbalance between the sensitivity and specificity of the FEV1/FEV6 ratio compared to two FEV1/FVC cut-off points for airway obstruction: equal to 70 (area under the curve = 0.98, P < 0.0001) and the LLN (area under the curve = 0.97, P < 0.0001), in the post-BD curves. According to an FEV1/FVC <0.70, the cut-off point for the FEV1/FEV6 ratio with the highest sum for sensitivity and specificity was 0.75. The FEV1/FEV6 ratio can be considered to be a good alternative to the FEV1/FVC ratio for the diagnosis of airway obstruction, both using a fixed cut-off point or below the LLN as reference. The FEV1/FEV6 ratio has the additional advantage of being an easier maneuver for the subjects and for the lung function technicians, providing a higher reproducibility than traditional spirometry maneuvers.
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    Hiperinsuflacao manual para desobstrucao das vias aereas em pediatria: revisao sistematica
    (Associação de Medicina Intensiva Brasileira - AMIB, 2013-09-01) Godoy, Vanessa Cristina Waetge Pires De; Zanetti, Nathalia Mendonca; Johnston, Cintia; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE:To perform an assessment of the available literature on manual hyperinflation as a respiratory physical therapy technique used in pediatric patients, with the main outcome of achieving airway clearance.METHODS:We reviewed articles included in the Lilacs (Latin American and Caribbean Literature on Health Sciences/Literatura Latino Americana e do Caribe em Ciências da Saúde), Cochrane Library, Medline (via Virtual Health Library and PubMed), SciELO (Scientific Electronic Library), and PEDro (Physiotherapy Evidence Database) databases from 2002 to 2013 using the following search terms: physiotherapy (techniques), respiratory therapy, intensive care, and airway clearance. The selected studies were classified according to the level of evidence and grades of recommendation (method of the Oxford Centre for Evidence-Based Medicine) by two examiners, while a third examiner repeated the search and analysis and checked the classification of the articles.RESULTS:Three articles were included for analysis, comprising 250 children (aged 0 to 16 years). The main diagnoses were acute respiratory failure, recovery following heart congenital disease and upper abdominal surgery, bone marrow transplantation, asthma, tracheal reconstruction, brain injury, airway injury, and heterogeneous lung diseases. The studies were classified as having a level of evidence 2C and grade of recommendation C.CONCLUSIONS:Manual hyperinflation appeared useful for airway clearance in the investigated population, although the evidence available in the literature remains insufficient. Therefore, controlled randomized studies are needed to establish the safety and efficacy of manual hyperinflation in pediatric patients. However, manual hyperinflation must be performed by trained physical therapists only.