Navegando por Palavras-chave "Oscillometry"

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    Oscilometria de impulso na avaliação da função pulmonar de crianças e adolescentes asmáticos
    (Universidade Federal de São Paulo (UNIFESP), 2019-10-25) Lima, Jales Henrique Pereira De [UNIFESP]; Wandalsen, Gustavo Falbo [UNIFESP]; http://lattes.cnpq.br/4807350957191775; http://lattes.cnpq.br/4616240489495871; http://lattes.cnpq.br/5314103949026669; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Asthma is one of the most common chronic diseases of childhood. Its classification can be given according to frequency, intensity of symptoms and pulmonary function. Spirometry is the traditional test for pulmonary function assessment, whereas impulse oscillometry is an alternative and easy to perform tool that measures airway impedance and assists in detecting changes in lung function. Spirometry has some limitations in asthmatic children and adolescents, often requiring complementary or substitute techniques. Objective: To evaluate and describe the pulmonary function of asthmatic children and adolescents evaluated by impulse oscillometry and compare the findings with those obtained by spirometry. Methods: A cross-sectional study evaluating the pulmonary function of 130 asthmatic children and adolescents aged 6 to 18 years, divided by disease control level according to Asthma Control Test or Children Asthma Control Test in controlled (ACT/C-ACT>19; n=70) and uncontrolled subjects (ACT/C-ACT≤19; n=60). The children and adolescents who participated in the study are assisted by the Allergy and Immunology outpatient clinic of Pediatrics Department, UNIFESP-EPM. Pulmonary function tests were performed using the MasterScreenTM equipment (CareFusion, USA). Results: One hundred thirty asthmatic children and adolescents were evaluated (51% male). The medians and interquartile range of resistance values at 5 Hz (R5%), resistance at 20 Hz (R20%), reactance at 5 Hz (X5%) and resonant frequency (Fres) were, respectively: 112,4% (86,8% – 130,2%), 105,9% (88,3% – 117,8%), 109,2% (86,4% – 160%) and 23,3 Hz (17,4 Hz – 26,2 Hz). Altered oscillometry was observed in 20% of cases and spirometry in 48%. Changes in oscillometry were more frequent in patients with controlled asthma. R5%, X5% and Fres presented moderate correlation with the main spirometric parameters, being stronger between R5% and FEF25-75% (r: -0,45; p<0,05) in the studied patients, X5% and FEV1/FVC% (r: -0,58; p<0,05) in patients with controlled asthma and between R5% and FEV1% (r: -0,39; p<0,05) in patients with uncontrolled asthma. Patients with controlled asthma who had hospitalization for asthma exacerbation had lower pulmonary function values and higher bronchodilator response values on spirometry. Patients with controlled asthma who presented bronchodilator response on oscillometry and spirometry presented higher values of R20% and Fres. Patients with uncontrolled asthma who presented bronchodilator response on spirometry had higher values of X5%. Conclusions: Impulse oscillometry values showed a moderate correlation with spirometric values. Spirometry showed greater sensitivity in the assessment of pulmonary function in asthmatic children and adolescents.
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    Prevalência de asma e avaliação da função pulmonar em pacientes com doença de Fabry
    (Universidade Federal de São Paulo (UNIFESP), 2021) Monteiro, Fernanda Pereira [UNIFESP]; Wandalsen, Gustavo Falbo [UNIFESP]; Universidade Federal de São Paulo
    Fabry disease (FD) is characterized by excessive accumulation of globotriaosylceramide inside the lysosome, affecting mainly the vascular endothelium with repercussion in multiple systems. Pulmonary complications in FD are still not well established. The objectives of our study were to assess lung function in patients with a confirmed diagnosis of DF who were followed up at a Brazilian referral center and to repeat the evaluations after 12 months to monitor the evolutionary patterns. Methods: The study included patients with a confirmed diagnosis of FD. Lung function was evaluated by spirometry and impulse oscillometry (IOS). Symptoms and medical history were obtained by questionnaire and review of medical records. The reassessment followed the interval of 12 months ± 2 months. Results: In the first moment, forty-seven patients were evaluated. Spirometry was abnormal in 32% of the patients and IOS in 47%. Restrictive pattern of pulmonary dysfunction was found in 60% (spirometry) and in 50% (IOS) of patients with abnormal results. Positive bronchodilator response was observed in 17% of the patients. Worse values of pulmonary function were observed in patients with proteinuria (FEV1: 80% vs 93%, p=0.02; R5: 152% vs 116%, p<0.01), fatigue (FEV1: 83% vs 97%, p=0.02), wheezing in the last year (R5: 164% vs 125%, p=0.02), renal insufficiency (FEV1: 65% vs 89%, p<0.01), and with classical phenotype (X5: 1.7cmH2O/L/s vs 2.6 cmH2O/L/s, p=0.04). Forty-one of these patients were reassessed. Spirometry was abnormal in 48% after one year with a mixed pattern (restrictive and obstructive) predominating. Altered IOS were found in 39% after reassessment. Worse evolution of pulmonary function values was observed in patients with classic phenotype (p = 0.04) and there was a trend towards worse evolution of pulmonary function in male patients. Conclusions: Pulmonary involvement is a relevant manifestation of FD, especially observed with disease progression and in the classical phenotype. IOS seems to be a sensitive test that may play a complementary role to spirometry in the evaluation of the pulmonary function of these patients, but a year is a relatively short period to monitor the evolution of the disease and progression in the deterioration of lung function.