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Abstract(s)
Introdução: A DPOC é uma das principais causas mundiais de morbilidade e mortalidade, representando um problema de saúde pública devido ao elevado consumo de recursos sanitários e económicos associados. A reabilitação pulmonar é uma recomendação standard nos cuidados a estes pacientes, de forma a controlar os sintomas da doença e optimizar a capacidade funcional destes indivíduos, reduzindo assim os custos de saúde associados às exacerbações e limitação da actividade e participação. Contudo, em pacientes com DPOC severa o exercício físico pode ser de difícil desempenho devido a dispneia extrema, diminuição da força muscular e fadiga, ou inclusivé hipoxémia e dispneia durante pequenos esforços e actividades diárias, limitando a sua qualidade de vida. Assim, a VNI têm sido usada em combinação com o exercício, de forma a melhorar a capacidade de exercício nestes doentes, ainda que sem consenso para a sua recomendação. Objectivo: Verificar se a utilização de VNI durante o exercício é mais eficaz que exercício sem VNI, na dispneia, distância percorrida, gasimetria e estado de saúde, em pacientes com DPOC, através de revisão sistemática e meta-análise. Resultados: Dos 208 estudos randomizados controlados identificados, foram incluídos apenas 7. Destes, 4 possibilitaram a realização de meta-análise para PaCO2 e dispneia. Seis dos 7 estudos apontaram para maior benefício da VNI em relação ao grupo controlo. Conclusão: Verificou-se a influência positiva da VNI durante o exercício, quer em termos de respostas agudas ou crónicas ao exercício, em pacientes hipercapnicos e normocapnicos. independentemente da realização de programas de treino de exercício.
ABSTRACT - Introduction: COPD is a major cause of morbidity and mortality worldwide, representing a major public health problem due to the high health and economic resource consumption. Pulmonary rehabilitation is a standard care recommendation for this patients, in order to control the symptoms and optimize the functional capacity, reducing healthcare costs associated with exacerbations and activity limitations and participation. However, in patients with severe COPD exercise performance can be difficult, due to extreme dyspnea, decreased muscle strength and fatigue. In adiction, hypoxemia and dyspnea during efforts and daily activities may occur, limiting their quality of life. Thus, NIV have been used as adjunct to exercise, in order to improve exercise capacity in these patients. However, there is no consense for this tecnhique recomendation. Objective: verify whether the use of NIV during exercise is effective than exercise without NIV in dyspnea, walked distance, blood gases and health status in COPD patients, through a systematic review and meta-analysis. Results: From 208 identified randomized controlled trials, only 7 were included. Of these, only 4 allowed the meta-analysis for PaCO2 and dyspnea. Six of the 7 studies indicated the benefit of NIV compared to the control group. Conclusion: We verified a positive influence of NIV during exercise, both in terms of acute and chronic responses to exercise in patients either hypercapnic and normocapnic, regardless of conducting training programs of exercise.
ABSTRACT - Introduction: COPD is a major cause of morbidity and mortality worldwide, representing a major public health problem due to the high health and economic resource consumption. Pulmonary rehabilitation is a standard care recommendation for this patients, in order to control the symptoms and optimize the functional capacity, reducing healthcare costs associated with exacerbations and activity limitations and participation. However, in patients with severe COPD exercise performance can be difficult, due to extreme dyspnea, decreased muscle strength and fatigue. In adiction, hypoxemia and dyspnea during efforts and daily activities may occur, limiting their quality of life. Thus, NIV have been used as adjunct to exercise, in order to improve exercise capacity in these patients. However, there is no consense for this tecnhique recomendation. Objective: verify whether the use of NIV during exercise is effective than exercise without NIV in dyspnea, walked distance, blood gases and health status in COPD patients, through a systematic review and meta-analysis. Results: From 208 identified randomized controlled trials, only 7 were included. Of these, only 4 allowed the meta-analysis for PaCO2 and dyspnea. Six of the 7 studies indicated the benefit of NIV compared to the control group. Conclusion: We verified a positive influence of NIV during exercise, both in terms of acute and chronic responses to exercise in patients either hypercapnic and normocapnic, regardless of conducting training programs of exercise.
Description
Mestrado em Fisioterapia
Keywords
Pneumologia Ventilação não invasiva Doença pulmonar obstrutiva crónica Reabilitação pulmonar Exercício físico Pneumology Non invasive ventilation Chronic obstructive pulmonary disease Pulmonary rehabilitation Physical exercise
Pedagogical Context
Citation
Correia S. Ventilação não invasiva durante o exercício em pacientes com DPOC: revisão sistemática com meta-análise [Dissertation]. Lisboa: Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa; 2013.
Publisher
Escola Superior de Tecnologia da Saúde de Lisboa