Artículos de revistas
Volumetric Capnography To Detect Ventilation Inhomogeneity In Children And Adolescents With Controlled Persistent Asthma [capnografia Volumétrica Na Identificação Da Não Homogeneidade Da Ventilação Em Crianças E Adolescentes Com Asma Persistente Controlada]
Registro en:
Jornal De Pediatria. , v. 87, n. 2, p. 163 - 168, 2011.
217557
10.2223/JPED.2077
2-s2.0-79955111325
Autor
Almeida C.C.B.
Almeida-Junior A.A.
Ribeiro M.A.G.O.
Nolasco-Silva M.T.
Ribeiro J.D.
Institución
Resumen
Objectives: To study changes in the variables of volumetric capnography in children and adolescents with asthma compared with a control group and to investigate their changes with the use of bronchodilators and bronchial provocation test with methacholine. Methods: One hundred and three patients with controlled persistent asthma and 40 healthy volunteers participated in the study. All of them underwent volumetric capnography and spirometry. All asthmatics repeated the tests after bronchodilator use. Among 103 asthma patients, 33 underwent methacholine challenge test, and measures were recorded on three occasions: before and after methacholine and after bronchodilator use. Results: Compared with the control group, asthmatics had an increase in the slope of phase III normalized by tidal volume and decreases in tidal volume, forced expiratory volume in one second, forced vital capacity, rate of obstruction and forced expiratory flow between 25 to 75% of forced vital capacity. After bronchodilator use, there was an increase in spirometric variables, volume of anatomic dead space, and decrease in the slope of phase II normalized by tidal volume, but the slope of phase III normalized by tidal volume did not change. After methacholine, there was an increase in this variable, which decreased after bronchodilator use. Conclusions: The increase in the slope of phase III normalized by tidal volume in asthma patients suggests that these patients have ventilation inhomogeneity in the distal air spaces, which may reflect chronic structural disorders or reversible acute changes seen on the bronchial provocation test. Copyright © 2011 by Sociedade Brasileira de Pediatria. 87 2 163 168 Ljungberg, H.K., Gustafsson, P.M., Peripheral airway function in childhood asthma, assessed by single-breath He and SF 6 washout (2003) Pediatric Pulmonology, 36 (4), pp. 339-347. , DOI 10.1002/ppul.10356 Macleod, K.A., Horsley, A.R., Bell, N.J., Greening, A.P., Innes, J.A., Cunningham, S., Ventilation heterogeneity in children with well controlled asthma with normal spirometry indicates residual airways disease (2009) Thorax, 64, pp. 33-37 Bourdin, A., Paganin, F., Prefaut, C., Kieseler, D., Godard, P., Chanez, P., Nitrogen washout slope in poorly controlled asthma (2006) Allergy: European Journal of Allergy and Clinical Immunology, 61 (1), pp. 85-89. , DOI 10.1111/j.1398-9995.2006.00970.x Verbanck, S., Schuermans, D., Paiva, M., Vincken, W., Nonreversible conductive airway ventilation heterogeneity in mild asthma (2003) Journal of Applied Physiology, 94 (4), pp. 1380-1386 Fletcher, R., Relationship between alveolar deadspace and arterial oxygenation in children with congenital cardiac disease (1989) British Journal of Anaesthesia, 62 (2), pp. 168-176 Arnold, J.H., Thompson, J.E., Benjamin, P.K., Respiratory deadspace measurements in neonates during extracorporeal membrane oxygenation (1993) Critical Care Medicine, 21 (12), pp. 1895-1900 Arnold, J.H., Bower, L.K., Thompson, J.E., Respiratory deadspace measurements in neonates with congenital diaphragmatic hernia (1995) Crit Care Med, 23, pp. 371-375 Hubble, C.L., Gentile, M.A., Tripp, D.S., Craig, D.M., Meliones, J.N., Cheifetz, I.M., Deadspace to tidal volume ratio predicts successful extubation in infants and children (2000) Critical Care Medicine, 28 (6), pp. 2034-2040 Coss-Bu, J.A., Walding, D.L., David, Y.B., Jefferson, L.S., Dead space ventilation in critically III children with lung injury (2003) Chest, 123 (6), pp. 2050-2056. , DOI 10.1378/chest.123.6.2050 Almeida Jr., A.A., Da, S.M.T.N., Almeida, C.C.B., Ribeiro, J.D., Relationship between physiologic deadspace/tidal volume ratio and gas exchange in infants with acute bronchiolitis on invasive mechanical ventilation (2007) Pediatric Critical Care Medicine, 8 (4), pp. 372-377. , DOI 10.1097/01.PCC.0000269389.51189.A8 Lucangelo, U., Gullo, A., Bernabè, F., Blanch, L., Capnographic measures (2004) Capnography: Clinical Aspects. Carbon Dioxide over Time and Volume, pp. 309-320. , Gravenstein JS, Jaffe MB, Paulus DA (editors). Cambridge: Cambridge University Press Olsson, K., Greiff, L., Karlefors, F., Johansson, S., Wollmer, P., Changes in airway dead space in response to methacholine provocation in normal subjects (1999) Clinical Physiology, 19 (5), pp. 426-432. , DOI 10.1046/j.1365-2281.1999.00197.x Koulouris, N.G., Latsi, P., Stavrou, E., Chroneou, A., Gaga, M., Jornanoglou, J., Unevenness of ventilation assessed by the expired CO(2) gas volume versus V(T) curve in asthmatic patients (2004) Respir Physiol Neurobiol, 140, pp. 293-300 Romero, P.V., Rodriguez, B., De Oliveira, D., Blanch, L., Manresa, F., Volumetric capnography and chronic obstructive pulmonary disease staging (2007) International Journal of COPD, 2 (3), pp. 381-391 Veronez, L., Moreira, M.M., Soares, S.T., Pereira, M.C., Ribeiro, M.A., Ribeiro, J.D., Volumetric capnography for the evaluation of pulmonary disease in adult patients with cystic fibrosis and noncystic fibrosis bronchiectasis (2010) Lung, 188, pp. 263-268 Ream, R.S., Schreiner, M.S., Neff, J.D., McRae, K.M., Jawad, A.F., Scherer, P.W., Volumetric capnography in children. Influence of growth on the alveolar plateau slope (1995) Anesthesiology, 82, pp. 64-73 Steiss, J.O., Rudloff, S., Landmann, E., Zimmer, K.P., Lindemann, H., Capnovolumetry: A new tool for lung function testing in children with asthma (2008) Clin Physiol Funct Imaging, 28, pp. 332-336 Ribeiro, M.A., (2010) Uso Da Capnografia Volumétrica Associada À Espirometria Na Identificação Da Disfunção Pulmonar Na Fibrose Cística, , [tese] Campinas (SP): Universidade Estadual de Campinas (1995) Global Initiative for Asthma (GINA), , National Heart, Lung and Blood Institute/World Health Organization Workshop. USA Miller, M.R., Hankinson, J., Brusasco, V., Burgos, F., Casaburi, R., Coates, A., Crapo, R., Wagner, J., Standardisation of spirometry (2005) European Respiratory Journal, 26 (2), pp. 319-338. , DOI 10.1183/09031936.05.00034805 Kars, A.H., Goorden, G., Stijnen, T., Bogaard, J.M., Verbraak, A.F., Hilvering, C., Does phase 2 of the expiratory PCO2 versus volume curve have diagnostic value in emphysema patients? (1995) Eur Respir J, 8, pp. 86-92 Verbanck, S., Schuermans, D., Van Muylem, A., Paiva, M., Noppen, M., Vincken, W., Ventilation distribution during histamine provocation (1997) Journal of Applied Physiology, 83 (6), pp. 1907-1916 Macklem, P.T., The physiology of small airways (1998) Am J Respir Crit Care Med, 157, pp. S181-S183 Jeffery, P.K., Comparison of the structural and inflammatory features of COPD and asthma. Giles F. Filley Lecture (2000) Chest, 117, pp. 251S-260S Chetta, A., Foresi, A., Del, D.M., Bertorelli, G., Pesci, A., Olivieri, D., Airways remodeling is a distinctive feature of asthma and is related to severity of disease (1997) Chest, 111 (4), pp. 852-857 Hamid, Q., Song, Y., Kotsimbos, T.C., Minshall, E., Bai, T.R., Hegele, R.G., Hogg, J.C., Inflammation of small airways in asthma (1997) Journal of Allergy and Clinical Immunology, 100 (1), pp. 44-51. , DOI 10.1016/S0091-6749(97)70193-3 Teel, G.S., Engeler, C.E., Tashijian, J.H., DuCret, R.P., Imaging of small airways disease (1996) Radiographics, 16, pp. 27-41 Haley, K.J., Sunday, M.E., Wiggs, B.R., Kozakewich, H.P., Reilly, J.J., Mentzer, S.J., Sugarbaker, D.J., Drazen, J.M., Inflammatory cell distribution within and along asthmatic airways (1998) American Journal of Respiratory and Critical Care Medicine, 158 (2), pp. 565-572 Horsley, A., Lung clearance index in the assessment of airways disease (2009) Respir Med, 103, pp. 793-799