Banca de DEFESA: FLÁVIO EMANOEL SOUZA DE MELO

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
DISCENTE : FLÁVIO EMANOEL SOUZA DE MELO
DATA : 30/06/2016
HORA: 09:00
LOCAL: Auditório do Departamento de Fisioterapia
TÍTULO:

EFFECTS OF NON-INVASIVE VENTILATION IN CPAP AND BI-LEVEL MODE IN EXERCISE TOLERANCE IN CARDIAC FAILURE

PALAVRAS-CHAVES:

Continuous positive airway pressure, Intermittent positive-pressure breathing, Exercise test, physical endurance.

PÁGINAS: 100
GRANDE ÁREA: Ciências da Saúde
ÁREA: Fisioterapia e Terapia Ocupacional
RESUMO:

Introduction: Heart failure (HF) is a major public health problem worldwide. Dyspnea and fatigue are the main clinical symptoms of heart failure and primarily responsible for exercise intolerance. In the management of this syndrome, regular exercise and noninvasive ventilation (NIV) are related to a decrease of symptoms and improvement of functional capacity. The use of NIV associated with exercise is recent, and there are only few randomized controlled trials on the subject. In this context, it is known that the use of NIV in CPAP mode applied before exercise increases exercise tolerance in people with heart failure; however, it's not yet known if the bi-level mode, applied under the same conditions, is able to generate similar or even better results, due to pressure increase  of the ventilatory support in this modality.Objective: Therefore, this study aims to test whether there is a difference between the acute effects of NIV on exercise tolerance in patients with HF, when applied CPAP or bi-level mode. Methodology: This is a controlled, randomized, double-blind and cross-over clinical trial, composed of 14 volunteers (age 63 ± 9 years), with chronic heart failure, functional class II and III (New York Heart Association) in clinical stability. The experiment took place in three different days with an interval of 48 hours between them. Each volunteer has a graduated walk test (GCT) per day, namely: one TGC without intervention (T-Co), another after 30 minutes of NIV in CPAP mode (T-CP), and another after 30 minutes of VNI in Bi-level mode (T-Bi), following randomized sequence. During the tests, we analyzed the walking distance (WD), perceived levels of fatigue and dyspnea, affective response and other physiological variables. Statistical analysis was performed using ANOVA for repeated measures followed by Bonferroni post-test, considering p-value less than or equal to 0.05 as statistically significant. Results: No difference was found between the DC obtained in T-CP (440.4 + 72,4m) and T-Bi (441.6 + 79,4m) (p = 1.00). However, the WD was higher after the use of NIV in both the T-CP, as in T-Bi compared to that observed in T-Co (381.2 + 79,8m) (p = 0.004 and p = 0.007, respectively). Conclusion: The use of a non-invasive ventilatory support, regardless of mode, promotes improvement in exercise tolerance in people with heart failure, which can allow this population range, more broadly, the benefits from the exercise of its functionality and quality of life.

MEMBROS DA BANCA:
Externo à Instituição - MICHEL SILVA REIS - UFRJ
Presidente - 1632408 - PATRICIA ANGELICA DE MIRANDA SILVA NOGUEIRA
Interno - 2566849 - WOUBER HERICKSON DE BRITO VIEIRA