Continuous laryngoscopy during exercise - proposal for a clinical protocol based on bibliographic review

• Autor(a) principal: Chantre, Tiago
• Data de Publicação: 2023
• Outros Autores: Alpoim Moreira, Inês, Barroso, Mafalda, Oliveira, Mariana, Sousa, Herédio
• Tipo de documento: Artigo
• Idioma: por; eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.34631/sporl.2055
• topic: Laringoscopia contínua durante o exercício; Obstrução laríngea induzida por exercício; Laringoscopia; Continuous laryngoscopy during exercise; Exercise-induced laryngeal obstruction; Laryngoscopy

Objectives - Establishment of a protocol for Continuous Laryngoscopy during Exercise (LCE). Study Design – Systematic Bibliographic Review. Material and Methods - Bibliographic review in the MEDLINE, Cochrane Central Register of Controlled Trials and Cumulative Index to Nursing and Allied Health Literature databases, based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) model, between 2001 and 2021. The studies included in the literature review analyzed LCE protocols in both pediatric and adult ages and were written in English or Portuguese. Articles that only discussed Exercise-Induced Laryngeal Obstruction, but not the LCE protocol and articles whose study objective was not to investigate the results of the LCE protocol were excluded. Based on the results obtained, a clinical protocol was developed for the Centro Hospitalar Universitário Lisboa Central and tested on a group of 10 healthy volunteers. Results – The search produced a total of 679 articles, and after applying the inclusion and exclusion criteria, 21 studies were selected. In these, there were a total of 1026 patients analyzed, with a male:female ratio of 1:1.7. The average age at which LCE was performed ranged from 9 to 45 years. The preferred exercise method in the protocols studied was the treadmill (n = 17; 81%), followed by the exercise bike (n = 4, 19%) and the rowing machine (n = 1; 4.8%). The proposed LCE protocol includes a modified Bruce protocol, with LCE ending when patients are exhausted or have limiting respiratory symptoms. Immediately before and after LCE, spirometry was performed. Glottic and supraglottic movements were assessed at rest, with moderate effort and maximum effort, in each phase of the respiratory cycle. Conclusions - Based on data from a bibliographical review, a protocol for carrying out LCE was developed, demonstrating feasibility and suitability for the reality of a Portuguese institution when tested on healthy volunteers. Further studies with patients are needed to validate these results.