Mecânica respiratória na doença pulmonar obstrutiva crônica: análise da complexidade e impedância ao longo do ciclo ventilatório
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UERJ |
Texto Completo: | http://www.bdtd.uerj.br/handle/1/12660 |
Resumo: | Recently there has been a growing interest in the study of nonlinear dynamics as a methodology for further analysis to characterize the respiratory system. Chronic obstructive pulmonary disease (COPD) introduces pathophysiological changes that culminate in a complex behavior that is "silent" in its initial phases. We observed the need to obtain information that is more detailed by using the Forced Oscillations Technique (FOT) for better understanding of factors that contribute to the illness. The present thesis aimed to evaluate the contribution of the FOT in assessing changes in respiratory mechanics within the ventilatory cycle in patients with COPD, including an evaluation of the complexity of the respiratory system. A total of 207 patients were evaluated in this study. In the first phase 114 subjects were included, 20 healthy volunteers (CG) and 94 with COPD. These latter, we obtained a total of 5 groups: normal to the spirometric exam (Stage 0) group with 20 subjects, the mild group (Stage I) with n=14, the moderate group (Stage II) of n=20, the severe group (Stage III) n=20 and very severe group (Stage IV) consisting of 20 patients. The parameters analyzed were average respiratory system impedance (Zm), inspiratory and expiratory impedance (Zi and Ze, respectively), the impedance at the beginning of inspiration and expiration (Zii and Zie), the peak-to-peak impedance (Zpp) and the mean change in impedance (ΔZrs). In the second phase, the complexity of the respiratory system was analyzed by the variability of airflow and Zrs (SDV and SDZrs, respectively), the sample entropy of airflow and Zrs (EnAmV' and EnAmZrs, respectively) and the entropy density of the recurrence period of airflow and ZRS (RPDEV' and RPDEZrs, respectively). At this stage, after were analyzed in 88 subjects related to the complexity of airflow analysis. A total of 72 COPD patients was divided into the following groups: G0 (n = 13), GI (n = 11), GII (n = 18), GIII (n = 16), GIV (n = 14). The GC was composed of 16 individuals. The analysis related to the complexity of Zrs involved a total of 97 individuals. A total of 74 COPD patients were divided into following groups: G0 (n = 17), GI (n = 10), GII (n = 16), GIII (n = 16), GIV (n = 15). The GC was composed of 23 healthy individuals. Respiratory impedance was higher in COPD patients compared to the CG, an increase with the progression of bronchial obstruction: Zm (p<0.0001), Zi (p<0.0001), Ze (p<0.0001), Zii (p<0.0001), Zie (p<0.0001), Zpp (p<0.0001) and ΔZrs (p<0.01). It was observed a significant increase in SDV' (p< 0.002) and SDZrs (p<0.0001) with bronchial obstruction. Moreover, the complexity of respiratory decreased, as observed in SampEnV' (p< 0.002) and RPDEZrs (p<0.0001). The SampZrs and RPDEV' parameters showed no statistically significant differences between groups. Most parameters of the Zrs had adequate values (AUC>0.8). RPDEZrs values and SDZrs showed AUC>0.80 in most of the studied groups. We concluded that individuals with COPD at different levels of bronchial obstruction have higher impedance when compared to normal individuals. Higher impedances in the expiratory phase were observed in subjects with COPD, especially in individuals with severe and very severe obstruction component. COPD introduces a loss of complexity. |
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Melo, Pedro Lopes dehttp://lattes.cnpq.br/4366715224334657Ferreira, Arthur de Sáhttp://lattes.cnpq.br/5432142731317894Nakagawa, Naomi Kondohttp://lattes.cnpq.br/9290134143124508Lopes, Agnaldo Joséhttp://lattes.cnpq.br/1548788734980219Bottino, Daniel Alexandrehttp://lattes.cnpq.br/6811587374997063http://lattes.cnpq.br/8999482416400932Silva, Karla Kristine Dames da2021-01-06T20:54:07Z2016-09-132014-02-27SILVA, Karla Kristine Dames da. Mecânica respiratória na doença pulmonar obstrutiva crônica: análise da complexidade e impedância ao longo do ciclo ventilatório. 2014. 132 f. Tese (Doutorado em Fisiopatologia Clínica e Experimental) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2014.http://www.bdtd.uerj.br/handle/1/12660Recently there has been a growing interest in the study of nonlinear dynamics as a methodology for further analysis to characterize the respiratory system. Chronic obstructive pulmonary disease (COPD) introduces pathophysiological changes that culminate in a complex behavior that is "silent" in its initial phases. We observed the need to obtain information that is more detailed by using the Forced Oscillations Technique (FOT) for better understanding of factors that contribute to the illness. The present thesis aimed to evaluate the contribution of the FOT in assessing changes in respiratory mechanics within the ventilatory cycle in patients with COPD, including an evaluation of the complexity of the respiratory system. A total of 207 patients were evaluated in this study. In the first phase 114 subjects were included, 20 healthy volunteers (CG) and 94 with COPD. These latter, we obtained a total of 5 groups: normal to the spirometric exam (Stage 0) group with 20 subjects, the mild group (Stage I) with n=14, the moderate group (Stage II) of n=20, the severe group (Stage III) n=20 and very severe group (Stage IV) consisting of 20 patients. The parameters analyzed were average respiratory system impedance (Zm), inspiratory and expiratory impedance (Zi and Ze, respectively), the impedance at the beginning of inspiration and expiration (Zii and Zie), the peak-to-peak impedance (Zpp) and the mean change in impedance (ΔZrs). In the second phase, the complexity of the respiratory system was analyzed by the variability of airflow and Zrs (SDV and SDZrs, respectively), the sample entropy of airflow and Zrs (EnAmV' and EnAmZrs, respectively) and the entropy density of the recurrence period of airflow and ZRS (RPDEV' and RPDEZrs, respectively). At this stage, after were analyzed in 88 subjects related to the complexity of airflow analysis. A total of 72 COPD patients was divided into the following groups: G0 (n = 13), GI (n = 11), GII (n = 18), GIII (n = 16), GIV (n = 14). The GC was composed of 16 individuals. The analysis related to the complexity of Zrs involved a total of 97 individuals. A total of 74 COPD patients were divided into following groups: G0 (n = 17), GI (n = 10), GII (n = 16), GIII (n = 16), GIV (n = 15). The GC was composed of 23 healthy individuals. Respiratory impedance was higher in COPD patients compared to the CG, an increase with the progression of bronchial obstruction: Zm (p<0.0001), Zi (p<0.0001), Ze (p<0.0001), Zii (p<0.0001), Zie (p<0.0001), Zpp (p<0.0001) and ΔZrs (p<0.01). It was observed a significant increase in SDV' (p< 0.002) and SDZrs (p<0.0001) with bronchial obstruction. Moreover, the complexity of respiratory decreased, as observed in SampEnV' (p< 0.002) and RPDEZrs (p<0.0001). The SampZrs and RPDEV' parameters showed no statistically significant differences between groups. Most parameters of the Zrs had adequate values (AUC>0.8). RPDEZrs values and SDZrs showed AUC>0.80 in most of the studied groups. We concluded that individuals with COPD at different levels of bronchial obstruction have higher impedance when compared to normal individuals. Higher impedances in the expiratory phase were observed in subjects with COPD, especially in individuals with severe and very severe obstruction component. COPD introduces a loss of complexity.Recentemente houve um crescimento do interesse pelo estudo da dinâmica não-linear para avaliação do sistema respiratório. A doença pulmonar obstrutiva crônica (DPOC) introduz alterações fisiopatológicas que culminam em um comportamento complexo e inicialmente silencioso . Observamos a necessidade da obtenção de informações mais detalhadas, utilizando a Técnica de Oscilações Forçadas (FOT), para melhor compreensão de fatores que contribuem para o adoecimento. A presente tese objetivou avaliar a contribuição da FOT na análise das alterações da mecânica respiratória ao longo do ciclo ventilatório de portadores de DPOC, incluindo a avaliação da complexidade do sistema respiratório. Um total de 207 pacientes com DPOC foi avaliado neste estudo. No primeiro momento, 114 indivíduos foram incluídos, 20 voluntários sadios (GC) e 94 com DPOC. Destes últimos, obtivemos um total de 5 grupos: o grupo normal ao exame (Grau 0) com 20 indivíduos, o grupo leve (Grau I) com 14, o grupo moderado (Grau II) com 20, o grupo grave (Grau III) com 20 e o grupo muito grave (Grau IV) composto por 20 pacientes. Os parâmetros analisados foram a impedância média do sistema respiratório (Zm), a impedância inspiratória e expiratória (Zi e Ze), a impedância no início da inspiração e da expiração (Zii e Zie), a impedância pico-a-pico (Zpp) e a variação média da impedância (ΔZrs). No segundo momento do estudo, a complexidade do sistema respiratório foi analisada através da variabilidade do fluxo aéreo e da Zrs (SDV´ e SDZrs, respectivamente), da entropia amostral do fluxo aéreo e da Zrs (EnAmV´ e EnAmZrs, respectivamente) e da entropia da densidade do período de recorrência do fluxo aéreo e da Zrs (RPDEV´e RPDEZrs, respectivamente). Nesta fase, foram avaliados 88 indivíduos. Um total de 72 portadores de DPOC foram divididos nos seguintes grupos: G0 (n=13), GI (n=11), GII (n=18), GIII (n=16), GIV (n=14). O GC foi composto por 16 indivíduos. As análises relacionadas à complexidade da Zrs envolveram um total de 97 indivíduos. Um total de 74 portadores de DPOC foram divididos nos seguintes grupos: G0 (n=17), GI (n=10), GII (n=16), GIII (n=16), GIV (n=15). O GC foi composto por 23 indivíduos saudáveis. A impedância respiratória foi maior em portadores de DPOC quando comparados ao GC: Zm (p<0,0001), Zi (p<0,0001), Ze (p<0,0001), Zii (p<0,0001), Zie (p<0,0001), Zpp (p<0,0001) e ΔZrs (p<0,01). Houve aumento significativo de SDV´ (p<0,002) e SDZrs (p<0,0001) com o aumento da obstrução brônquica. Por outro lado, a complexidade do sistema respiratório diminuiu, conforme EnAmV´ (p<0,002) e RPDEZrs (p<0,0001). A maioria dos parâmetros da Zrs apresentou valores adequados (AUC>0,8), em pacientes muito graves e graves. A EnAmV´ apresentou valores adequados em todos os grupos com DPOC (AUC> 0,80). Os valores de RPDEZrs e SDZrs demonstraram AUC >0,80 na maioria dos grupos estudados (Grupos I, II, III e IV). Concluiu-se que indivíduos com DPOC apresentam impedâncias maiores quando comparados a indivíduos normais. Impedâncias mais elevadas na fase expiratória foram observadas em indivíduos com DPOC, especialmente em obstrução grave e muito grave. A DPOC introduz uma perda de complexidade.Submitted by Boris Flegr (boris@uerj.br) on 2021-01-06T20:54:07Z No. of bitstreams: 1 TESE_FINAL_PUBLICADA_Karla_Kristine_Dames_da_Silva.pdf: 3804817 bytes, checksum: f0626dd6f2009f03d422d2b3a4f0ce26 (MD5)Made available in DSpace on 2021-01-06T20:54:07Z (GMT). No. of bitstreams: 1 TESE_FINAL_PUBLICADA_Karla_Kristine_Dames_da_Silva.pdf: 3804817 bytes, checksum: f0626dd6f2009f03d422d2b3a4f0ce26 (MD5) Previous issue date: 2014-02-27application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Fisiopatologia Clínica e ExperimentalUERJBRCentro Biomédico::Faculdade de Ciências MédicasForced oscillationsComplexityRespiratory impedanceChronic obstructive pulmonary diseaseEntropyVariabilityOscilaçõesEntropiaImpedância (Eletricidade)Oscilações forçadasComplexidadeImpedância respiratóriaDoença pulmonar obstrutiva crônicaEntropiaVariabilidadeCNPQ::CIENCIAS BIOLOGICAS::FISIOLOGIA::FISIOLOGIA DE ORGAOS E SISTEMAS::FISIOLOGIA DA RESPIRACAOMecânica respiratória na doença pulmonar obstrutiva crônica: análise da complexidade e impedância ao longo do ciclo ventilatórioRespiratory mechanics in chronic obstructive pulmonary disease: analysis of the complexity and impedance throughout the ventilatory cycleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALTESE_FINAL_PUBLICADA_Karla_Kristine_Dames_da_Silva.pdfapplication/pdf3804817http://www.bdtd.uerj.br/bitstream/1/12660/1/TESE_FINAL_PUBLICADA_Karla_Kristine_Dames_da_Silva.pdff0626dd6f2009f03d422d2b3a4f0ce26MD511/126602024-02-26 16:36:33.727oai:www.bdtd.uerj.br:1/12660Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T19:36:33Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false |
dc.title.por.fl_str_mv |
Mecânica respiratória na doença pulmonar obstrutiva crônica: análise da complexidade e impedância ao longo do ciclo ventilatório |
dc.title.alternative.eng.fl_str_mv |
Respiratory mechanics in chronic obstructive pulmonary disease: analysis of the complexity and impedance throughout the ventilatory cycle |
title |
Mecânica respiratória na doença pulmonar obstrutiva crônica: análise da complexidade e impedância ao longo do ciclo ventilatório |
spellingShingle |
Mecânica respiratória na doença pulmonar obstrutiva crônica: análise da complexidade e impedância ao longo do ciclo ventilatório Silva, Karla Kristine Dames da Forced oscillations Complexity Respiratory impedance Chronic obstructive pulmonary disease Entropy Variability Oscilações Entropia Impedância (Eletricidade) Oscilações forçadas Complexidade Impedância respiratória Doença pulmonar obstrutiva crônica Entropia Variabilidade CNPQ::CIENCIAS BIOLOGICAS::FISIOLOGIA::FISIOLOGIA DE ORGAOS E SISTEMAS::FISIOLOGIA DA RESPIRACAO |
title_short |
Mecânica respiratória na doença pulmonar obstrutiva crônica: análise da complexidade e impedância ao longo do ciclo ventilatório |
title_full |
Mecânica respiratória na doença pulmonar obstrutiva crônica: análise da complexidade e impedância ao longo do ciclo ventilatório |
title_fullStr |
Mecânica respiratória na doença pulmonar obstrutiva crônica: análise da complexidade e impedância ao longo do ciclo ventilatório |
title_full_unstemmed |
Mecânica respiratória na doença pulmonar obstrutiva crônica: análise da complexidade e impedância ao longo do ciclo ventilatório |
title_sort |
Mecânica respiratória na doença pulmonar obstrutiva crônica: análise da complexidade e impedância ao longo do ciclo ventilatório |
author |
Silva, Karla Kristine Dames da |
author_facet |
Silva, Karla Kristine Dames da |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Melo, Pedro Lopes de |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/4366715224334657 |
dc.contributor.referee1.fl_str_mv |
Ferreira, Arthur de Sá |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/5432142731317894 |
dc.contributor.referee2.fl_str_mv |
Nakagawa, Naomi Kondo |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/9290134143124508 |
dc.contributor.referee3.fl_str_mv |
Lopes, Agnaldo José |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/1548788734980219 |
dc.contributor.referee4.fl_str_mv |
Bottino, Daniel Alexandre |
dc.contributor.referee4Lattes.fl_str_mv |
http://lattes.cnpq.br/6811587374997063 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/8999482416400932 |
dc.contributor.author.fl_str_mv |
Silva, Karla Kristine Dames da |
contributor_str_mv |
Melo, Pedro Lopes de Ferreira, Arthur de Sá Nakagawa, Naomi Kondo Lopes, Agnaldo José Bottino, Daniel Alexandre |
dc.subject.eng.fl_str_mv |
Forced oscillations Complexity Respiratory impedance Chronic obstructive pulmonary disease Entropy Variability |
topic |
Forced oscillations Complexity Respiratory impedance Chronic obstructive pulmonary disease Entropy Variability Oscilações Entropia Impedância (Eletricidade) Oscilações forçadas Complexidade Impedância respiratória Doença pulmonar obstrutiva crônica Entropia Variabilidade CNPQ::CIENCIAS BIOLOGICAS::FISIOLOGIA::FISIOLOGIA DE ORGAOS E SISTEMAS::FISIOLOGIA DA RESPIRACAO |
dc.subject.por.fl_str_mv |
Oscilações Entropia Impedância (Eletricidade) Oscilações forçadas Complexidade Impedância respiratória Doença pulmonar obstrutiva crônica Entropia Variabilidade |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS BIOLOGICAS::FISIOLOGIA::FISIOLOGIA DE ORGAOS E SISTEMAS::FISIOLOGIA DA RESPIRACAO |
description |
Recently there has been a growing interest in the study of nonlinear dynamics as a methodology for further analysis to characterize the respiratory system. Chronic obstructive pulmonary disease (COPD) introduces pathophysiological changes that culminate in a complex behavior that is "silent" in its initial phases. We observed the need to obtain information that is more detailed by using the Forced Oscillations Technique (FOT) for better understanding of factors that contribute to the illness. The present thesis aimed to evaluate the contribution of the FOT in assessing changes in respiratory mechanics within the ventilatory cycle in patients with COPD, including an evaluation of the complexity of the respiratory system. A total of 207 patients were evaluated in this study. In the first phase 114 subjects were included, 20 healthy volunteers (CG) and 94 with COPD. These latter, we obtained a total of 5 groups: normal to the spirometric exam (Stage 0) group with 20 subjects, the mild group (Stage I) with n=14, the moderate group (Stage II) of n=20, the severe group (Stage III) n=20 and very severe group (Stage IV) consisting of 20 patients. The parameters analyzed were average respiratory system impedance (Zm), inspiratory and expiratory impedance (Zi and Ze, respectively), the impedance at the beginning of inspiration and expiration (Zii and Zie), the peak-to-peak impedance (Zpp) and the mean change in impedance (ΔZrs). In the second phase, the complexity of the respiratory system was analyzed by the variability of airflow and Zrs (SDV and SDZrs, respectively), the sample entropy of airflow and Zrs (EnAmV' and EnAmZrs, respectively) and the entropy density of the recurrence period of airflow and ZRS (RPDEV' and RPDEZrs, respectively). At this stage, after were analyzed in 88 subjects related to the complexity of airflow analysis. A total of 72 COPD patients was divided into the following groups: G0 (n = 13), GI (n = 11), GII (n = 18), GIII (n = 16), GIV (n = 14). The GC was composed of 16 individuals. The analysis related to the complexity of Zrs involved a total of 97 individuals. A total of 74 COPD patients were divided into following groups: G0 (n = 17), GI (n = 10), GII (n = 16), GIII (n = 16), GIV (n = 15). The GC was composed of 23 healthy individuals. Respiratory impedance was higher in COPD patients compared to the CG, an increase with the progression of bronchial obstruction: Zm (p<0.0001), Zi (p<0.0001), Ze (p<0.0001), Zii (p<0.0001), Zie (p<0.0001), Zpp (p<0.0001) and ΔZrs (p<0.01). It was observed a significant increase in SDV' (p< 0.002) and SDZrs (p<0.0001) with bronchial obstruction. Moreover, the complexity of respiratory decreased, as observed in SampEnV' (p< 0.002) and RPDEZrs (p<0.0001). The SampZrs and RPDEV' parameters showed no statistically significant differences between groups. Most parameters of the Zrs had adequate values (AUC>0.8). RPDEZrs values and SDZrs showed AUC>0.80 in most of the studied groups. We concluded that individuals with COPD at different levels of bronchial obstruction have higher impedance when compared to normal individuals. Higher impedances in the expiratory phase were observed in subjects with COPD, especially in individuals with severe and very severe obstruction component. COPD introduces a loss of complexity. |
publishDate |
2014 |
dc.date.issued.fl_str_mv |
2014-02-27 |
dc.date.available.fl_str_mv |
2016-09-13 |
dc.date.accessioned.fl_str_mv |
2021-01-06T20:54:07Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
SILVA, Karla Kristine Dames da. Mecânica respiratória na doença pulmonar obstrutiva crônica: análise da complexidade e impedância ao longo do ciclo ventilatório. 2014. 132 f. Tese (Doutorado em Fisiopatologia Clínica e Experimental) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2014. |
dc.identifier.uri.fl_str_mv |
http://www.bdtd.uerj.br/handle/1/12660 |
identifier_str_mv |
SILVA, Karla Kristine Dames da. Mecânica respiratória na doença pulmonar obstrutiva crônica: análise da complexidade e impedância ao longo do ciclo ventilatório. 2014. 132 f. Tese (Doutorado em Fisiopatologia Clínica e Experimental) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2014. |
url |
http://www.bdtd.uerj.br/handle/1/12660 |
dc.language.iso.fl_str_mv |
por |
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Universidade do Estado do Rio de Janeiro |
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Programa de Pós-Graduação em Fisiopatologia Clínica e Experimental |
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UERJ |
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BR |
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Centro Biomédico::Faculdade de Ciências Médicas |
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Universidade do Estado do Rio de Janeiro |
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