O uso da Técnica de Oscilações Forçadas na análise da mecânica ventilatória de indivíduos portadores de silicose classificados em diferentes graus de obstrução

• Autor(a) principal: Peleteiro, Paula Morisco de Sá
• Data de Publicação: 2011
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/12728
• topic: Silicosis; Mechanical Ventilation; Spirometry; Forced Oscillation Technique; Silicose; Mecânica Ventilatória; Espirometria; Técnica de Oscilações Forçadas; CNPQ::CIENCIAS BIOLOGICAS::FISIOLOGIA::FISIOLOGIA DE ORGAOS E SISTEMAS::FISIOLOGIA DA RESPIRACAO

The term silicosis is the name given to the pulmonary fibrosis caused by inhalation of dust containing crystalline silica. Is a typical occupational disease, chronic, incurable, starting in the peripheral airways and that can progress independently of the end of exposure. The pulmonary function tests, although not used as a diagnostic tool for silicosis, are widely employed to follow these individuals. Recent works suggests that the Forced Oscilation Technique (FOT) may be applied in the detection of early respiratory changes in silicosis. However, few studies have been analyzing the changes on respiratory mechanics associated with silicosis through the FOT. In this context, the aims of this study were (1) to analyze changes respiratory mechanics in subjects with silicosis with different degrees of obstruction by FOT, and (2) to evaluate the potential of the FOT to detect alterations in the lung function resulting from silicosis. This is a sectional study evaluation of prevalent cases, with the evaluation unit the individual. The examinations included measurement of FOT and spirometry. Sixty-seven volunteers were analyzed: 21 healthy subjects and 46 with silicosis. Spirometry was used to classify airway obstruction in the silicosis groups. This classification resulted in three categories: normal spirometric exam (n = 12); mild obstruction (n = 22); moderate or severe obstruction (n = 12.). All subjects performed FOT exam for the analysis of resistive and reactive properties of the respiratory system. The order of the examinations was FOT, followed by spirometry. Considering the groups classified according to the spirometry, the resistive and reactive the parameters and the impedance of the respiratory system at 4Hz (|Z4Hz|), have changed significantly with the progression of obstructive. The analysis of the diagnostic power of FOT parameters R0, Rm, and Rsr4 |Z4Hz| showed to be accurate to identify the changes of respiratory mechanics in silicosis patients with mild obstructive lung disease. To the moderate and severe obstructions, all the parameters analyzed showed adequate to identify these changes. In the analysis between the control and normal exam, no parameters of the FOT showed adequate measure to use to correctly identify these subjects. The FOT parameters adequately described the pathophysiological changes associated with silicosis and presented adequate accuracy for clinical use, indicating that this technique can be helpful in the evaluation respiratory mechanics in this disease.