Relação entre alteração torácica musculoesquelética e prova de função pulmonar em lactentes nascidos prematuros e com muito baixo peso

• Autor(a) principal: Marinonio, Ana Silvia Scavacini [UNIFESP]
• Data de Publicação: 2017
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5198246; http://repositorio.unifesp.br/handle/11600/50368
• topic: Todlers; Photogrametry; Thorax; Musculoeskeletal; Premature; Lung Function; Perioperative care; Infant; Lung; Musculoskeletal system; Assistência perioperatória; Recém-nascido prematuro; Fotogrametria; Pulmão; Sistema musculoesquelético; Cirurgia Ginecologica

Preterm infants may present lung function alterations. Furthermore, studies showed thoracic musculoskeletal alterations due to respiratory pattern alterations in with very low birth weight preterm infants, especially those with bronchopulmonary dysplasia. Objective: To verify the prevalence of thoracic musculoskeletal alterations and lung function alterations and the existence of an association between both variables in toddlers from 6 months to 1 year of age born before 37 weeks of gestational age and birth weight less than or equal to 1500g. Methods: Cross-sectional study with a convenience sample of children 6-12 months of corrected age born prematurely with very low birth weight. Malformations, neurological diseases or respiratory diseases whiting the last 15 days were excluded. Pulmonary function was evaluated using the Infant Pulmonary Lab-Collins, USA, according to the American Thoracic Society techniques and measurements of thoracic angles: Acromium/manubrium/acromium (A1), Acromium/xiphoid appendix/acromium (A2), Manubrium/left acromium/trapezium (A3), Right inframamilar point/xiphoid apendix/left inframamilar point (A4), Left trapezium/acromium/left deltoid (A5) and Measure of costal retraction (Ma) by photogrammetry using the Software for postural analysis SAPO®. Univariate linear regression was used to study the association between measurements of thoracic angles and parameters of pulmonary function. Results: 38 toddlers were studied, 50% male (gestational age 29.9 ± 2.4 weeks, birth weight 1.145 ± 252 g, corrected age 8.9 ± 2.2 m, weight 7.760 ± 1.138 kg and height 68.8 ± 4.8cm). Of the 38 infants, 31.5% had pulmonary function alterations and 24% and 32% presented alterations in A3 and Ma angles. The linear regression showed significant associations between A2 and FEV0.5 <-2 z-score, between A3 and FVC <-2 z-score, between A4 and VR <80% of predicted value and FEV0.5/FVC <- 2 z-score and between A5 and VR <80% of predicted. Conclusion: Premature infants show relatively high frequency of pulmonar function and thoracic musculoskeletal alterations. The musculoskeletal alterations due to hypertrophy of the trapezium and deltoid muscles were associated to alterations of lung function, showing that the shape of the thorax might be influenced by pulmonary function.