Cibelle Andrade Lima1, Armèle de Fátima Dornelas de Andrade2, Shirley Lima Campos3, Daniella Cunha Brandão4, Guilherme Fregonezi5, Ianny Pereira Mourato6, Andrea Aliverti7, Murilo Carlos Amorim de Britto8. 1. Universidade Federal de Pernambuco - UFPE, Rua Pessoa de Melo, 333, 702, Madalena, Recife, PE 50721610, Brazil. Electronic address: cibellea@yahoo.com. 2. Universidade Federal de Pernambuco - UFPE, Departamento de Fisioterapia, Av. Jornalista Anibal Fernandes, Cidade Universitária, Recife, PE 50740-560-901, Brazil. Electronic address: armeledornelas@yahoo.com. 3. Universidade Federal de Pernambuco - UFPE, Departamento de Fisioterapia, Av. Jornalista Anibal Fernandes, Cidade Universitária, Recife, PE 50740-560-901, Brazil. Electronic address: shirleylcampos@uol.com.br. 4. Universidade Federal de Pernambuco - UFPE, Departamento de Fisioterapia, Av. Jornalista Anibal Fernandes, Cidade Universitária, Recife, PE 50740-560-901, Brazil. Electronic address: daniellacunha@hotmail.com. 5. Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Campus Universitário Lagoa Nova, Caixa Postal 1524, CEP:59072-970 Natal-RN, Brazil. Electronic address: gfregonezi@msn.com. 6. Universidade Federal de Pernambuco - UFPE, Departamento de Fisioterapia, Av. Jornalista Anibal Fernandes, Cidade Universitária, Recife, PE 50740-560-901, Brazil. Electronic address: iannymourato@hotmail.com. 7. Dipartimento di Elettronica, Informazione e Bioingegneria Politecnico di Milano, Piazza Leonardo da Vinci, 32, I-20133 Milan, Italy. Electronic address: andrea.aliverti@biomed.polimi.it. 8. Instituto Materno Infantil de Pernambuco, Rua dos Coelhos 300, Pós Graduação, Boa Vista, Mailbox: 1393, Recife, PE 50070-550, Brazil. Electronic address: murilobritto@ig.com.br.
Abstract
BACKGROUND:Dyspnea and exercise intolerance are the symptoms that most affect the quality of life of children and adolescents with respiratory disorders resulting from cystic fibrosis (CF). OBJECTIVE: To evaluate the effect of noninvasive ventilation (NIV) on treadmill 6-min walk distance and regional chest wall volumes in cystic fibrosis patients. METHOD: Crossover clinical trial, randomized, controlled and open with 13 children and adolescents with CF, aged 7-16 years, with pulmonary impairment (NTC01987271). The patients performed a treadmill walking test (TWT) during 6 min, with and without NIV on a BiLEVEL mode, an interval of 24-48 h between tests. Before and after each test, patients were assessed by spirometry and optoelectronic plethysmography. RESULTS:Walking distance in TWT with NIV was significantly higher that without ventilatory support (mean ± sd: 0.41 ± 0.08 vs. 0.39 ± 0.85 km, p = 0.039). TWT with NIV increase forced expiratory volume on 1 s (FEV1; p = 0.036), tidal volume (Vt; p = 0.005), minute ventilation (MV; p = 0.013), pulmonary rib cage volume (Vrcp; p = 0.011), and decrease the abdominal volume (Vab; p = 0.013) after test. There was a significant reduction in oxygen saturation (p = 0.018) and permanent increase in respiratory rate after 5 min (p = 0.021) after the end test without NIV. CONCLUSION: During the walking test on the treadmill, the NIV change thoracoabdominal kinematics and lung function in order to optimized ventilation and tissue oxygenation, with improvement of walk distance. Consequently, NIV is an effective tool to increase functional capacity in children and adolescents with cystic fibrosis.
RCT Entities:
BACKGROUND:Dyspnea and exercise intolerance are the symptoms that most affect the quality of life of children and adolescents with respiratory disorders resulting from cystic fibrosis (CF). OBJECTIVE: To evaluate the effect of noninvasive ventilation (NIV) on treadmill 6-min walk distance and regional chest wall volumes in cystic fibrosispatients. METHOD: Crossover clinical trial, randomized, controlled and open with 13 children and adolescents with CF, aged 7-16 years, with pulmonary impairment (NTC01987271). The patients performed a treadmill walking test (TWT) during 6 min, with and without NIV on a BiLEVEL mode, an interval of 24-48 h between tests. Before and after each test, patients were assessed by spirometry and optoelectronic plethysmography. RESULTS: Walking distance in TWT with NIV was significantly higher that without ventilatory support (mean ± sd: 0.41 ± 0.08 vs. 0.39 ± 0.85 km, p = 0.039). TWT with NIV increase forced expiratory volume on 1 s (FEV1; p = 0.036), tidal volume (Vt; p = 0.005), minute ventilation (MV; p = 0.013), pulmonary rib cage volume (Vrcp; p = 0.011), and decrease the abdominal volume (Vab; p = 0.013) after test. There was a significant reduction in oxygen saturation (p = 0.018) and permanent increase in respiratory rate after 5 min (p = 0.021) after the end test without NIV. CONCLUSION: During the walking test on the treadmill, the NIV change thoracoabdominal kinematics and lung function in order to optimized ventilation and tissue oxygenation, with improvement of walk distance. Consequently, NIV is an effective tool to increase functional capacity in children and adolescents with cystic fibrosis.
Authors: Brenda M Button; Christine Wilson; Ruth Dentice; Narelle S Cox; Anna Middleton; Esta Tannenbaum; Jennifer Bishop; Robyn Cobb; Kate Burton; Michelle Wood; Fiona Moran; Ryan Black; Summar Bowen; Rosemary Day; Julie Depiazzi; Katherine Doiron; Michael Doumit; Tiffany Dwyer; Alison Elliot; Louise Fuller; Kathleen Hall; Matthew Hutchins; Melinda Kerr; Annemarie L Lee; Christina Mans; Lauren O'Connor; Ranjana Steward; Angela Potter; Tshepo Rasekaba; Rebecca Scoones; Ben Tarrant; Nathan Ward; Samantha West; Dianne White; Lisa Wilson; Jamie Wood; Anne E Holland Journal: Respirology Date: 2016-04-18 Impact factor: 6.424