ABSTRACT
O Teste de Caminhada de 6 Minutos em Esteira (TC6E) tem sido utilizado como um dos testes de avaliação funcional em indivíduos com Doença Pulmonar Obstrutiva Crônica (DPOC). Os objetivos deste estudo foram avaliar a demanda metabólica (VO2/VO2max), ventilatória (VE /VVM), a oxigenação (SpO2) e sensação de dispnéia (SD) durante TC6E, entre indivíduos saudáveis e portadores de DPOC. Foram avaliados 22 homens; 12 com DPOC, Grupo 1 (G1) (VEF1<60% do previsto, 73,5±3,6 anos) e 10 saudáveis, Grupo 2 (G2) (63,3±5,3anos). Para análise do VO2/ VO2max e VE/VVM foi utilizado um sistema metabólico. Na análise intergrupo (Mann-Whitney; p<0,05) em relação a VO2/VO2max constatou-se diferença significativa tanto na situação basal (repouso), como durante o TC6E. Para as variáveis VE/VVM, SpO2 e SD, verificou-se esta diferença apenas na situação basal. Em relação a situação basal e o TC6E para ambos os grupos, observou-se diferença significativa (Wilcoxon, p<0,01) no que se refere a VO2/VO2max e VE/VVM. Para a oxigenação, constatou-se este comportamento apenas para o G1, e em relação a SD, para ambos os grupos. Conclui-se que houve maior demanda metabólica e ventilatória para G1 e que o TC6E caracterizou-se como uma atividade intensa para ambos os grupos; sugerindo a necessidade de melhor fundamentação da metodologia do teste.
The Six Minute Walk Test on Treadmill (6MWT) was used as the functional evaluation in individuals with Chronic Obstructive Pulmonary Disease (COPD). The objectives of this study was to evaluate the Metabolic (VO2/VO2max) and Ventilatory (VE/MVV) Demand, oxygenation and sensation of dyspnea during the 6MWT in healthy individuals and individuals with COPD. 22 males were evaluated, 12 with COPD classified as Group 1 (G1) (FEV1<60%; average age 73.5±6.3), and 10 healthy individuals (average age 63.3±5.3), classified as Group 2 (G2). For analysis between the VO2/VO2max and VE/MVV following the metabolic system. In analysis between groups (Mann-Whitney; p?0.05) in relation the VO2/VO2max there was a significant difference both in basal situation (rest), and during the 6MWT. For the variables VE/MVV, SpO2 and SD, verified difference only in basal situation. In relation to the basal situation and the 6MWT for both groups, there was a significant difference (Wilcoxon, p<0.01) on that refers to the VO2/VO2max and VE/MVV. For oxygenation, verified this behavior only for G1 and in relation to SD, for both groups. Concluded that there was more metabolic and ventilatory for G1 and the 6MWT characterizes itself as an activity of high intensity even for individuals with COPD, like healthy individuals; suggesting the necessity that methodology of this test is well grounded and studied.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Pulmonary Disease, Chronic Obstructive , Dyspnea , Walk TestABSTRACT
PURPOSE: Chronic rejection accounts for the majority of late renal graft losses and there is good evidence that both immunologic and non-immunologic factors are important in late graft loss. The hyperfiltration hypothesis postulates that kidneys with reduced renal mass will progress toward failure due to hypertrophy of the remaining nephron to meet the excess metabolic demand, eventually leading to nephron exhaustion. The impact of metabolic demand and renal mass supply on the early graft function, especially hyperfiltration phenomenon, remains uncertain. METHODS: In this study, we analyzed age, gender, body weight, height, body surface area (BSA), lean body weight (LBW), and serum creatinine (SCr) of both donors and recipients. We weighed the donated kidney and measured the recipient's SCr and LBW for six months postoperatively. Modified Cockcroft-Gault Equation standardized for BSA was used to calculate renal glomerular filtration rate (CrCl, mL/min/1.73 m2). The variables and the CrCl of the 3rd day and 6th month were analyzed with accordance to donor/recipient LBW ratio(D/R LBW) and graft weight/recipient LBW (GW/RLBW) by independent sample t-test and paired t-test using SPSS, and P1), the 3rd day and 6th month CrCl were 80.82+/-28.74 and 71.66+/-12.12, respectively. In R group (D/R LBW3), the 3rd day CrCl was 86.08+/-25.13, which was significantly decreased to 73.48+/-11.64 at the 6th month (P=0.023). In L group (GW/RLBW< or =3), the 3rd day and 6th month CrCl were 66.95+/-19.94 and 73.34+/-10.60 (P=0.158), respectively. the 3rd day CrCl of H group was higher than that of L group significantly (P=0.047), but 6th month CrCl showed no difference between the two groups (P=0.975). CONCLUSIONS: The 3rd day CrCl represents early graft function well. GW/RLBW has a strong correlation with early graft function. In L group with low early graft function, CrCl was tended to be increased to meet the metabolic demand for following the 6 months. Conversely, in H group with high early graft function, CrCl was decreased to reduce the excess graft function. So the 6th month CrCl represents adapted graft function. In this study, therefore, we postulate that the hyperfiltration or hypofiltration develops according to metabolic demand and renal mass supply.