Floor Maze Test is capable of differentiating spatial navigation between frail and pre-frail institutionalized older persons / Floor Maze Test é capaz de diferenciar a navegação espacial entre idosos institucionalizados frágeis e pré-frágeis

ABSTRACT. Investigation of the association between physical frailty and cognitive performance through spatial navigation is important to enable the identification of individuals with cognitive impairment and physical comorbidity. Objective: To analyze the association between spatial navigation and frailty in frail and pre-frail institutionalized older adults. Methods: Forty older people of both sexes, aged 60 years or over, residing in four Brazilian Long-Term Care Facilities (LTCFs) participated in this study. The following tests were applied: Mini-Mental State Examination (MMSE), 2.44m Timed Up and Go, Floor Maze Test (FMT), and Fried's frailty criteria. For data analysis, the Mann-Whitney and independent t-tests were used to compare the groups (frail x pre-frail), principal component analysis was used to explore the main variables related to the data variance, and binary logistic regression to estimate associations. Results: There was a significant difference in performance in the FMT immediate maze time (IMT) (p=0.02) and in the delayed maze time (DMT) (p=0.009) between the pre-frail and frail older adults. An association between FMT DMT performance and frailty was found, showing that older people with shorter times on the DMT (better performance) had approximately four times the chance of not being frail (odds ratio - OR=4.219, 95% confidence interval - 95%CI 1.084-16.426, p=0.038). Conclusion: Frailty is associated with impaired spatial navigation ability in institutionalized older adults, regardless of gait speed performance.

RESUMO. A investigação da associação entre fragilidade física e desempenho cognitivo por meio da navegação espacial é importante para possibilitar a identificação de indivíduos com déficit cognitivo e comorbidade física. Objetivo: Analisar a associação entre navegação espacial e fragilidade em idosos institucionalizados frágeis e pré-frágeis. Métodos: Participaram deste estudo 40 idosos de ambos os sexos, com idade igual ou superior a 60 anos, residentes em quatro instituições de longa permanência (ILPI) brasileiras. Foram aplicados os seguintes testes: Miniexame do Estado Mental (MEEM), 2,44m Timed Up and Go, Floor Maze Test (FMT) e os critérios de fragilidade de Fried. Para a análise dos dados, foram utilizados os testes t independente e de Mann-Whitney para comparar os grupos (frágeis x pré-frágeis), foi feita análise de componentes principais para explorar as principais variáveis relacionadas à variância dos dados e regressão logística binária para estimar associações. Resultados: Houve diferença significativa no desempenho do FMT no tempo imediato do labirinto (TIL) (p=0,02) e no tempo posterior do labirinto (TPL) (p=0,009) entre os idosos pré-frágeis e frágeis. Encontrou-se associação entre o desempenho no FMT TPL e fragilidade, mostrando que idosos com menor tempo de TPL (melhor desempenho) tiveram aproximadamente quatro vezes mais chance de não serem frágeis (odds ratio - OR=4,219, intervalo de confiança de 95% - IC95% 1,084-16,426, p=0,038). Conclusão: A fragilidade está associada à habilidade de navegação espacial prejudicada em idosos institucionalizados, independentemente do desempenho da velocidade da marcha.

Aplicação do IVCF-20 adaptado para o telefone como estratégia de avaliação em tempos de Covid-19 / Application of the ivcf-20 adapted for the phone as an evaluation strategy in times of Covid-19

Introdução: o risco de fragilidade em idosos é algo que deve ser monitorizado, sendo importante seu acompanhamento pelo sistema de saúde, especialmente durante uma pandemia. Objetivo: estimar o risco de fragilidade em idosos comunitários adscritos de uma Unidade Básica de Saúde (UBS) durante a pandemia de COVID-19 com a aplicação do questionário de Índice de Vulnerabilidade Clínico-Funcional-20 (IVCF-20) adaptado para telefone. Métodos: estudo transversal com 152 idosos (≥ 60 anos) de ambos os sexos, cadastrados na Estratégia em Saúde da Família referente a uma UBS na região urbana de Londrina-PR. A coleta de dados foi realizada em etapa única, durante contato telefônico, utilizando para o registro de informações o IVCF-20, sendo realizadas três tentativas de contato telefônico. Resultados: 68,4% dos idosos eram hipertensos e 24,3% diabéticos. Com relação à moradia, 94,7% dos idosos "não" moram sozinhos e 70,4% possuem uma "boa percepção de saúde". Para classificação do IVCF-20, 73,0% dos homens são classificados como "robustos", quando comparados às mulheres (51,7%). Conclusão: a aplicação do IVCF-20 por telefone apresenta capacidade de uso em momentos de risco para a saúde pública, como a pandemia de COVID-19.

Introduction: The risk of frailty in the elderly is something that must be monitored, and its monitoring by the health system is important, especially during a pandemic. Objective: to estimate the risk of frailty in community-dwelling elderly people enrolled in a Basic Health Unit (BHU) during the COVID-19 pandemic with the application of the Clinical-Functional Vulnerability Index-20 (CFVI-20) questionnaire adapted for telephone use. Methods: cross-sectional study with 152 elderly (≥ 60 years) of both sexes, registered in the Family Health Strategy referring to a BHU in the urban region of Londrina-PR. Data collection was carried out in a single step, during telephone contact, using the CFVI-20 to record information, with three telephone contact attempts being made. Results: 68.4% of the elderly were hypertensive and 24.3% diabetic. With regard to housing, 94.7% of the elderly "don't" live alone and 70.4% have a "good perception of health". For the CFVI-20 classification, 73.0% of men are classified as "robust" when compared to women (51.7%). Conclusion: the application of the CFVI-20 by telephone is capable of being used in moments of risk to public health, such as the COVID-19 pandemic.

Functionality and disease severity in spinocerebellar ataxias / Relação entre a função e a gravidade nas ataxias espinocerebelares

ABSTRACT Background: Spinocerebellar ataxias (SCAs) are a group of neurodegenerative diseases characterized by deterioration of balance and functionality that tends to follow disease progression. There is no established link between formal clinical markers for severity and functional/balance scores that could guide rehabilitation teams. Objective: To evaluate the relationship between functional scales and ataxia severity in order to identify cutoff landmarks for functional loss and estimate the mean SARA (Scale for Assessment and Rating of Ataxia) score for the risk ratings for falls on the BBS (Berg Balance Scale). Methods: Consecutive patients with a molecular diagnosis of SCA (total 89: 31 with SCA2 and 58 with SCA3) were assessed for functionality FIM-ADL (Functional Independence Measure-activities of daily living and Lawton-IADL (instrumental activities of daily living), balance (BBS) and disease severity (SARA). Results: The main disability cutoff landmarks were that the need for supervision for FIM-ADL starts with 12 points on SARA and the need for supervision for Lawton-IADL starts with 14 points on SARA. The first items to require assistance were "expression" and "shopping", respectively. At 20 points on SARA, patients were dependent on all FIM and Lawton items. The item with the greatest impact on distinguishing dependents from independents was "means of transport" in Lawton-IADL and the domain "locomotion" in FIM-ADL. The mean SARA score for patients classified as low risk in the BBS was 9.9 points, and it was 17.4 for medium risk and 25.2 for high risk. Conclusions: Analysis on the correlation between the severity of ataxia and functional scales can form an important guide for understanding the progression of functional dependence among individuals with SCAs.

RESUMO Antecedentes: As ataxias espinocerebelares (SCA) são um grupo de doenças neurodegenerativas caracterizadas pela deterioração do equilíbrio e da funcionalidade, que tende a acompanhar a progressão da doença. Não existe uma ligação estabelecida entre os marcadores clínicos formais de gravidade e escores funcionais e de equilíbrio que possam orientar as equipes de reabilitação. Objetivo: Avaliar a relação entre escalas funcionais e de gravidade da ataxia, buscando identificar pontos de corte para a perda funcional relacionados aos escores de gravidade e aos patamares de Risco de Quedas. Métodos: Uma amostra consecutiva de 89 pacientes com diagnóstico molecular de SCA (31-SCA2 e 58-SCA3) foram avaliados para funcionalidade MIF-AVDs (Medida de independência funcional-Atividades da vida diária) e Lawton-AIVDs (Atividades instrumentais da vida diária), equilíbrio (EEB-escala de Equilíbrio de Berg), e gravidade da ataxia (SARA-escala para avaliação e graduação de ataxia). Resultados: Os principais pontos de corte de deficiência foram: com 12 pontos no SARA começa a necessidade de supervisão para MIF-AVDs e com 14 pontos no SARA começa a necessidade de supervisão para Lawton-AIVDs. Os primeiros itens a necessitar de assistência foram "expressão" e "compras", respectivamente. Com 20 pontos no SARA os pacientes eram dependentes em todos os itens MIF/LAWTON. O item com maior impacto na discriminação entre dependentes e independentes foi "meio de transporte" na Lawton e o domínio "locomoção" na MIF. O escore médio no SARA foi de 9,9 pontos para pacientes classificados com baixo risco na EEB, 17,4 para médio risco e 25,2 para alto risco. Conclusões: A análise da correlação entre a gravidade da ataxia e as escalas funcionais pode ser um importante guia no entendimento da progressão da dependência funcional em indivíduos com SCA.

Cardiac autonomic modulation response and functional capacity in older women / Respuesta de la modulación autonómica cardíaca y capacidad funcional en mujeres mayores / Resposta da modulação autonômica cardíaca e capacidade funcional em mulheres idosas

ABSTRACT Objective: To analyze cardiac autonomic modulation response and functional capacity in physically active older women. Methods: Seventy-five older women (60-70 years) from the community were divided into the following groups: sedentary (n=19), hydro-gymnastics (n=18), pilates (n=19), and dance (n=19). Blood pressure, body composition, heart rate variability, and functional capacity were assessed for the characterization of the groups at rest and 48 hours after the last physical exercise session. Results: The sedentary group presented higher waist-to-hip ratio, diastolic blood pressure, and resting heart rate compared to the other groups (p<0.05). It was also observed that the dance group presented better functional capacity and VO2peak scores (all p<0.05). Regarding cardiac autonomic modulation, both dance and pilates groups demonstrated better RMSSD (26.71 ± 9.07 and 29.82 ± 7.16, respectively; p<0.05), LF (45.79 ± 14.81 and 45.95 ± 15.16 n.u., respectively; p<0.05), and LF/HF (0.92 ± 0.56 and 0.58 ± 0.26, respectively; p<0.05) scores. In the symbolic analysis, the dance group had a greater predominance of parasympathetic autonomic modulation than the other groups (p<0.05). Conclusion: These results conclude that physically active elderly women, practicing hydro-gymnastics, pilates or dance, presented physiological benefits, such as better functional capacity and improvements in hemodynamic variables and autonomic cardiac modulation. In addition, the group that practiced dance presented greater parasympathetic modulation, as well as greater functional capacity, when compared to the other modalities. Level of evidence: I; STARD: studies of diagnostic accuracy.

RESUMEN Objetivo: Analizar la respuesta de la modulación autonómica cardíaca y la capacidad funcional en mujeres mayores físicamente activas. Métodos: Setenta y cinco mujeres mayores (60 a 70 años) de la comunidad fueron divididas en los siguientes grupos: sedentaria (n = 19), hidrogimnasia (n = 18), pilates (n = 19) y danza (n = 19). La presión arterial, la composición corporal, la variabilidad de la frecuencia cardíaca y la capacidad funcional fueron evaluadas para la caracterización de los grupos en reposo y 48 horas después de la última sesión de ejercicio físico. Resultados: El grupo sedentario presentó mayor relación cintura-cadera, presión arterial diastólica y frecuencia cardíaca en reposo cuando comparado a los otros grupos (p <0,05). Se observó que el grupo de danza presentó mejores puntajes de capacidad funcional y VO2Pico (todos p <0,05). Con relación a la modulación autonómica cardíaca, los grupos de danza y pilates demostraron mejores puntajes para RMSSD (26,71 ± 9,07 y 29,82 ± 7,16, respectivamente; p <0,05), LF (45,79 ± 14,81 y 45,95 ± 15,16 nu, respectivamente; p <0,05), y LF/HF (0,92 ± 0,56 y 0,58 ± 0,26, respectivamente; p <0,05). En el análisis simbólico, el grupo de danza presentó mayor predominancia de la modulación autonómica parasimpática que los demás grupos (p <0,05). Conclusión: Esos resultados concluyen que las mujeres mayores físicamente activas, practicantes de hidrogimnasia, pilates o danza, tienen beneficios fisiológicos, como mejor capacidad funcional y mejora de las variables hemodinámicas y de la modulación cardíaca autonómica. Además, el grupo que practicaba danza tuvo mayor modulación parasimpática y mayor capacidad funcional cuando comparado con las otras modalidades. Nivel de evidencia: I; STARD: estudios de precisión diagnóstica.

RESUMO Objetivo: Analisar a resposta da modulação autonômica cardíaca e a capacidade funcional em idosas fisicamente ativas. Métodos: Setenta e cinco mulheres idosas (60 a 70 anos) da comunidade foram divididas nos seguintes grupos: sedentária (n = 19), hidroginástica (n = 18), pilates (n = 19) e dança (n = 19). A pressão arterial, a composição corporal, a variabilidade da frequência cardíaca e a capacidade funcional foram avaliadas para a caracterização dos grupos em repouso e 48 horas depois da última sessão de exercício físico. Resultados: O grupo sedentário apresentou maior relação cintura-quadril, pressão arterial diastólica e frequência cardíaca em repouso quando comparado aos outros grupos (p <0,05). Observou-se também que o grupo da dança apresentou melhores escores de capacidade funcional e VO2pico (todos p < 0,05). Com relação à modulação autonômica cardíaca, os grupos de dança e pilates demonstraram melhores escores para RMSSD (26,71 ± 9,07 e 29,82 ± 7,16, respectivamente; p < 0,05), LF (45,79 ± 14,81 e 45,95 ± 15,16 nu, respectivamente; p<0,05) e LF/HF (0,92 ± 0,56 e 0,58 ± 0,26, respectivamente; p < 0,05). Na análise simbólica, o grupo da dança apresentou maior predominância da modulação autonômica parassimpática do que os demais grupos (p < 0,05). Conclusão: Esses resultados concluem que idosas fisicamente ativas praticantes de hidroginástica, pilates ou dança, têm benefícios fisiológicos, como melhor capacidade funcional e melhora das variáveis hemodinâmicas e da modulação cardíaca autonômica. Além disso, o grupo que praticava dança teve maior modulação parassimpática e maior capacidade funcional quando comparado com outras modalidades. Nível de evidência: I; STARD: estudos de precisão diagnóstica.

Short-Term Effects of a Resistance Training Program Using Elastic Tubing in Patients with Heart Disease

Abstract Background Resistance training is effective in cardiac rehabilitation; however, it is conventionally performed using free weights or machines, which can pose logistic challenges to patients with restricted mobility. For its ease of access and cost-effectiveness, elastic tubing is a particularly appealing alternative, but it remains underutilized for this purpose. Objective To evaluate muscle strength, functional capacity, aerobic capacity, and quality of life in patients with heart disease in phase II of cardiovascular rehabilitation after a resistance training intervention based solely on elastic tubing. Methods Thirteen patients with heart disease (age 63.33±10.80 years) trained with elastic tubing twice weekly for 6 weeks, with progressive load increase every 15 days. The following muscle groups were evaluated and trained: shoulder abductors and flexors, elbow flexors, and knee flexors and extensors. Muscle strength was evaluated using a dynamometer; functional capacity, with a 6-minute walk test and cardiopulmonary exercise test; and quality of life, using the SF-36 questionnaire. Data normality was assessed using the Shapiro-Wilk test. The paired Student's t-test was used for comparisons before and after training, at a significance level of <5%. Results There were significant differences in muscle strength (except for elbow flexion) and functional capacity (485.5 ± 123.3 vs 578.7 ± 110.5; p=0.0399) after the intervention. No statistical differences were found in cardiorespiratory fitness or quality of life. Conclusions Short-term resistance training with elastic tubing improved peripheral muscle strength and functional capacity in patients with heart disease, and should be encouraged for this population. (Int J Cardiovasc Sci. 2020; xx(x):xxx-xxx)

Larger Tidal Volumes On Carbon Dioxide Elimination And Oxygen Saturations In Normal Or Overweight Patients

Obesity poses particular challenges to adequate mechanical ventilation in addition to surgical constraints, primarily by restricted lung mechanics due to excessive adiposity, frequent respiratory comorbidities (i.e. sleep apnea, asthma), and concerns of postoperative respiratory depression and other pulmonary complications. Patients with known pulmonary or cardiovascular disease were excluded. The investigations included ASAphysical status 1 or 2 patients, scheduled for abdominal surgery. Patients were considered for inclusion in the trial if they were over 18 yr age. Ventilation with larger tidal volumes with isocapnia maintained with added apparatus dead space increases the tension of oxygen and sevoflurane in arterial blood in overweight patients. Further studies are needed to better define optimum protective ventilation strategies and analyze their impact on the perioperative outcomes of surgical patients with obesity.

Relación de los índices de masa corporal y cintura-cadera con la capacidad residual funcional pulmonar en niños chilenos obesos versus normopeso: un estudio transversal / Relation among body mass index, waist-hip ratio, and pulmonary functional residual capacity in normal weight versus obese Chilean children: A cross-sectional study

Introducción. La obesidad está asociada a un descenso acelerado de la función ventilatoria. Las formas más frecuentes de evaluar el estado nutricional y medir la grasa abdominal y las caderas son el índice de masa corporal (IMC) y el índice cintura-cadera (ICC). Existe escasa evidencia que sugiera su relación con la capacidad residual funcional (CRF). Nuestro objetivo fue determinar la relación entre el IMC, el ICC y la CRF en niños obesos de la ciudad de Talca, Chile. Población y métodos. Se reclutaron niños de ambos sexos (6-12 años). Se evaluaron peso, talla, IMC, ICC y función pulmonar a través de pletismografía corporal. Dependiendo de la distribución de los datos, se utilizó la prueba t de Student o U de Mann-Whitney para muestras independientes y, la prueba r de Pearson o Spearman para establecer la correlación entre ICC y CRF. Resultados. Los niños se dividieron en normopeso (n= 18) y obesos (n= 18). Se reportó una disminución significativa de la CRF (p= 0,025) en niños obesos y una relación inversa entre ICC y CRF, la cual fue moderada en niños normopeso (s= -0,489; p= 0,03) y alta en obesos (r= -0,681; p= 0,001). Conclusiones. Los niños obesos mostraron una menor CRF respecto de los normopeso, que, a su vez, se relacionó con el ICC. Estos resultados indican efectos sistémicos que produce la obesidad en la función ventilatoria en niños y la necesidad de incorporar indicadores de distribución de grasa corporal a temprana edad.

Introduction. Obesity is associated with a rapid decrease in ventilatory function. The most common way of assessing nutritional status and measuring abdominal fat and hips are the body mass index (BMI) and the waist-hip ratio (WHR). There is scarce evidence suggesting their relation to functional residual capacity (FRC). Our objective was to determine the relation among BMI, WHR, and FRC in obese children in the city of Talca, Chile. Population and methods. Male and female children were recruited (6-12 years). Weight, height, BMI, WHR, and pulmonary function were assessed; the latter with body plethysmography. Depending on data distribution, Student's t test or the Mann-Whitney U test were used for independent samples, while Pearson's or Spearman's r test was used to establish the correlation between WHR and FRC. Results. Children were divided into normal weight (n = 18) and obese (n = 18). A significant reduction in FRC (p = 0.025) was reported in obese children, while a reverse association was observed between WHR and FRC, which was moderate in normal weight children (s = -0.489; p = 0.03) and high in obese children (r = -0.681; p = 0.001). Conclusions. Obese children showed a lower FRC compared to normal weight children, which, in turn, was associated with WHR. These results are indicative of the systemic effects caused by obesity on children's ventilatory function and the need to use body fat distribution indicators at an early age.

Functional residual capacity in healthy infants aged 1-24 months using the baby body plethysmography (Carefusion TM)

BACKGROUND@#The only lung volume that can be measured reliably in infants is the functional residual capacity (FRC). Published reference values vary, thus, there is a need to determine values for healthy infants using the available equipment.@*OBJECTIVES@#To determine the normal values of FRC in healthy infants using the baby body plethysmogram (CareFusion) and to determine the correlation between FRC and weight, length, age, and gender.@*METHODS@#FRC was measured using the CareFusion MasterScreen baby body plethysmogram in 62 healthy infants aged 1-24 months old. FRC was measured after sedation with Chloral hydrate at 50 mg/kg body weight. Three measurements were performed from which the mean (SD) FRC was calculated. To depict the change in FRC with growth, regression analysis between FRC as dependent variable and weight, length, and age as independent variables was done.@*CONCLUSION@#The FRC values obtained in this study is 24.56 ml/kg (4.41). There is a direct correlation of FRC with age, weight, and length. The result of this study was comparable to other studies and may be used as a reference value for healthy infants.

Use Of Early Labour Room Bubble Cpap In Preterms Born At 28-32 Weeks Of Gestation

Objective: To study the use of early labour room Bubble CPAP in preterm neonates born at 28–32 weeks of gestation and to analyse the outcome in relation to need for mechanical ventilation, duration of hospital stay and mortality at the Neonatal Intensive Care Unit (NICU), Tertiary Care Teaching Government Hospital Kurnool, Andhra Pradesh for a period of 1 Year. Methods : Facility Based Interventional Studied (Randomised Control Study) Participants : Study sample of 109 preterm babies of age 28–32 weeks of gestation Cases : 54 cases, neonates with respiratory distress who were started on CPAP in the labour room within 15 minutes of life. Controls : 55 babies, neonates with respiratory distress who were started on CPAP after 15 minutes to 6 hours of life. In the present study, both the groups(cases and controls) were monitored till they were discharged and the need for mechanical ventilation was noted. Clinical diagnosis of RDS was made based on the time of onset of respiratory distress and clinical examination and respiratory scoring(Silverman Anderson Score) . Chest X–ray and routine investigations were done in all neonates. Duration of CPAP and difference in mortality between the two groups was analysed. Outcome : In the present study, preterm neonates born at 28–32 weeks of gestation who were started on early labour room CPAP vs control group outcome is assessed in relation to need for mechanical ventilation and duration of hospital stay and mortality. Results: It is observed that 16 (29.63%) cases required mechanical ventilation whereas 28 (50.91%) preterm neonatesin the control group needed mechanical ventilation. There was a statistically significant difference between the two groups (p < 0.05). The duration of stay in NICU in neonates with early CPAP was significantly less when compared to the controlled group. 30(76.9%) neonates were discharged within 14 days among cases and 16 (48.48%) neonates among control group. There is no difference in mortality between the 2 groups. Conclusions : The following conclusions could be drawn out of the present study on preterm neonates. 1. The early administration of CPAP in the delivery room in preterm neonates developing respiratory distress decreases the need for mechanical ventilation. 2. The duration of stay in NICU in neonates with early CPAP was significantly less. 3. There is no difference in mortality between the two groups.

Experimental research on the effect of functional residual capacity on the deposition of inhalable particles in human alveoli region / 生物医学工程学杂志

Research on the deposition of inhalable particles in the alveoli of the lungs is important to the causes, development for common respiratory diseases such as emphysema, and even the optimization of clinical treatment and prevention programs of them. In this paper, an experimental model was established to simulate the deposition of terminal bronchioles and pulmonary acinus particles. The deposition rate of inhalable particles with different particle sizes in the pulmonary acinus was studied under different functional residual capacity. The results showed that the particle diameter was an important factor affecting the deposition of particles in the lung alveoli. Particles with 1 μm diameter had the highest deposition rate. With the functional residual capacity increasing, particulate deposition rate significantly reduced. The results of this study may provide data support and optimization strategy for target inhalation therapy of respiratory diseases such as emphysema and pneumoconiosis. The established model may also provide a feasible experimental model for studying the deposition of inhalable particles in the pulmonary alveoli.

Differential diagnostic values of functional residual capacity plethysmograph for infant bronchial foreign body and bronchiolitis / 国际儿科学杂志

Objective To investigate the lung function data from infants of bronchial foreign body and bronchiolitis,and to explore the diagnostic values of functional residual capacity plethysmograph(FRCp) in the two diseases.Methods During January 2016 to January 2018,forty-six infants diagnosed with bronchial foreign body were selected as subjects.As well as 50 children diagnosed with bronchiolitis were selected as control group.All of the children had completed tidal breath pulmonary function test,lung compliance measurements using interrupter technique and plethysmographic measurements of FRCp.The differential diagnostic values of FRCp for the two diseases were analyzed with the receiver operating characteristic curve.Results In the bronchial foreign body group,respiratory rate (RR) was 31 ± 7 times per minute,VT/kg was 7.7 ± 1.5ml/kg,TPTEF/TE was 24.3 (9.4％,VPEF/VE was 26.1％ ± 7.6％,Ti/Te was 0.66 ± 0.10,and FRCp was 280.6(208.4 ～ 396.1) ml.In bronchial foreign body infants,FRCp was obviously higher than that in control group (P ＜0.01),RR was higher than that in control group(P ＜0.05).There were no significant differences found in other indicators between the two groups.The optimal cut-off value of FRCp was 202.95 ml for the differentiation between the two groups,with a sensitivity of 85％ and a specificity of 54％.Conclusion Most bronchial foreign body infants have obstructive ventilation dysfunction with elevated FRCp.FRCp in bronchial foreign body infants were obviously higher than that in bronchiolitis infants.Measurements of FRCp may be useful in the differential diagnosis of infant bronchial foreign body and bronchiolitis.

Functional residual capacity increase during laparoscopic surgery with abdominal wall lift / Aumento da capacidade residual funcional durante cirurgia laparoscópica com elevação da parede abdominal

Abstract Background and objectives: The number of laparoscopic surgeries performed is increasing every year and in most cases the pneumoperitoneum method is used. One alternative is the abdominal wall lifting method and this study was undertaken to evaluate changes of functional residual capacity during the abdominal wall lift procedure. Methods: From January to April 2013, 20 patients underwent laparoscopic cholecystectomy at a single institution. All patients were anesthetized using propofol, remifentanil and rocuronium. FRC was measured automatically by Engstrom Carestation before the abdominal wall lift and again 15 minutes after the start of the procedure. Results: After abdominal wall lift, there was a significant increase in functional residual capacity values (before abdominal wall lift 1.48 × 103 mL, after abdominal wall lift 1.64 × 103 mL) (p < 0.0001). No complications such as desaturation were observed in any patient during this study. Conclusions: Laparoscopic surgery with abdominal wall lift may be appropriate for patients who have risk factors such as obesity and respiratory disease.

Resumo Justificativa e objetivos: O número de cirurgias laparoscópicas feitas tem aumentado a cada ano e, na maioria dos casos, o método com pneumoperitônio é o escolhido. Uma opção é o método de elevação da parede abdominal. Este estudo foi feito para avaliar as alterações da capacidade residual funcional durante o procedimento de elevação da parede abdominal. Métodos: De janeiro a abril de 2013, 20 pacientes foram submetidos à colecistectomia laparoscópica em uma única instituição. Todos foram anestesiados com propofol, remifentanil e rocurônio. A CRF foi medida automaticamente com o Engström Carestation antes da elevação da parede abdominal e, novamente, 15 minutos após o início do procedimento. Resultados: Após elevar a parede abdominal, um aumento significativo foi observado nos valores da capacidade residual funcional (antes da elevação da parede abdominal: 1,48 × 103 mL: após a elevação da parede abdominal: 1,64 × 103 mL) (p <0,0001). Não houve complicações, como dessaturação, em nenhum paciente durante este estudo. Conclusões: A cirurgia laparoscópica com elevador da parede abdominal pode ser apropriada para pacientes com fatores de risco como obesidade e doenças respiratórias.

Monitorización de la capacidad residual funcional en pacientes con síndrome de dificultad respiratoria aguda grave. Presentación de un caso y revisión de la literatura / Monitoring of residual functional capacity in patients with severe acute respiratory distress syndrome. Case report and review of the literature / Monitorização da capacidade residual funcional em pacientes com SDRA grave. Apresentação de um caso e revisão da literatura

Resumen: Se presenta el caso de un paciente masculino en la quinta década de vida con diagnóstico de tumoración renal. Fue ingresado a cirugía para embolización selectiva de arteria renal ipsilateral al sitio de la lesión tumoral. Durante el periodo transoperatorio se presentó hemorragia masiva, por lo cual recibió múltiples transfusiones y se ingresó al área de terapia intensiva. Se documentó lesión renal aguda (AKIN III) y desarrollo de síndrome de dificultad respiratoria aguda (SDRA) grave de acuerdo con los Criterios de Berlín 2012. Se propusieron métodos no convencionales de ventilación entre los cuales la ventilación mecánica inversa, ventilación con liberación de presión (APRV)/bilateral y ventilación controlada a volumen y regulada a presión (PRVC) no mostraron mejoría. Se decidió cambio de estrategia a reclutamiento guiado por la capacidad residual funcional (CRF). Se observó una mejoría en los parámetros de ventilación y niveles de fracción de oxígeno inspirado (FiO2) y evolución grave con desarrollo de pancreatitis y sangrado que requirió intervención quirúrgica con posterior deceso del paciente. Se realiza presentación del caso así como de la revisión de la literatura para maniobras de reclutamiento guiado por CRF.

Abstract: We report the case of a male patient of the 5th decade of life with a diagnosis of renal tumor. Is entered surgery for selective embolization of renal artery ipsilateral to the site of the tumor lesion. During Trans operative, presented massive bleeding, receiving multiple transfusions, requiring admission to intensive care unit. Acute kidney injury (AKIN III) was documented, severe acute respiratory distress syndrome (ARDS) development according to criteria of Berlin 2012. Unconventional modes of ventilation among which were reverse ventilation, bi-level (APRV) and PRVC were used without improvement. It was decided to change recruitment strategy led by FRC in view, with improved ventilation parameters and levels of FiO2. Poor outcome with subsequent development of pancreatitis and bleeding requiring reoperation with subsequent death of the patient. Case presentation and review of the literature for recruitment maneuvers guided by FRC in view is performed.

Resumo: Apresenta-se o caso de um paciente do sexo masculino na quinta década de vida com um diagnóstico de tumor renal. É admitido a cirurgia para embolização seletiva da artéria renal ipsilateral no local da lesão tumoral. Durante o período transoperatório, apresenta uma hemorragia profusa, pelo que recebeu múltiplas transfusões, e foi admitido na unidade de terapia intensiva. Documenta-se insuficiência renal aguda (AKI lll) e o desenvolvimento de SDRA grave de acordo com critérios de Berlim 2012. Proporciona-se métodos não convencionais de ventilação, entre os quais estavam a ventilação mecânica inversa, ventilação com liberação de pressão (APRV)/bilateral e ventilação controlada a volume e regulada para pressão (PRVC) sem melhoria. Determina-se a mudança de estratégia de recrutamento guiado pela capacidade residual funcional (CRF). Apresenta uma melhoria nos parâmetros de ventilação e níveis da fração de oxigênio inspirado (FiO2). Evolução grave com subsequente desenvolvimento de pancreatite e sangrando, necessitou de intervenção cirurgica, com posterior morte do paciente. É feita apresentação do caso, bem como a revisão da literatura para manobras de recrutamento guiado pelo CRF.

Advances of infant body plethysmography / 国际儿科学杂志

Recently,commercialized infant body plethysmography has been widely used in clinic and re-search,especially with the publication of recommendation for this equipment and methodology. As the most valu-able equipment in measuring airway resistance and lung volume,infant body plethysmography can show series of valuable data on lung function,which is important in assessing pulmonary growth and development,evaluating respiratory mechanics and helping diagnose disease. However,the application of infant body plethysmography in clinic and physiology measurements is still limited by the effectivity of this equipment and appropriate reference values. This review is to introduce body plethysmography in infants,describe frequently-used data of lung func-tion,and discuss its potential clinical significance and availability of reference values.

Estado nutricional e capacidade funcional na úlcera por pressão em pacientes hospitalizados / Nutritional status and functional capacity predispose hospitalized patients to pressure ulcers

OBJETIVO: Correlacionar a incidência de úlcera por pressão com o estado nutricional e a capacidade funcional de pacientes internados. MÉTODOS: Estudo de corte transversal realizado em dois hospitais, totalizando 130 pacientes (idade mediana = 52 (14-85) anos, 77 (59,2 por cento) homens e 53 (40,8 por cento) mulheres), sendo 72 (55,4 por cento) internados para tratamento clínico, 40 (30,8 por cento) para tratamento cirúrgico e 18 (13,8 por cento) em terapia intensiva. Os pacientes foram avaliados pela avaliação subjetiva global e classificados, de acordo com sua capacidade funcional, em acamados e não acamados. Registrou-se a presença e número de úlceras, e sua gravidade. A classificação das úlceras foi estabelecida como grave, para lesões de 3º e 4º graus, e leve, para os graus 1 e 2. RESULTADOS: A incidência de úlcera por pressão na população estudada foi de 19,2 por cento (n=25). Não houve associação significativa com o sexo, a idade e tipo de tratamento do paciente. Os pacientes acamados apresentaram 7,5 vezes mais chance de apresentar úlceras (19/50; 38,0 por cento) do que os que deambulavam (6/80; 7,5 por cento; OR=7,5; IC95 por cento: 2,7-20,7; p<0,001). A incidência de úlcera nos pacientes gravemente desnutridos (20/49; 40,8 por cento) foi 10 vezes maior que nos pacientes considerados não gravemente desnutridos (5/81; 6,1 por cento; OR=10,4 IC95 por cento: 3,6-30,5; p<0,0001) Pela análise multivariada, tanto a capacidade funcional (acamado, OR=9,2; IC95 por cento: 2,8-30,1; p<0,001) quanto o estado nutricional (desnutrido grave, OR=3,8; IC95 por cento: 1,0-13,9; p=0,04) associaram-se com a úlcera por pressão. CONCLUSÃO: A incidência de úlcera por pressão está diretamente correlacionada com a desnutrição e com a restrição ao leito dos pacientes internados.

OBJECTIVE: This study investigated if pressure ulcer correlated with the nutritional status and functional capacity of hospitalized patients. METHODS: This cross-sectional study included 130 patients of two hospitals, 77 (59.2 percent) men and 53 (40.8 percent) women. The median age of the sample was 52 (14-85) years. Seventy-two (55.4 percent) patients were hospitalized for clinical treatment, 40 (30.8 percent) for surgical treatment and 18 (13.8 percent) for intensive care. Nutritional status was determined by subjective global assessment. The patients were then classified according to their functional capacity as bedridden or not. The number and severity of pressure ulcers was recorded. Grades 3 and 4 pressure ulcer were considered severe and grades 1 and 2 were considered mild. RESULTS: The incidence of pressure ulcers in the studied population was 19.2 percent (n=25). Pressure ulcer were not associated with gender, age and type of treatment. Bedridden patients were 7.5 times more likely to have pressure ulcer (19/50; 38.0 percent) than those who could walk (6/80; 7.5 percent; OR=7.5; CI95 percent: 2.7-20.7; p<0.001). The incidence of pressure ulcers in severely malnourished patients (20/49; 40.8 percent) was 10 times greater than that of better nourished patients (5/81; 6.1 percent; OR=10.4 CI95 percent: 3.6-30.5; p<0.0001). According to multivariate analysis, both functional capacity (bedridden, OR=9.2; CI95 percent: 2.8-30.1; p<0.001) and nutritional status (severe malnutrition, OR=3.8; CI95 percent: 1.0-13.9; p=0.04) are associated with pressure ulcer. CONCLUSION: Pressure ulcers correlate directly with malnutrition and bedridden status in hospitalized patients.

Prueba de caminata en seis minutos en sujetos chilenos sanos de 20 a 80 años / Reference values for the 6-minutes walking test in healthy subjects 20-80 years old

Background: The six minute walking distance test (6MWD) is widely used to evaluate exercise capacity in several diseases due to its simplicity and low cost. Aim: To establish reference values for 6MWD in healthy Chilean individuals. Material and methods: We studied 175 healthy volunteers aged 20-80 years (98 women) with normal spirometry and without history of respiratory, cardiovascular or other diseases that could impair walking capacity. The test was performed twice with an interval of 30 min. Heart rate, arterial oxygen saturation (with a pulse oxymeter) and dyspnea were measured before and after the test. Results: Walking distance was 576 ± 87 m in women and 644 ± 84 m in men (p < 0.0001). For each sex, a model including age, height and weight produced 6MWD prediction equations with a coefficient of determination (R²) of 0.63 for women and 0.55 for men. Conclusions: Our results provide reference equations for 6MWD that are valid for healthy subjects between 20 and 80 years old.

El sildenafil mejora la capacidad de ejercicio en pacientes con insuficiencia cardíaca crónica / Sildenafil Improves Exercise Capacity in Patients with Chronic Heart Failure

Antecedentes Los agentes inhibidores de la fosfodiesterasa 5, como el sildenafil, son vasodilatadores moderados ampliamente utilizados para el tratamiento de la disfunción eréctil. En la actualidad, la evidencia disponible establece su potencial aplicación en otras patologías, como la hipertensión pulmonar, la disfunción endotelial y la insuficiencia cardíaca crónica. Objetivo El presente estudio fue diseñado para comprobar si la administración de sildenafil en pacientes con insuficiencia cardíaca crónica en clase funcional II-III mejora la capacidad de ejercicio en comparación con placebo. Material y métodos Se seleccionaron en forma aleatoria 70 pacientes portadores de insuficiencia cardíaca crónica de cualquier etiología, excepto valvulares, todos con tratamiento óptimo. Para su inclusión en el estudio, los pacientes debían tener un diámetro diastólico ventricular izquierdo > 55 mm, una fracción de eyección < 35% y una presión arterial sistólica > 90 mm Hg. Se excluyeron los que se encontraban anémicos, aquellos con indicación de cirugía por cualquier causa o los que por diversos motivos no pudieran realizar una caminata de seis minutos. Luego de una caminata de seis minutos fueron aleatorizados para recibir 50 mg de sildenafil o placebo, conformándose dos grupos, placebo y sildenafil, ambos con 35 participantes. Luego de 1 hora de la ingestión de las drogas se realizó una nueva caminata de seis minutos. Antes y después de cada caminata se controlaron las siguientes variables: presión arterial sistólica, diastólica y frecuencia cardíaca; se registraron también los metros caminados en cada prueba. Resultados Características generales, grupo placebo versus grupo sildenafil: hombres: 74% vs 88%, etiología isquémico-necrótica: 71% vs 77%, clase funcional II: 37% vs 34%, clase funcional III: 63% vs 66%, edad: 68 ± 10 vs 68 ± 12 años, fracción de eyección: 26,5% ± 7,8% vs 26,5% ± 6,5%, diámetro diastólico ventricular izquierdo: 65 ± 6 vs 66 ± 9 mm (todas p = ns). Las variables del grupo placebo versus sildenafil antes de la primera caminata fueron: presión arterial sistólica: 115 ± 15 vs 115 ± 21 mm Hg y diastólica: 71 ± 10,5 vs 68 ± 13 mm Hg (ambas p = ns) y frecuencia cardíaca: 74 ± 13 vs 64 ± 6 (p < 0,001). Luego de la primera caminata y antes de la administración de las drogas: presión arterial sistólica: 126 ± 20 vs 133 ± 26 mm Hg, diastólica: 68 ± 11 vs 72 ± 15 mm Hg y frecuencia cardíaca 84 ± 2 vs 80 ± 9 (todas p = ns). Antes de la segunda caminata y luego de la administración de las drogas, grupo placebo versus sildenafil: presión arterial sistólica: 112 ± 14 vs 95 ± 18 mm Hg, diastólica: 69 ± 8 vs 57 ± 12 mm Hg (ambas p < 0,001) y frecuencia cardíaca: 73 ± 11 vs 75 ± 10 (p = ns). Finalmente, luego de la segunda caminata, presión arterial sistólica: 123 ± 17 vs 115 ± 26 mm Hg (p < 0,05), diastólica: 65 ± 7 vs 60 ± 12 mm Hg (p < 0,02) y frecuencia cardíaca: 84 ± 13 vs 86 ± 12 (p = ns). Cuatro pacientes (11%) en el grupo sildenafil presentaron cefalea y ninguno en el grupo placebo. No se registraron eventos mayores. El grupo sildenafil caminó 222 ± 69 metros antes y 313 ± 76 luego de la administración de la droga; la diferencia en metros fue de 91 ± 19. El grupo placebo caminó 233 ± 67 metros antes y 242 ± 67 luego de la administración de la droga; la diferencia en metros fue de 9 ± 5. Al comparar estos resultados, la diferencia en metros recorridos resultó significativa a favor del grupo sildenafil: 91 ± 19 vs 9 ± 5 (p < 0,0001). Conclusiones En pacientes con insuficiencia cardíaca en clase funcional II-III bajo tratamiento óptimo, el sildenafil mejoró la capacidad de ejercicio en comparación con placebo.

Background Phosphodiesterase type 5 inhibitors, as sildenafil, are moderate vasodilators widely used for erectile dysfunction. The evidence currently available establishes that they are potentially useful to treat other conditions like pulmonary hypertension, endothelial dysfunction and chronic heart failure. Objective To evaluate whether sildenafil is useful to improve exercise capacity compared to placebo in patients with chronic heart failure in functional class II-III. Material and Methods A total of 70 patients with chronic heart failure of any etiology, excluding valvular heart disease, were randomly selected. All patients were receiving optimal medical treatment. Patients were included if they had a left ventricular-diastolic diameter of 55 mm, an ejection fraction <35% systolic blood pressure >90 mm Hg. Patients with anemia, an indication of surgery due to any cause, and those unable to undergo a 6-minute walk test were excluded from the study. After the 6-minute walk test, the patients were randomly assigned to receive 50 mg of sildenafil (sildenafil group) or placebo (placebo group); each group had 35 patients. A second 6-minute walk test was performed 1 hour after the drug was administered. The following variables were evaluated before and after each test: systolic blood pressure, heart rate and the distance walked in meters in each test. Results General characteristic, placebo group versus sildenafil group: men: 74% vs. 88%, ischemic dilated cardiomyopathy: 71% vs. 77%, functional class II: 37% vs. 34%, functional class III: 63% vs. 66%, age: 68±10 vs. 68±12 years, ejection fraction: 26.5%±7.8% vs. 26.5%±6.5%, left ventricular end-diastolic diameter: 65±6 vs. 66±9 mm (all p = ns). Before the fírst 6-minute walk test, the following variables were measured in the placebo versus the sildenafil group: systolic blood pressure: 115±15 vs. 115±21 mm Hg; diastolic blood pressure: 71±10.5 vs. 68±13 mm Hg (both p = ns); heart rate: 74±13 vs. 64±6 (p <0.001). After the first test and before drug administration: systolic blood pressure: 126±20 vs. 133±26 mm Hg, diastolic blood pressure: 68±11 vs. 72±15 mm Hg; heart rate 84±2 vs. 80±9 (all p = ns). Before the second test and after drug administration, placebo versus sildenafil: systolic blood pressure: 112±14 vs. 95±18 mm Hg; diastolic blood pressure: 69±8 vs. 57±12 mm Hg (both p <0.001); heart rate: 73±llvs. 75±10 (p = ns). Finally after the second walk test: systolic blood pressure: 123±17 vs. 115±26 mm Hg (p <0.05), diastolic blood pressure: 65±7 vs. 60±12 mm Hg (p <0.02) and heart rate: 84±13 vs. 86±12 (p = ns). The incidence of headache was 11% (4 patients) in the sildenafil group and 0% in the placebo group. No major events were reported. The sildenafil group walked 222±69 and 313±76 meters before and after drug administration, respectively; the difference was 91±19 meters. The placebo group walked 233±67 and 242±67 meters before and after drug administration, respectively; the difference was 9±5 meters. The difference in the distance walked was greater in the sildenafil group: 91±19 vs. 9±5 (p <0.0001). Conclusions In patients with heart failure in functional class II-III under optimal medical therapy, sildenafil improved exercise capacity compared to placebo.

Alterações na capacidade funcional de pacientes após dois anos da cirurgia de revascularização do miocárdio / Changes in functional capacity of patients two years after coronary artery bypass grafting surgery

OBJETIVO: Verificar alterações na capacidade funcional dos pacientes que se submetem à cirurgia de revascularização do miocárdio (CRM) por meio do teste de caminhada de seis minutos (TC6) no seguimento de dois anos. MÉTODOS: Estudo de coorte prospectivo, no qual foram arrolados 215 pacientes submetidos a CRM, 13 não preencheram os critérios de inclusão. Foram 202 pacientes avaliados no pré-operatório, 13 morreram no período da internação e seis no seguimento de dois anos. Quatro pacientes foram considerados perdas de seguimento. Foram acompanhados 179 pacientes no período de 2 anos, classificados em ativos e sedentários, conforme a prática de atividade física no tempo livre e submetidos ao TC6 no préoperatório e 2 anos depois. RESULTADOS: Dos 202 pacientes avaliados no pré-operatório da CRM, 67 por cento eram do sexo masculino, com idade média de 63 (± 9,75) anos. Pré e após 2 anos da CRM, 52 pacientes se mantiveram ativos e as distâncias caminhadas foram 359m (± 164,47) e 439m (± 171,34), respectivamente, P= 0,016. A distância caminhada no pré e pós-operatório, dos 45 pacientes que permaneceram sedentários, foi, respectivamente, 255m (± 172,15) e 376m (± 210,92) P<0,001. Oitenta e dois pacientes transitaram entre estes dois grupos, 71 passaram de sedentários para ativos e caminharam 289m (± 157,15) no pré e 380m (± 125,44) no pós-operatório, P= 0,001; os 11 pacientes que eram ativos e passaram a sedentários caminharam no pré 221m (± 191,91) e, no pós-operatório, 384m (± 63,73) P= 0,007. CONCLUSÃO: A capacidade funcional dos pacientes submetidos à CRM melhorou de forma importante no seguimento de médio prazo.

OBJECTIVE: To check changes in the functional capacity of patients undergoing coronary artery bypass grafting (CABG) by testing six-minute walk test (6MWT) following two years. METHODS: A prospective cohort study where 215 patients were enrolled who underwent CABG, 13 did not meet the criteria for inclusion. 202 patients were evaluated preoperatively, 13 died during hospitalization and 6 in the follow up of two years. Four patients were considered lost follow up. This study followed 179 patients for two years classified into active and sedentary, according to physical activity in leisure time and to the 6MWT preoperatively and 2 years later. RESULTS: One hundred and twenty patients were evaluated in the day before CABGS, being 67 percent male with an average age of 63 (± 9.75) years. Before surgery and 2 years later, 52 were active and the 6MWT distances performed had been 359m (± 164.47) and 439m (± 171.34), respectively; P= 0.016. Forty five patients were classified as sedentary before and 2 years after surgery. The 6MWT distances walked before and after surgery had been 255m (± 172.15) and 376m (± 210.92), respectively; P < 0.001. Eighty two patients transited between these two groups, 71 passed from sedentary to active and had walked before and after surgery 289m (± 157.15) and 380m (± 125.44), respectively; P= 0.001. The 11 patients who were active and passed to the sedentary group walked 221m (± 191.91) and 384m (± 63.73), respectively; P= 0.007. CONCLUSION: The functional capacity of the patients submitted to CABGS had a significant improvement in a medium period of follow-up.

Utility of Infant Pulmonary Function Test in Bronchopulmonary Dysplasia / 소아알레르기및호흡기학회지

PURPOSE: Pulmonary function is decreased in varying degrees in healthy premature infants as well as those with bronchopulmonary dysplasia. The evaluation of pulmonary function in infants is finally standardized after strenuous efforts, but it has not yet been in Korea. In this study, we aimed at the evaluation of the utility of pulmonary function tests in premature infants with chronic lung disease by objectively measuring pulmonary function and by analyzing the risk factors that may decrease lung function. METHODS: Fifty-four premature infants born in Severance Hospital were selected. Among the 54 infants, 31 were male and 23 were female, and their mean age was 5.6+/-3.7 years. Exhalyser was used to measure tidal volume and functional residual capacity, and then their change after the inhalation of bronchodilators was evaluated. There was no test related complication in all subjects. RESULTS: Among the 54 subjects, 22 were at the gestational age of <28 weeks, 25 were at the gestational age between 28 and 33 weeks, and 7 were at the gestational age between 33 and 37 weeks. As for birth weight, 23 had extreme low birth weight, 23 had very low birth weight, and 8 had low birth weight. The delta functional residual capacities (FRCs) before and after the inhalation of bronchodilator were significantly increased in infants with younger gestational age (P<0.05) and lower birth weight (P<0.05). There was a significant negative correlation between gestational age and birth weight, and a significant positive correlation with the duration of ventilator care and that of oxygen therapy. The delta FRC before the inhalation of bronchodilator was significantly lower in infants with lower birth weight, and the tidal volume before the inhalation of bronchodilator correlated negatively with the duration of ventilator care. CONCLUSION: The reversibility of FRC is increased in premature infants with lower birth weight, younger gestational age, and longer duration of ventilator care and oxygen therapy. The reversibility of FRC may be a useful parameter of pulmonary function that can be safely measured in premature infants with chronic lung disease.

Transplante hepático: repercussões na capacidade pulmonar, condição funcional e qualidade de vida / Liver transplantation: effects in pulmonary capacity, functional condition and quality of life

RACIONAL: O transplante hepático é utilizado para o tratamento de doenças hepáticas em estado avançado, quando a sobrevida e a função hepática são aumentadas após o procedimento. OBJETIVO: Avaliar e comparar a função pulmonar, a condição funcional e a qualidade de vida de pacientes candidatos ao transplante hepático e após a realização do procedimento cirúrgico no período de 1, 3, 6, 9 e 12 meses de pós-operatório. MÉTODOS: Trabalho transversal, observacional, com amostra de conveniência, composta por 30 pacientes, divididos em seis grupos (com cinco indivíduos em cada grupo), nos seguintes tempos: pré-transplante, 1, 3, 6, 9 e 12 meses de pós-operatório. Todos os indivíduos foram avaliados em um único momento, quando foram mensurados a capacidade vital forçada, o volume expiratório forçado no primeiro segundo, as pressões inspiratória e expiratória máxima, a distância percorrida no teste de caminhada de 6 minutos e os domínios relacionados à qualidade de vida através do questionário de qualidade de vida auto-aplicativo "Short Form 36". RESULTADOS: Houve melhora em todas as variáveis ao comparar o período pré-transplante com os consecutivos meses de pós-operatório, onde a pressão inspiratória máxima, a distância percorrida e o domínio da capacidade funcional apresentaram mudanças estatisticamente significantes. CONCLUSÃO: O transplante hepático é uma alternativa para o tratamento das doenças hepáticas avançadas e proporciona aos pacientes benefícios nas condições respiratórias e funcionais, contribuindo para melhora da qualidade de vida.

BACKGROUND: The liver transpslantation is used for treatment of end-stage liver disease, where the survival and liver function are markedly improved after transplantation. AIM: To evaluate and compare lung function, functional capacity and quality of life in patients submitted to liver transplantation after 1, 3, 6, 9 and 12 months of procedure. METHODS: Observational study with convenience groups composed by 30 patients, which had been divided in six groups (5 subjects each), in preoperative period and in the period of 1, 3, 6, 9 and 12 months after liver transplantation. All the individuals were evaluated at the same time, verificating the measurement of the forced vital capacity, forced expiratory volume in one second, maximum inspiratory and expiratory pressure, distance and domains related to quality of life. RESULTS: According to the explanation, it was observed improvement in all variables in subsequent groups to the liver transplantation in periods of 1, 3, 6, 9 and 12 months when compared to the preoperative group. The most significant changes occurred during the maximum inspiratory pressures, the distance and physical functioning. CONCLUSIONS: The liver transplantation as an alternative treatment for advanced liver disease, gives the patients benefits in respiratory and physical-functional conditions with improvement of life quality.