RESUMO
El asma en niños es una condición prevalente y con un significativo impacto en la calidad de vida del niño y su cuidador. Un alto porcentaje de los niños están expuestos a la contaminación atmosférica, lo que se traduce en un significativo impacto en su salud respiratoria. Los niños son un grupo especialmente vulnerable por razones fisiológicas, medioambientales y de comportamientos propios de la edad. Existe suficiente evidencia que algunos contaminantes atmosféricos son capaces de aumentar los síntomas de asma y desencadenar exacerbaciones en niños asmáticos. También existe evidencia creciente que la exposición prolongada y precoz a contaminantes atmosféricos pueden aumentar el riesgo de desarrollar asma, especialmente los contaminantes relacionados con el tráfico vehicular. Estos efectos adversos disminuyen cuando disminuye la contaminación atmosférica producto de las regulaciones ambientales. Estudios sobre la carga atribuible estiman que un 13% de los nuevos niños asmáticos pueden deberse a la contaminación atmosférica. El sistema respiratorio y el sistema inmunológico del niño están en desarrollo, por lo que exposiciones a contaminantes atmosféricos pueden tener consecuencias de largo plazo. Existen varios mecanismos identificados que apoyan los resultados de los estudios epidemiológicos destacando el daño por estrés oxidativo. Los médicos que atienden niños tienen que tomar en cuenta este conocimiento e incorporarlo a su práctica clínica.
Asthma in children is a prevalent condition with a significant impact on the quality of life of the child and their caregiver. A high percentage of children are exposed to air pollution, which has a significant impact on their respiratory health. Children are a particularly vulnerable group for age-specific physiological, environmental and behavioral reasons. There is sufficient evidence that some air pollutants are capable of increasing asthma symptoms and triggering exacerbations in asthmatic children. There is also growing evidence that early and prolonged exposure to air pollutants can increase the risk of developing asthma, especially traffic-related air pollution. These adverse effects decrease when atmospheric pollution decreases as a result of environmental regulations. Studies on attributable burden estimate that 13% of new asthmatics in children may occur due to air pollution. The respiratory system and the immune system of the child are developing, so exposure to air pollutants can have long-term consequences. There are several identified mechanisms that support the results of epidemiological studies highlighting damage from oxidative stress. Physicians caring for children need to take this knowledge into account and incorporate it into their clinical practice.
Assuntos
Humanos , Criança , Asma/epidemiologia , Poluição do Ar/efeitos adversos , Asma/etiologiaRESUMO
To evaluate the effects of a1fentanil doses on cardiovascular and respiratory function, changes in mean arterial pressure (MAP), heart rate (HR), respiratory rate(RR) and PaCO2 induced by alfentanil (5 and 10 ug/kg) after intravenous administration over 10 s were measured in 20 young adult male patients (ASA physical status 1) who were scheduled for lower extremity operations under spinal anesthesia. After fixation of spinal anesthesia level and stabilization of vital signs, control measurements were done. MAP and HR were measured at 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25, 30 min and, RR and PaCO2 were measured at 5, 10, 15, 20, 30 min after alfentanil administration. While there were no significant changes in MAP or HR in either of the two groups after alfentanil administration, RR and PaCO2 showed significant changes and returned to control values by 10 and 20 min, respectively, with low doses of alfentanil and by 30 and 30 min, respectively, with high doses of alfentanil. These results suggest that 5 or 10 ug/kg of alfentanil has no influence on cardiovascular function but, as the administered dose is increased, RR and minute ventilation decrease more profoundly and recovery is delayed.