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The different decubitus on the respiratory system resistance in eutrophic and obese subjects

Full text
Author(s):
Mayara Holtz de Paula
Total Authors: 1
Document type: Master's Dissertation
Press: Ribeirão Preto.
Institution: Universidade de São Paulo (USP). Faculdade de Medicina de Ribeirão Preto (PCARP/BC)
Defense date:
Examining board members:
Ada Clarice Gastaldi; Luciana Dias Chiavegato; Carolina Fu; Anderson Marliere Navarro
Advisor: Ada Clarice Gastaldi
Abstract

Background: It is known that changes in gravity force action, promoted by change of posture, influence volumes and capacities lung, but the behavior of lung elastic and plastic properties, has not yet well clarified in literature. Aim: To evaluate the effect of different positions on respiratory system resistance. Methods: Participants were allocated to different groups, according to the body mass index (BMI Kg/m2 ). The positions were evaluated by Impulse Oscillometry System (IOS) in a random order: seated (Se), supine (Su), left lateral (LL) or right lateral decubitus (RL) and following parameters was obtained: total, central and peripheral resistance, reactance and resonant frequency. Spirometry was then performed to analyze the following variables: forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC and mean forced expiratory flow (FEF25-75%). Results: A total of 110 volunteers were recruited, 36 with BMI<25 kg/m2 (26.8 years, 21.7 kg/m2 ), 19 with BMI between 25-29kg/m2 (26.1 years, 26.6 kg/m2 ), 21 with BMI between 30-39 kg/m2 (30 years, 34.5 kg/m2 ), 21 with BMI between 40-49 kg/m2 (35.4 years, 45 kg/m2 ) and 13 with BMI> 50 kg/m2 (35.5 years, 54.2 kg/m2 ). No ventilatory disturbances were detected by spirometry, all higher than predicted (80%). The groups began to differentiate from the range of 30-39 kg/m 2 , there were important differences between individuals with BMI>50 and 40-49 with those with BMI <25 and 25-29, mainly in peripheral pathways (p<0.0001). The supine position presented higher resistance values for all groups. These differences compared to changes in decubitus are more frequent in the lower BMI ranges (<25 to 29 kg/m 2 ). It was also observed that overweight individuals tend to follow the same pattern as those with BMI within normal range. Conclusion: The respiratory impedance is higher in obese than eutrophic subjects, with more contribution of peripheral resistance, but with smaller variations related to position change when compared to eutrophic ones. (AU)

FAPESP's process: 16/03815-3 - Effect of different positions on the respiratory system resistance in obese and eutrophic subjects
Grantee:Mayara Holtz de Paula
Support Opportunities: Scholarships in Brazil - Master