1. TEDE PUCRS
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  3. Programa de Pós-Graduação em Pediatria e Saúde da Criança
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dc.creatorFernandes, Morgana Thaís Carollo-
dc.creator.Latteshttp://lattes.cnpq.br/7890106575135063por
dc.contributor.advisor1Jones, Marcus Herbert-
dc.contributor.advisor1Latteshttp://lattes.cnpq.br/2057491798074403por
dc.date.accessioned2020-01-31T12:32:59Z-
dc.date.issued2019-08-30-
dc.identifier.urihttp://tede2.pucrs.br/tede2/handle/tede/9081-
dc.description.resumoIntrodução: Detectar alterações das vias aéreas é muito importante para o manejo e diagnóstico de crianças asmáticas. Para a adoção eficiente e custo-efetivo de opções de tratamento direcionadas à prática clínica diária, biomarcadores confiáveis e bem definidos contribuem na identificação de fenótipos e endotipos de asma com maior probabilidade de resposta. Nesse cenário, a técnica de oscilações forçadas (FOT) é um método promissor na monitorização e diagnóstico de doenças respiratórias. Objetivo: evidenciar parâmetros da técnica de oscilações forçadas (FOT) que possam ser utilizados como biomarcadores para o diagnóstico e monitoramento da asma. Métodos: estudo transversal, observacional com abordagem quantitativa. A amostra foi composta por crianças e adolescentes com asma e controles saudáveis, entre 3 e 17 anos de idade, recrutados no Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). A antropometria, história clínica e medidas da impedância respiratória foram obtidas em todos os participantes. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da instituição de ensino sob parecer nº: 3.100.553 e o consentimento informado foi obtido de todos os participantes e seus responsáveis. Resultados: Foram recrutados 101 indivíduos (61 do sexo masculino), sendo 38 portadores de asma (grupo Asma) e 63 controles sadios (grupo Controle). Nas medidas espectrais pré broncodilatador observou-se que todas as variáveis apresentam diferenças significativas (p<0,001), com resistência mais alta e a reatância mais baixa (negativa) no grupo de asmáticos. Na análise within-breath observou-se que nas medidas realizadas antes da administração do broncodilatador as diferenças são significativas entre os dois grupos, com p≤0,001 em todas as comparações exceto na diferença entre a resistência média da inspiração e a expiração (dRmean). A acurácia das medidas de resistência para discriminar asma foi de 0,94 para ReE, 0,89 para ReI e 0,76 para ReE-ReI e para reatância foi de 0,91 para XeE, 0,91 para XeI e 0,79 para XeE-XeI. A correção das estimativas de acurácia, sensibilidade, especificidade e área sob a curva por confundidores (estatura) na curva ROC não modificou os resultados. Conclusões: os dados obtidos sugerem que as medidas de FOT within-breath tem excelente poder discriminatório para asma em crianças e adolescentes. A medida da impedância pode ajudar no diagnóstico de asma e também avaliar o efeito do tratamento na função pulmonar, podendo ser utilizada isoladamente ou como método complementar à espirometria. Na nossa amostra as medidas de resistência foram as que tiveram melhor performance de discriminação.por
dc.description.abstractIntroduction: Detecting airway changes is very important for treatment and diagnosis of asthmatic children. For the efficient and cost-effective adoption of treatment options directed at daily clinical practice, reliable and well-defined biomarkers contribute to the identification of asthma phenotypes and endotypes that are most likely to respond. In this scenario, the forced oscillation technique (FOT) is a promising method in the diagnosis and monitoring of respiratory diseases. Objective: To evidence forced oscillation technique (FOT) parameters that may be used as biomarkers for the diagnosis and monitoring of asthma. Methods: cross-sectional observational study with a quantitative approach. The sample consisted of children and adolescents with asthma and healthy controls, aged 3 to 17 years old, recruited from the São Lucas Hospital of the Pontifical Catholic University of Rio Grande do Sul (PUCRS). The anthropometry, clinical history and respiratory impedance measurements were obtained in all participants. The Research Ethics Committee of the educational institution under opinion No. 3,100,553 approved the project and informed consent was obtained from all participants and their guardians. Results: A total of 101 individuals (61 males) were recruited, 38 with asthma (Asthma group) and 63 healthy controls (Control group). Pre-bronchodilator spectral measurements showed that all variables had significant differences (p <0.001), with higher resistance and lower (negative) reactance in the asthmatic group. In the within-breath analysis, we observed that in the measurements taken before bronchodilator administration, the differences were significant between the two groups, with p≤0.001 in all comparisons except in the difference between mean inspiratory resistance and expiration (dRmean). The accuracy of resistance measures to discriminate asthma was 0.94 for ReE, 0.89 for ReI and 0.76 for ReE-ReI and for reactance was 0.91 for XeE, 0.91 for XeI and 0.79 to XeE-XeI. Correcting estimates of accuracy, sensitivity, specificity, and area under the curve by confounders (stature) on the ROC curve did not change the results. Conclusions: The data obtained suggest that within-breath FOT measurements have excellent discriminatory power for asthma in children and adolescents. Measurement of impedance may aid in the diagnosis of asthma, may also assess the effect of treatment on pulmonary function, and may be used alone or as a complementary method to spirometry. In our sample, the resistance measures had the best discrimination performance.eng
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dc.description.sponsorshipCoordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESpor
dc.formatapplication/pdf*
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dc.languageporpor
dc.publisherPontifícia Universidade Católica do Rio Grande do Sulpor
dc.publisher.departmentEscola de Medicinapor
dc.publisher.countryBrasilpor
dc.publisher.initialsPUCRSpor
dc.publisher.programPrograma de Pós-Graduação em Medicina/Pediatria e Saúde da Criançapor
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Within-breath respiratory impedance and airway obstruction in patients with chronic obstructive pulmonary disease. Clin (São Paulo, Brazil) [Internet]. 2015 Jul [cited 2016 Jan 28];70(7):461–9. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4496751&tool=pmcentrez&rendertype=abstract 86. Davidson RN Hussain A, Saunders KB GCA. Within-breath changes of airway calibre in patients with airflow obstruction by continuous measurement of respiratory impedance. Br J Dis Chest. 1986;80(4):335–52. 87. Veras TN, Pinto LA. Viabilidade da realização de espirometria em pré-escolares. J Bras Pneumol. 2011; 88. World Health Organization. Growth reference data for 5-19 years. Who Child Growth Stand. 2013; 89. de Onis M, Garza C, Onyango AW, Borghi E. Comparison of the WHO Child Growth Standards and the CDC 2000 Growth Charts. J Nutr. 2007; 90. Brasil. Resolução No 466, de 12 de dezembro de 2012. Diário of da União. 2012;por
dc.rightsAcesso Abertopor
dc.subjectTécnica de Oscilações Forçadaspor
dc.subjectTeste de Função Pulmonarpor
dc.subjectImpedância Respiratóriapor
dc.subjectCriançapor
dc.subjectAsmapor
dc.subjectForced Oscillation Techniqueeng
dc.subjectRespiratory Function Testseng
dc.subjectRespiratory Mechanicseng
dc.subjectChildeng
dc.subjectAsthmaeng
dc.subject.cnpqCIENCIAS DA SAUDE::MEDICINApor
dc.subject.cnpqCIENCIAS DA SAUDE::ENFERMAGEMpor
dc.subject.cnpqMEDICINA::SAUDE MATERNO-INFANTILpor
dc.titleAcurácia das medidas de impedância respiratória para o diagnóstico de asma em criançaspor
dc.typeTesepor
dc.restricao.situacaoTrabalho será publicado como artigo ou livropor
dc.restricao.prazo60 mesespor
dc.restricao.dataliberacao31/01/2025por
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