Brazilian Journal of Pulmonology

ISSN (on-line): 1806-3756 | ISSN (printed): 1806-3713

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Effects of positive expiratory pressure on pulmonary clearance of aerosolized technetium-99m-labeled diethylenetriaminepentaacetic acid in healthy individuals

Efeitos da pressão expiratória positiva na depuração pulmonar do ácido dietilenotriaminopentacético marcado com tecnécio-99m em aerossol em indivíduos saudáveis

Isabella Martins de Albuquerque1, Dannuey Machado Cardoso2, Paulo Ricardo Masiero3, Dulciane Nunes Paiva4, Vanessa Regiane Resqueti5, Guilherme Augusto de Freitas Fregonezi5, Sérgio Saldanha Menna-Barreto6

J Bras Pneumol.2016;42(6):404-408

Abstract PDF PT PDF EN Portuguese Text

Objective: To evaluate the effects of positive expiratory pressure (PEP) on pulmonary epithelial membrane permeability in healthy subjects. Methods: We evaluated a cohort of 30 healthy subjects (15 males and 15 females) with a mean age of 28.3 ± 5.4 years, a mean FEV1/FVC ratio of 0.89 ± 0.14, and a mean FEV1 of 98.5 ± 13.1% of predicted. Subjects underwent technetium-99m-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA) radioaerosol inhalation lung scintigraphy in two stages: during spontaneous breathing; and while breathing through a PEP mask at one of three PEP levels-10 cmH2O (n = 10), 15 cmH2O (n = 10), and 20 cmH2O (n = 10). The 99mTc-DTPA was nebulized for 3 min, and its clearance was recorded by scintigraphy over a 30-min period during spontaneous breathing and over a 30-min period during breathing through a PEP mask. Results: The pulmonary clearance of 99mTc-DTPA was significantly shorter when PEP was applied-at 10 cmH2O (p = 0.044), 15 cmH2O (p = 0.044), and 20 cmH2O (p = 0.004)-in comparison with that observed during spontaneous breathing. Conclusions: Our findings indicate that PEP, at the levels tested, is able to induce an increase in pulmonary epithelial membrane permeability and lung volume in healthy subjects.

 


Keywords: Lung/metabolism; Technetium Tc 99m pentetate/pharmacokinetics; Radiopharmaceuticals; Positive-pressure respiration.

 


Reference values for sniff nasal inspiratory pressure in healthy subjects in Brazil: a multicenter study

Valores de referência da pressão inspiratória nasal em indivíduos saudáveis no Brasil: estudo multicêntrico

Palomma Russelly Saldanha de Araújo, Vanessa Regiane Resqueti, Jasiel Nascimento Jr, Larissa de Andrade Carvalho, Ana Gabriela Leal Cavalcanti, Viviane Cerezer Silva, Ester Silva, Marlene Aparecida Moreno, Arméle de Fátima Dornelas de Andrade, Guilherme Augusto de Freitas Fregonezi

J Bras Pneumol.2012;38(6):700-707

Abstract PDF PT PDF EN Portuguese Text

Objective: The objectives of this study were to determine reference values for sniff nasal inspiratory pressure (SNIP) and to propose reference equations for the population of Brazil. Methods: We evaluated 243 healthy individuals (111 males and 132 females), between 20 and 80 years of age, with an FVC and FEV1/FVC ratio > 80% and > 85% of the predicted value, respectively. All of the subjects underwent respiratory muscle strength tests to determine MIP, MEP, and SNIP. Results: We found that SNIP values were higher in males than in females (p < 0.05) and that SNIP correlated negatively with age, for males (r = −0.29; p < 0.001) and for females (r = −0.33; p < 0.0001). Linear regression also revealed that age influenced the predicted SNIP, for males (R2 = 0.09) and females (R2 = 0.10). We obtained predicted SNIP values that were higher than those obtained for other populations. Conclusions: We have devised predictive equations for SNIP to be used in adults (20-80 years of age) in Brazil. These equations could help minimize diagnostic discrepancies among individuals.

 


Keywords: Respiratory Muscles; Respiratory Function Tests; Reference Values; Linear Models.

 


Diurnal variations in the parameters of pulmonary function and respiratory muscle strength in patients with COPD

Variação diurna de parâmetros de função pulmonar e de força muscular respiratória em pacientes com DPOC

Guilherme Fregonezi, Vanessa Regiane Resqueti, Juliana Loprete Cury, Elaine Paulin, Antonio Fernando Brunetto (in memoriam)

J Bras Pneumol.2012;38(2):257-263

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Objective: To evaluate the magnitude of diurnal changes in the parameters of pulmonary function and respiratory muscle strength/endurance in a sample of patients with COPD. Methods: A group of 7 patients underwent spirometry, together with determination of MIP and MEP, at two distinct times (between 8:00 and 8:30 a.m. and between 4:30 and 5:00 p.m.) on a single day. Between assessments, the patients remained at rest in the laboratory. Results: In accordance with the Global Initiative for Chronic Obstructive Pulmonary Disease staging system, COPD was classified as moderate, severe, and very severe in 1, 3, and 3 of the patients, respectively. From the first to the second assessment, there were significant decreases in FVC, FEV1, and MEP (of 13%, 15%, and 10%, respectively), as well as (less than significant) decreases in PEF, MIP, and maximal voluntary ventilation (of 9%, 3%, and 11%, respectively). Conclusions: In this sample of COPD patients, there were diurnal variations in the parameters of pulmonary function and respiratory muscle strength. The values of FEV1, FVC, and MEP were significantly lower in the afternoon than in the morning.

 


Keywords: Pulmonary disease, chronic obstructive; Respiratory function tests; Respiratory muscles.

 


 

 


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