Avalia??o da fun??o pulmonar em obesos m?rbidos com sonol?ncia diurna excessiva

• Main Author: Gon?alves, Marize J?come
• Other Authors: CPF:44456042400
• Format: Others
• Language: Portuguese
• Published: Universidade Federal do Rio Grande do Norte 2014
• Subjects: Obesidade; fun??o pulmonar; Sonol?ncia diurna excessiva; Marcadores antropom?tricos; Ronco; Obesity; Pulmonary function; Daytime sleepiness; Anthropometric markers; Snoring; CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL
• Online Access: http://repositorio.ufrn.br:8080/jspui/handle/123456789/16672

Made available in DSpace on 2014-12-17T15:16:05Z (GMT). No. of bitstreams: 1 MarizeJG.pdf: 1501362 bytes, checksum: 8f9c4ae91001822e07351c0f246be869 (MD5) Previous issue date: 2009-07-30 === Background: Obesity impairment to the pulmonary function related to the magnitude of adiposity and is associated with excessive daytime sleepiness (EDS) and snoring, among others symptoms of respiratory disorders related to sleep. It is possible that obese individuals with excessive daytime sleepiness may make changes in lung function on spirometry monitored during the day as a consequence of fragmented sleep or episodes of nocturnal hypoventilation that cause respiratory and changes that can persist throughout the day. The combination of these findings alone sleepiness observed by subjective scales with pulmonary function in obese patients is unknown. Objective: To assess the influence of EDS and snoring on pulmonary function in morbidly obese and distinguish between different anthropometric markers, the snoring and sleepiness which the best predictors of spirometric function and respiratory muscle strength and endurance of these patients. Methods: We evaluated 40 morbidly obese markers on the anthropometric, spirometric respiratory variables, maximal inspiratory and expiratory pressures (MIP and MEP) and maximal voluntary ventilation (MVV) and the measured excessive daytime sleepiness (the Epworth sleepiness scale) and snoring (snoring scale of Stanford). The data were treated when the differences between the groups of obese patients with and without sleepiness, whereas the anthropometric variables, respiratory and snoring. Pearson's correlation was performed, and multiple regression analysis assessed the predictors of pulmonary function. For this we used the software SPSS 15.0 for windows and p <0.05. Results: 39 obese patients were included (28 women), age 36.92+11.97y, body mass index (BMI) 49.3+5.1kg/m?, waist-hip ratio (WHR) 0.96+0.07 and neck circumference (NC) 44.1+4.2 cm. Spirometric values and respiratory pressures were up 80% of predicted values, except for endurance (MVV <80%). Obese with EDS have lower tidal volume. Positive correlation was observed between BMI and EDS, EDS and NC and between snoring and BMI, and negative correlation between EDS and tidal volume (TV), and between snoring and snoring FVC and FEV1. In linear regression the best predictor of pulmonary function was snoring, followed by NC. NC has more obese with higher strength (MEP, p = 0.031) and endurance (MVV p = 0.018) respiratory muscle. Conclusion: Obese with EDS tend to have lower TV. In addition, snoring and NC can better predict pulmonary function in obese when compared with other anthropometric markers or EDS. Obese patients with higher NC tend to have greater capacity for overall strength of respiratory muscles, but may have low muscle endurance === Introdu??o: A obesidade acarreta preju?zo na fun??o pulmonar relacionada ? magnitude da adiposidade e se associa a sonol?ncia diurna excessiva (SDE) e ronco como sintomas de dist?rbios respirat?rios relacionados ao sono. ? poss?vel que indiv?duos obesos com sonol?ncia diurna excessiva possam apresentar altera??o na fun??o pulmonar monitorados na espirometria durante o dia como conseq??ncia da fragmenta??o do sono ou de epis?dios de hipoventila??o noturnos que ocasionam modifica??es respirat?rias e que podem persistir durante o dia. A associa??o destes achados isolados de sonol?ncia, observados atrav?s de escalas subjetivas com a fun??o pulmonar em obesos, ? desconhecida. Objetivos: Avaliar a influencia da SDE e do ronco na fun??o pulmonar em obesos m?rbidos e distinguir entre os distintos marcadores antropom?tricos, o ronco e a SDE quais os melhores preditores da fun??o espirom?trica e da for?a e resist?ncia muscular respirat?ria destes pacientes. M?todos: Foram avaliados 40 obesos m?rbidos quanto aos marcadores antropom?tricos, as vari?veis respirat?rias espirom?tricas, press?es inspirat?ria e expirat?ria m?ximas (PIM?x e PEM?x) e ventila??o volunt?ria m?xima (VVM) e mensuradas a sonol?ncia diurna excessiva (Escala de Sonol?ncia de Epworth) e ronco (Escala de Ronco de Stanford). Os dados foram tratados quando as diferen?as entre os grupos de obesos com e sem sonol?ncia, considerando as vari?veis antropom?tricas, respirat?rias e o ronco. A correla??o de Pearson foi realizada e a an?lise de Regress?o M?ltipla avaliou os preditores da fun??o pulmonar. Para tal foi utilizado o software SPSS 15.0 para windows e p<0,05. Resultados: 39 obesos foram inclu?dos (28 mulheres), idade 36,92+11,97a, ?ndice de massa corporal (IMC) 49,3+5,1kg/m?, rela??o cintura-quadril (RCQ) 0,96+0,07 e Circunfer?ncia do Pesco?o (CP) 44,1+4,2cm. Os valores espirom?tricos e de press?es respirat?rias encontravam-se acima de 80% dos valores preditos, exceto a resist?ncia (VVM<80%). Obesos com SDE apresentam menor volume corrente. Foi observada correla??o positiva entre SDE e IMC, SDE e CP e entre ronco e IMC; e correla??o negativa entre SDE e Volume Corrente, ronco e CVF e entre ronco e VEF1. Na regress?o linear o melhor preditor da fun??o pulmonar foi o ronco, seguido da CP. Obesos com maior CP tem maior for?a (PEM; p=0,031) e resist?ncia (VVM; p=0,018) muscular respirat?ria. Conclus?o: Obesos com SDE tendem a ter menor VC. Al?m disso, o ronco e a CP podem melhor predizer a fun??o pulmonar em obesos quando comparados aos demais marcadores antropom?tricos e a SDE. Obesos com maior CP tendem a ter maior capacidade de geral for?a dos m?sculos respirat?rios, entretanto podem apresentar baixa resist?ncia muscular