Avaliação da capacidade funcional de pessoas com doença pulmonar obstrutiva crônica com o uso de ventilação não invasiva binível: ensaio controlado randomizado cruzado de grupo único

Abstract

Introduction: Using non-invasive ventilation (NIV) during exercise in people with chronic respiratory diseases improves arterial oxygenation, reduces dyspnea, and increases exercise tolerance measured by functional capacity tests. Although NIV can be used both acutely during exercise and as a continuous therapy, its influence on the performance of functional capacity tests is not fully understood. Objective: Evaluate the impact of the use of NIV on the performance of the 6-minute step test (6MST) and 1-minute sit-to-stand test (1-MSTST) of people with chronic obstructive pulmonary disease (COPD). Methods: Single-group crossover randomized controlled trial in which 6MST and 1-MSTST were performed in two conditions: with and without NIV. Before and after the tests, mean blood pressure (MBP), heart rate (HR), peripheral oxygen saturation (SpO2), subjective perception of exertion using the Borg Scale and blood lactate. Results: Fifteen persons (66.3±10.2 years) were included, 46.7% of whom were women. Regarding FEV1 (% predicted), 53.3% presented values ​​≥ 50% of predicted and 66.6% of the sample, despite presenting symptoms related to dyspnea, did not present spirometric changes related to obstruction (GOLD 0). The mean performance in 1-MSTST with use of NIV and without NIV was, respectively, 28.2±4.54 vs. 25.9±4.45 repetitions (p=0.039). A significant difference (p<0.05) was found between both performances, with the use of NIV increasing by 2.3 repetitions. About 1-MSTST, SpO2 with NIV also showed a significant increase (0.933±1.49 vs. -1.4±2.67, p=0.006). The performance at 6MST with and without NIV, respectively, was 134.9±18.44 vs.135.3 vs. 24.2 (p= 0.96). In both tests, MBP, Borg Scale, HR and lactate were not significantly impacted using NIV. Conclusion: The use of NIV acutely exclusively impacted the 1-MSTST performance with lower peripheral oxygen desaturation in people with COPD. Therefore, the use of NIV during 6MST does not impact performance in this population collected.