Repercussões cardiorrespiratórias agudas no uso correto de inaladores aerossóis de pó seco / Acute cardiopulmonary repercussions in the correct use of the dry-powder inhalers

Modelo do estudo: Trata-se de estudo original, transversal, clínico e comparativo. Objetivo do estudo: Avaliar as repercussões cardiorrespiratórias agudas no uso correto de inaladores aerossóis de pó seco (IPS) em pacientes com asma. Metodologia: Foram avaliados, em dois momentos, 17 pacientes adultos asmáticos em uso de IPS (Formoterol e Budesonida). As variáveis avaliadas, pré e pós-uso do IPS, foram: antropométrica, cognitiva, força muscular, sinais vitais, saturação de oxigênio, pressões respiratórias e pico de fluxo. No primeiro momento (M1) foi avaliada e monitorada a execução rotineira antes e imediatamente após uso do IPS e entregue folheto explicativo sobre o uso correto. No segundo momento (M2), 30 dias após M1, houve a mesma avaliação, entretanto, com execução correta do IPS. Resultados: No M2 ocorreram aumentos significativos da pressão inspiratória de 64,2±2,03 para 74,1±31,7 (cmH2O); pressão expiratória de 71,05±33,8 para 80±31,4 (cmH2O); capacidade vital de 3,3±0,9 para 3,9±0,9 (l) e reduções na frequência de pulso de 80,310,7 para 72,2±9,4 (bpm) e do duplo produto de 10001±1693 para 8846±1416 (teste t-Student pareado, p<0,05). Conclusões: O uso correto de IPS traz ao paciente repercussões cardiorrespiratórias positivas, melhorando as condições respiratórias e reduzindo o trabalho cardíaco.

Study model: It is a cross-over, clinical and comparative study. Objective: To evaluate the acute respiratory and cardiac respercussions in correct use of the dry powder inhalers (DPI) in patients with asthma. Methodology: Seventeen adult patients with asthma using DPI (Formoterol and Budesonide)were evaluated in two moments. The mensuared variables, before and after use of DPI, were: anthropometric, cognitive, muscle strength, vital signs, periferic oxygen saturation, respiratory pressures and peak expiratory flow. In the first moment (M1) was evaluated and monitored the usual performance before and immediately after using DPI and delivered an explicative leaflet about the correct use. In the second moment (M2), 30 days after M1, there was the same evaluation, however, with correct use ofthe DPI. Results: In the M2 there were increases to inspiratory pressure of 64,2±2,03 to 74,1±31,7(cmH2O); expiratory pressure of 71,05±33,8 to 80±31,4 (cmH2O); vital capacity of 3,3±0,9 to 3,9±0,9(l) and reductions in the pulse frequence of 80,3±10,7 to 72,2±9,4 (bm) and double product of 10001±1693 to 8846±1416 (paired t test, p<0,05). Conclusions: The correct use of the DPI promoves the positive respiratory and cardiac repercussions, improving respiratory conditions and reducing cardiac work.

Improvements in insulin sensitivity and muscle blood flow in aerobic-trained overweight-obese hypertensive patients are not associated with ambulatory blood pressure.

To verify whether there are relationships between vascular and hormonal responses to aerobic training in hypertensive persons, sedentary hypertensive patients were randomized to an aerobic training or a callisthenic exercise group. The patients' 24-hour blood pressure, arterial compliance, forearm blood flow, and hormonal profile were evaluated at baseline and after 3-month training protocols. Mean maximal oxygen consumption (VO(2) max) increased by 8% in the aerobic group (P<.001), while no change was observed in the control group. There was a decrease in insulin resistance (homeostatic model assessment of insulin resistance, P=.039) and plasma cortisol (P=.006) in the aerobic group only, that also demonstrated an increase in forearm blood flow (P<.001) after training. No relationship was observed between change in blood pressure or change in body mass and other parameters. Aerobic training can promote a decrease in cardiovascular risk in hypertensive adults by improving vascular function and insulin resistance, despite no changes in ambulatory blood pressure after a 3-month intervention.