Abstract
Backgound and Objectives: Positive airway pressure continues (CPAP) produces significant hemodynamic changes that may influence the variability of breathing pattern and heart rate, acting as an additional therapy to prevent atelectasis and to combat hypoxia. The rate of inhaled 99 m Technetiumdiethylenetriaminepentaacetic acid (99mTc-DTPA), along with changes in the lung epithelium cause an increase in the rate of clearance of this compound. The aim of this study was evaluate the pulmonary clearance rate of 99mTechnetium Diethylenetriaminepentaacetic acid (99mTc-DTPA) through the use of different levels of CPAP. Methods: It was a quasi-experimental study involving 17 healthy individuals with normal lung functional. 99mTc-DTPA, as aerosol, was nebulized for 3 minutes with the individual in a sitting position. The pulmonary clearance rate was assessed through pulmonary scintigraphy under spontaneous breathing and under 20 and 10 cmH2 O CPAP in the sitting position. The clearance rate was expressed as the half-time (T½) that is the time for the activity to decrease to 50% of the peak value. Results: 20 cmH2 O CPAP produced significant reduction of the T½ of 99mTc-DTPA in the sitting position (p=0.005). However, 10 cmH2 O CPAP did not alter the T½ of DTPA in the same positions. Conclusion: High levels of continuos positive pressure in normal lungs resulted in faster 99mTc-DTPA clearance moreover, 10 cmH2 O did not alter its clearance rate. KEYWORDS: Noninvasive ventilation. Technetium Tc 99m Pentetate. Radionuclide Imaging.
Highlights
Justificativa e Objetivos: A pressão positiva contínua nas vias aéreas (CPAP) produz alterações hemodinâmicas que influenciam na variabilidade do padrão respiratório e da frequência cardíaca, atuando como terapia adicional na prevenção de atelectasias e no combate à hipóxia
Backgound and Objectives: Positive airway pressure continues (CPAP) produces significant hemodynamic changes that may influence the variability of breathing pattern and heart rate, acting as an additional therapy to prevent atelectasis and to combat hypoxia
The pulmonary clearance rate was assessed through pulmonary scintigraphy under spontaneous breathing and under 20 and 10 cmH2O CPAP in the sitting position
Summary
Dulciane Nunes Paiva[1], Diogo Fanfa Bordin[2], Ricardo Gass[2], Camila da Cunha Niedermeyer[2], Michele Saldanha[2], Dannuey Machado Cardoso[3], Mario Bernardo-Filho[4], Sérgio Saldanha Menna-Barreto5 1Programa de Pós-Graduação em Promoção da Saúde da Universidade de Santa Cruz do Sul (Unisc), Santa Cruz do Sul, RS, Brasil. 2Curso de Fisioterapia da Universidade de Santa Cruz do Sul (Unisc), Santa Cruz do Sul, RS, Brasil. 3Departamento de Educação Física e Saúde da Universidade de Santa Cruz do Sul (Unisc), Santa Cruz do Sul, RS, Brasil. 4Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil. 5Departamento de Medicina Interna da Faculdade de Medicina da Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil. O objetivo deste estudo foi avaliar a taxa de depuração pulmonar do 99mTc-DTPA através do uso de diferentes níveis de CPAP. Aerossol 99mTc-DTPA foi nebulizado durante 3 minutos com o indivíduo na posição sentada. A taxa de depuração pulmonar foi avaliada através de cintilografia pulmonar sob respiração espontânea e com CPAP de 10 e 20 cmH2O na posição sentada. Resultados: A CPAP de 20 cmH2O reduziu significativamente o T1⁄2 do 99mTc-DTPA na posição sentada (p=0,005). Conclusão: Níveis elevados de pressão positiva contínua em pulmões normais resultaram em depuração mais rápida do 99mTc-DTPA, entretanto, pressão de 10 cmH2O não produziu alteração na taxa de depuração
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