Características clínicas e funcionais de pacientes em avaliação para transplante de pulmão do Hospital Israelita Albert Einstein (HIAE)
Clinical and functional characteristics of patients undergoing evaluation for lung transplantation at the Hospital Israelita Albert Einstein (HIAE)
Silvia Ferreira Maciel, Juliana de Cássia Moura Oliveira, Melline Della Torre de Almeida, José Eduardo Afonso Junior
Resumo
Introdução: A sobrevida, após o transplante pulmonar, depende de variáveis prognósticas dos candidatos em lista, tais como: idade, diagnóstico e capacidade de exercício. Objetivo: Caracterizar a população de pacientes em avaliação para inclusão em lista para transplante de pulmão assistidos pela equipe de fisioterapia do Hospital Israelita Albert Einstein (HIAE). Métodos: Estudo clínico, unicêntrico, coorte retrospectivo. Foram avaliados, 98 pacientes pela equipe de fisioterapia, para possível inclusão em lista de transplante pulmonar do HIAE, entre fevereiro de 2007 a maio de 2012. Os pacientes foram classificados quanto ao tipo de doença: doenças obstrutivas, doenças restritivas, doenças supurativas e outras. Foram incluídos, todos os indivíduos submetidos a uma avaliação respiratória fisioterapêutica completa e que realizaram o teste de caminhada de seis minutos (TC6). Resultados: Os pacientes demonstraram características similares, tais como histórico de tabagismo, dependência de oxigênio e sedentarismo. Os pacientes obstrutivos apresentaram volume expiratório forçado no primeiro segundo (VEF1 )de 0,85 ± 0,45 L (27,40±14,85 %) e os restritivos, capacidade vital forçada (CVF) de 1,54 ± 0,59 L (43,59±14,82%). Com relação à capacidade funcional, o grupo das doenças supurativas era mais jovem e obteve melhor desempenho no TC6: 343±129m (55,51±19,91%) vs 279±114m (48,51±19,08%) vs 266±122m (46,06±22,78), quando comparados com os grupos de doenças obstrutivas e restritivas, respectivamente. Conclusão: Na nossa população, candidatos a transplante de pulmão, apesar de cursarem com histórico progressivo de sintomas de forma similar e limitação na capacidade funcional, apresentam características clínicas e/ou antropométricas distintas. Sendo assim, possivelmente, podem apresentar prejuízos na qualidade de vida, por implicações não somente respiratórias, mas, também, musculoesqueléticas e, consequentemente, sociais.
Palavras-chave
Abstract
Introduction: The time of life after the transplantation depends on variables of the candidates in waiting lists such as age, diagnosis and exercise tolerance. Objective: To characterize the patient population evaluated for inclusion in the list for lung transplantation who were assisted by the physiotherapy team at Hospital Israelita Albert Einstein (HIAE), as well as their clinical and functional characteristics. Methods: Clinical study, singlecenter, retrospective cohort. We evaluated 98 patients by the physiotherapy team for possible inclusion in the lung transplant list of HIAE between February 2007 and May 2012. The patients were classified according to type of diseases: obstructive disease, restrictive diseases, suppurative diseases and others. We included all patients undergoing a complete respiratory evaluation of physical therapy and the Six Minute Walk Test (6MWT). Results: Patients showed similar characteristics such as history of smoking, oxygen dependency and inactivity. Patients with obstructive diseases presented the forced expiratory volume in the first second (FEV1) of 0.85 ± 0.45 L (27.40±14.85 %) and restrictive diseases, forced vital capacity (FVC) of 1.54 ± 0.59 L (43.59±14.82 %). Regarding functional capacity, the suppurative group was younger and presented a better performance on the 6MWT: 343±129m (55.51±19.91 %), compared to the obstructive and restrictive diseases 279±114m (48.51±19.08 %) vs 266±122m (46.06±22.78 %) respectively. Conclusion: In our population, candidates for lung transplantation, have similar symptoms and limitations in functional capacity, with distinct clinical and / or anthropometric characteristics. Thus, they may present impairments in quality of life, not only caused by respiratory disorders, but also caused by musculoskeletal and therefore social implications.
Keywords
Referências
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