Impact of high-flow nasal cannula compared to Venturi mask on exercise tolerance in lung transplant candidates: a crossover randomized clinical trial
Impacto da cânula nasal de alto fluxo em comparação à máscara de venturi na tolerância ao exercício em candidatos a transplante de pulmão: um ensaio clínico randomizado cruzado
Emilia Maria Matos Rocha, Gezabell Rodrigues, Daniela Gardano Bucharles Mont’Alverne, Eanes Delgado Barros Pereira, Franciane Muniz Lucena Monteiro, Marcelo Alcantara Holanda, Suliana Mesquita Paula, Rafael Mesquita, Filadelfo Rodrigues Filho
Abstract
Background: Exercise is important for good health in lung transplant candidates and can be facilitated by oxygen supplementation. Aim: To compare the effects of the High-Flow Nasal Cannula (HFNC) and the Venturi mask (VM) on exercise tolerance in lung transplant candidates. Methods: This is a randomized crossover clinical trial carried out in the pulmonary rehabilitation program of a public hospital. Lung transplant candidates, over 18 years of age and needing oxygen during exercise were recruited. Two endurance tests on a treadmill were performed in random order with an interval of seven days, one with HFNC and the other with VM (both with FIO2 50%). The variables evaluated herein were endurance time (primary outcome), heart and respiratory rate, oxygen saturation, peripheral lactate, dyspnea, and lower limb fatigue symptoms. Results: Twelve participants were included (mean age 42 ± 10 years, 67% male). The time reached in the endurance test with the VM was 580 s (95% Confidence Interval, CI 403 – 756 s) and with the HFNC was 937 s (95% CI 668 – 1205 s); with mean difference of 357 s (95% CI 181 – 533 s) and P=0.001. No significant difference was observed after comparing the responses in other variables between the two conditions. There was no desaturation during any of the tests. Conclusion: The HFNC promoted an increase in exercise tolerance when compared to the VM in lung transplant candidates, and both systems were effective in preventing peripheral oxygen desaturation.
Keywords
Resumo
Introdução: O exercício é importante para uma boa saúde em candidatos a transplante de pulmão e pode ser facilitado pela suplementação de oxigênio. Objetivo: Comparar os efeitos da Cânula Nasal de Alto Fluxo (CNAF) e da Máscara de Venturi (MV) na tolerância ao exercício em candidatos a transplante de pulmão. Métodos: Este é um ensaio clínico randomizado cruzado realizado no programa de reabilitação pulmonar de um hospital público. Foram recrutados candidatos a transplante de pulmão, maiores de 18 anos e com necessidade de oxigênio durante o exercício. Dois testes de resistência em esteira foram realizados em ordem aleatória com intervalo de sete dias, um com a CNAF e outro com a MV (ambos com FIO2 50%). As variáveis avaliadas foram tempo de resistência (endurance) (desfecho primário), frequência cardíaca e respiratória, saturação de oxigênio, lactato periférico, dispneia e sintomas de fadiga de membros inferiores. Resultados: Doze participantes foram incluídos (idade média de 42 ± 10 anos, 67% do sexo masculino). O tempo alcançado no teste de resistência com a MV foi de 580 s (Intervalo de Confiança de 95%, IC 403 – 756 s) e com a CNAF foi de 937 s (IC 95% 668 – 1205 s); apresentando diferença média de 357 s (IC 95% 181 – 533 s) e P=0,001. Nenhuma diferença significativa foi observada após a comparação das respostas nas demais variáveis entre as duas condições. Não houve dessaturação durante nenhum dos testes. Conclusão: A CNAF promoveu um aumento na tolerância ao exercício quando comparada à MV em candidatos a transplante de pulmão, e ambos os sistemas foram eficazes na prevenção da dessaturação periférica de oxigênio.
DOI da versão traduzida: https://doi.org/10.47066/2966-4837.2024.0004pt
Palavras-chave
Referências
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Submetido em:
26/06/2024
Aceito em:
21/10/2024
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