Capacidade cardiorrespiratória de crianças e adolescentes com doença falciforme submetidas a teste de esforço submáximo

• Ano de defesa: 2017
• Autor(a) principal: Cobra, Carolina Lemos Nogueira [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Exercise test; Sickle cell anemia; Respiratory function tests; Child; Adolescent; Teste de esforço; Doença falciforme; Testes de função respiratória; Criança; Adolescente
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5200093; http://repositorio.unifesp.br/handle/11600/50373

Objective: To evaluate the cardiorespiratory capacity of children and adolescentes with sickle cell disease submitted to a submaximal physical effort test. Methods: A unicentric, transversal and analytic study comparing 88 children and adolescentes with sickle cell disease (SCD group) with 49 healthy children and adolescentes (control group - CG), aged (patients and controls) from 6 to 18 years. Both groups were submitted to the following evaluations: cardiorespiratory capacity by the submaximal physical effort test Six-Minute Step Test - TD6', evaluated before, during (3 and 6 minutes) and after (10 minutes); heart rate (HR) and transcutaneous pulse oximetry oxygen saturation (SpO2). After the test the number of steps taken was evaluated, and the degree of fatigue and dyspnea, graduated by the scale of dyspnea and effort of Borg. Pulmonary function was evaluated before and after bronchodilator inhalation, by Spirometry. Statistical analysis: the groups were paired by age, sex, weight, height and BMI. Parametric and non-parametric methods were used depending the variables studied. Tests were considered significant when p<0.05. Results: There was no significant statistical difference in the demographic characteristics between the SCD group and the CG group. Mean age and BMI per group (SCD vs CG) 10.6 vs 9.8 years (p= 0.117) and 17.7 vs 18.8 kg/m² (p= 0,101). Comparing the spirometry parameters of SCD vs GC groups, it was observed the following diagnoses - Normal: 47 (66.2%) vs 37 (90.2%); Obstructive response to BD: 7 (9.9%) vs 2 (4.9%); Obstructive without BD response: 12 (16.9%) vs 0 (0%); Restrictive: 5 (7%) vs 2 (4.9%) p=0.003. In TD6 it was observed a significant statistical difference between SCD and CG groups regarding HR, SpO2. The number of steps taken by SCD group 126 (72-206) was lower than CG group 145 (89-289) (p <0.001). Conclusions: In this study, children and adolescents with SCD presented a cardiorespiratory response to submaximal exercise below that predicted in comparison to healthy children and adolescents with the same age and weightstature characteristics. The pulmonary function of the SCD group was predominantly obstructive pulmonary alteration not responsive to bronchodilator inhalation.