持续气道正压通气对慢性心力衰竭患者气道的影响。

Effects of the continuous positive airway pressure on the airways of patients with chronic heart failure.

机构信息

Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.

出版信息

Arq Bras Cardiol. 2010 Jul;95(1):115-21. doi: 10.1590/s0066-782x2010005000068. Epub 2010 Jun 11.

DOI:10.1590/s0066-782x2010005000068

PMID:20563517

Abstract

BACKGROUND

Heart failure can present with asymptomatic dysfunction at decompensation, with limitations and decrease in the productive capacity. The Continuous Positive Airway Pressure (CPAP) is a non-pharmacological means to decrease afterload.

OBJECTIVE

To analyze the effects of CPAP (10 cmH2O), for 30 days in patients with chronic heart failure.

METHODS

We assessed 10 patients with heart failure (6 males, 4 females) of several etiologies, with a mean age of 54 +/- 14 years, with a BMI of 21 +/- 0.04 kg/m(2). The therapy was applied for 60 min., 5 times a week for 30 days, during the daytime. The echocardiogram and the ergospirometry were analyzed, before and 30 days after the therapy.

RESULTS

There was a 19.59% increase in the left ventricular ejection fraction (LVEF): 23.9 +/- 8.91 vs 27.65 +/- 9.56%; p = 0.045. At the ergospirometry, the exercise time (ET) showed a significant increase from 547 +/- 151.319 vs 700 +/- 293.990 sec., p = 0.02; oxygen consumption (VO2) was 9.59 +/- 6.1 vs 4.51 +/- 2.67 ml x kg(-1) x min(-1), p = 0.01, whereas the carbon dioxide production (VCO2) at rest (9.85 +/- 4.38 vs 6.44 +/- 2.88 ml x kg(-1) x min(-1), p = 0.03) decreased.

CONCLUSION

The CPAP resulted in an increase in the LVEF and ET, decreased the oxygen consumption and the carbon dioxide production at rest.

摘要

背景

心力衰竭在失代偿时可能表现为无症状性功能障碍，存在活动受限和生产能力下降。持续气道正压通气（CPAP）是一种降低后负荷的非药物手段。

目的

分析 CPAP（10cmH2O）对慢性心力衰竭患者的影响，持续 30 天。

方法

我们评估了 10 名心力衰竭患者（6 名男性，4 名女性），其病因各不相同，平均年龄 54+/-14 岁，BMI 为 21+/-0.04kg/m2。治疗应用于白天，每周 5 次，每次 60 分钟，持续 30 天。在治疗前和治疗后 30 天分析了超声心动图和运动心肺功能测试。

结果

左心室射血分数（LVEF）增加了 19.59%：23.9+/-8.91 与 27.65+/-9.56%；p=0.045。在运动心肺功能测试中，运动时间（ET）从 547+/-151.319 秒显著增加到 700+/-293.990 秒，p=0.02；耗氧量（VO2）为 9.59+/-6.1 与 4.51+/-2.67mlxkg(-1)xmin(-1)，p=0.01，而休息时二氧化碳产量（VCO2）从 9.85+/-4.38 下降到 6.44+/-2.88mlxkg(-1)xmin(-1)，p=0.03。