de Melo Robert, Alcantara Livia, Sarmet Max, Sheers Nicole L, Berlowitz David J, Maldaner Vinicius
Post Graduation Department, Escola Superior de Ciências da Saúde (ESCS), Brasilia, Distrito Federal, Brazil.
Human Movement and Rehabilitation Graduation Program, Unievangelica, Anapolis, Goias, Brazil.
Pulm Med. 2025 Jan 10;2025:4073171. doi: 10.1155/pm/4073171. eCollection 2025.
Lung volume recruitment (LVR) is a stacked-breath assisted inflation technique in which consecutive insufflations are delivered, without exhaling in between, until the maximum tolerable inflation capacity is reached. Although LVR is recommended in some neuromuscular disease guidelines, there is little information detailing when and how allied health professionals (AHPs) prescribe LVR. This study is aimed at describing the use of LVR in practice across Brazil. A cross-sectional e-survey (Sep-Nov 2023) explored LVR practices among qualified clinical or home care AHPs in Brazil. It gathered participant data on geographical region, profession, and experience. It delved into LVR specifics: clinical population and indications for use, prescription (frequency, dosage, and interfaces), related side effects, outcomes assessed, and combined therapies. Results were presented descriptively. One hundred two surveys (74 physical therapists (PTs) and 28 speech and language pathologists (SLPs)) from diverse locations were collected. LVR was predominantly prescribed for adults (57%), with the most common diagnosis being amyotrophic lateral sclerosis (84%). Changes in peak cough flow and vital capacity were the most common reasons for LVR prescription. Maximal insufflation capacity was reportedly measured by 58% of PTs and 22% of SLPs. Chest wall soreness and discomfort were the most common side effects, and many respondents did not provide warnings about potential side effects (42% PTs and 50% SLPs). The study highlighted common use of other respiratory therapy devices alongside LVR. LVR is available in routine clinical and home care settings in Brazil. There is a lack of standardization regarding indications, prescription, and outcome measures among PTs and SLPs in Brazil. Clear recommendations and guidelines are needed to standardize these parameters, enabling more objective data and facilitating comparisons between centers.
肺容积复张(LVR)是一种叠加呼吸辅助通气技术,即连续进行通气,期间不呼气,直至达到最大耐受通气量。尽管一些神经肌肉疾病指南推荐使用LVR,但关于何时以及如何由专职医疗人员(AHP)开具LVR处方的信息却很少。本研究旨在描述LVR在巴西各地的实际使用情况。一项横断面电子调查(2023年9月至11月)探讨了巴西合格的临床或家庭护理AHP对LVR的使用情况。该调查收集了参与者的地理区域、职业和经验等数据。它深入研究了LVR的具体情况:临床人群、使用指征、处方(频率、剂量和接口)、相关副作用、评估的结果以及联合治疗。结果以描述性方式呈现。收集了来自不同地点的102份调查问卷(74名物理治疗师(PT)和28名言语和语言病理学家(SLP))。LVR主要用于成人(57%),最常见的诊断是肌萎缩侧索硬化症(84%)。咳嗽峰值流量和肺活量的变化是开具LVR处方最常见的原因。据报道,58%的PT和