Análise do perfil respiratório de pacientes com doença neuromuscular com indicação de uso de ventilação não invasiva (VNI)

Abstract

Introduction: Neuromuscular diseases (NMD) present a progressive loss of respiratory muscle strength, which alters lung compliance and reduces bronchial hygiene. Objectives: To describe the respiratory clinical-functional profile of children, adolescents and young adults with NMD with indication for NIV use. Methods: This is a retrospective cohort study of patients with NIV indication. Patients who were able to perform the breathing tests were included, with evaluation before and after the use of NIV. Results: There was a reduction in symptoms, mainly dyspnea (p < 0.02). The median of the sample was 16 years. The median FVC remained 1.38 after NIV. Through the paired t test, PFT, CV% and FVC showed significant differences (p<0.05). Spearman's correlation test indicates an association between the difference in PEF and PFT (r=0.503 p<0.02); inverse relationship between PFT and the number of hours (r=-0.33 p<0.05); linear relationship between MIP and age (r=0.413 p<0.01) and an inverse relationship between MEP and the number of hours of NIV (r=-0.34 p<0.04). The hospitalization rate requiring intubation was zero. Conclusions: Among the benefits of NIV is the tendency to reduce symptoms and decrease the rate of respiratory failure requiring hospitalization. In a small number of the sample, there was an increase in maximal inspiratory pressures, which may be a result of muscle rest, due to the pressure of ventilatory support. This has been shown to slow the decline in lung function but is not associated with the number of hours of NIV use.