Objective: The aim of the present study was to evaluate the effects that inspiratory muscle training (IMT) and respiratory exercises have on muscle strength, peak expiratory flow (PEF) and severity variables in children with asthma. Methods: This was a randomized analytical study involving 50 children with asthma allocated to one of two groups: an IMT group, comprising 25 children submitted to IMT via an asthma education and treatment program; and a control group, comprising 25 children who were submitted only to monthly medical visits and education on asthma. The IMT was performed using a pressure threshold load of 40% of maximal inspiratory pressure (MIP). The results were evaluated using analysis of variance, the chi-square test and Fisher's exact test, values of p < 0.05 being considered significant. Results: In the comparative analysis, pre-and post-intervention values of MIP, maximal expiratory pressure (MEP) and PEF increased significantly in the IMT group: MIP from −48.32 ± 5.706 to −109.92 ± 18.041 (p < 0.0001); MEP from 50.64 ± 6.55 to 82.04 ± 17.006 (p < 0.0001); and PEF from 173.6 ± 50.817 to 312 ± 54.848 (p < 0.0001). In the control group, however, there were no significant differences between the two time points in terms of MIP or MEP, although PEF increased from 188 ± 43.97 to 208.80 ± 44.283 (p < 0.0001). There was a significant improvement in the severity variables in the IMT group (p < 0.0001). Conclusions: Programs involving IMT and respiratory exercises can increase mechanical efficiency of the respiratory muscles, as well as improving PEF and severity variables.Keywords: Breathing exercises; Asthma/therapy; Asthma/rehabilitation. ResumoObjetivo: Avaliar efeitos do treinamento muscular inspiratório (TMI) e exercícios respiratórios na força muscular, pico de fluxo expiratório (PFE) e variáveis de gravidade em crianças asmáticas. Métodos: Estudo analítico, experimental aleatório em 50 crianças asmáticas alocadas aleatoriamente em dois grupos: um grupo composto de 25 crianças que realizaram TMI em um programa de assistência e educação em asma (grupo TMI); e um grupo controle, composto de 25 crianças que foram submetidas apenas às consultas médicas mensais e educação em asma. O TMI foi realizado com o threshold com a carga de 40% da pressão inspiratória máxima (PImáx). A análise dos resultados foi realizada através da análise da variância, teste de qui-quadrado e teste exato de Fisher, sendo considerado significante o valor de p > 0,05. Resultados: Na análise comparativa, observou-se aumento significativo da PImáx, da pressão expiratória máxima (PEmáx) e do PFE pré-e pós-intervenção no grupo TMI, como se segue: PImáx de −48,32 ± 5,7 para −109,92 ± 18 (p < 0,0001); PEmáx de 50,64 ± 6,5 para 82,04 ± 17(p < 0,0001); e PFE de 173,6 ± 50 para 312 ± 54 (p < 0,0001). Entretanto, não houve aumento significativo da PImáx e PEmáx no grupo controle, somente no PFE, de 188 ± 43,97 para 208,80 ± 44,283 (p < 0,0001). Houve melhora significativa das variáveis de gravidade no grupo TMI (p < 0,0001). Conc...
(PR = 3.86), wheezing in early childhood (PR = 4.58), and allergic rhinitis (PR = 3.21).
Complicações pulmonares em crianças submetidas à cirurgia cardíaca em um hospital universitárioPulmonary complications in pediatric cardiac surgery at a university hospital Federal Abstract Objective: To identify the prevalence of pulmonary complications in children subjected to cardiac surgery, as well as demographic and clinical characteristics of the studied population.Methods: The sample comprised 37 children of both genders, subjected to cardiac surgery at the Hospital Universitário Presidente Dutra, São Luis (MA), during the year of 2007. Patients who had pre-operative pulmonary disease, patients with neurological disorders, intra-operative death besides lack of data in medical records were not included. The data were obtained from data collection of medical and nursing developments of the respective medical records.Results: The population of the study was predominantly composed by female children, from the countryside and at school age. Pathologies considered as low risk were the majority, highlighting the patent ductus arteriosus, ventricular septal defect and interatrial septal defect. It was observed that most children used cardiopulmonary bypass for over 30 minutes, with a median of 80 minutes, suffered a median sternotomy, using only the mediastinal drain and made use of postoperative mechanical ventilation, with the median of about 6.6 hours. Only 8.1%, in other words, three patients developed pulmonary complications, and of those, two died.Conclusion: Most of the sample children was female, school aged and from the countryside. The low time of cardiopulmonary bypass and mechanical ventilation, in addition to congenital heart diseases with low risk, may have been factors that contributed to the low rate of postoperative pulmonary complications.Descriptors: Congenital Heart Diseases. Surgery. Postoperative Complications.
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