O objetivo deste trabalho foi avaliar o efeito da aplicação da pressão positiva contínua nas vias aéreas (CPAP), na frequência respiratória (FR), no volume corrente (VC) e no volume minuto (VM), em pacientes em pós-operatório de cirurgia bariátrica. Foram estudadas dez pacientes com média de idade 29,8±8 anos, classificadas como obesas mórbidas [índice de massa corpórea (IMC) de 47,5±7,2 kg/m²] que receberam CPAP de 8 a 10 cmH2O, por 30 minutos, uma vez ao dia, durante dois dias consecutivos, no pós-operatório de cirurgia bariátrica. Antes e após a aplicação da CPAP, foram aferidos a FR e o VM por meio do ventilômetro e, de forma indireta, foi calculado o VC. Para verificar a normalidade dos dados foi aplicado o teste de Shapiro-Wilk, e, após, as medidas foram comparadas com o uso do Teste t de Student e de Man-Whitney. As análises foram processadas com o uso do SPSS 7,5 considerando o nível de 5% de significância. Houve um aumento significativo para as seguintes variáveis estudadas no primeiro e no segundo dia de aplicação: FR=20±6 resp/min versus 26±7 resp/min (p=0,009) e FR=22±7 resp/min versus 26±8 resp/min (p=0,007); VM=9,57±2,75 L versus 12,39±4,18 L (p=0,041) e VM=9,71±2,52 L versus 11,18±2,96 L (p=0,037). Os valores do VC=360±157,59 mL versus 440±69,18 mL (p=0,21) e 401±90,46 mL versus 416±78,04 mL (p=0,18) não apresentaram diferença significativa na comparação pré- e pós-aplicação, nos dois dias de terapia. Assim, foi possível concluir que a CPAP pode ser aplicada como recurso auxiliar da fisioterapia respiratória no tratamento de pacientes em período pós-operatório de cirurgia bariátrica, para a manutenção do VC, porém atenção deve ser tomada durante a aplicação, pois pode haver aumento da FR.

The objective was to evaluate the effect of continuous positive airway pressure (CPAP) in the respiratory rate (RR), tidal volume (TV) and minute volume (MV) in patients after bariatric surgery. Ten patients with mean age 29.8±8 years, classified as morbidly obese (BMI 47.5±7.2 kg/m²) who received CPAP from 8 to 10 cmH2O, for 30 minutes, once a day for two consecutive days, in the post-bariatric surgery were studied. Before and after applying CPAP were measured RR and the MV through the ventilometer, and indirectly the TV were calculated . The Shapito-Wilk was applied to check the normality of data, and then the measures were compared using the Student's t-test and Mann-Whitney test. Analyses were processed using the SPSS 7.5 considering the 5% level of significance. There was a significant increase for the following variables in the first and second days of application: RR=20±6 breathing/min versus 26±7 breathing/min (p=0.009), and RR=22±7 breathing/min versus 26±8 breathing/min (p=0,007); MV=9.57±2.75 L versus 12.39±4.18 L (p=0.041), and MV=9.71±2.52 L versus 11,18±2.96 L (p=0.037). The values of TV=360±157,59 mL versus 440±69,18 mL (p=0,21), and 401±90,46 mL versus 416±78,04 mL (p=0,18) did not differ significantly when comparing pre- and post-application in two days therapy. Thus, it was concluded that CPAP can be applied as an auxiliary respiratory therapy in the treatment of patients in post-bariatric surgery for the maintenance of TV, but care should be taken during application, there may be increased RR.

INTRODUCTION: Upper limb exercises are frequently used in respiratory physiotherapy, with UL elevation and controlled inspiratory timing. However, the use of expiration during upper limb elevation appears to be a strategy that could minimize the action of accessory muscles in patients with chronic obstructive pulmonary disease. In this context, little is known about the synchrony of upper limb (UL) movements associated with breathing. The aim of this study was to investigate the respiratory pattern of chronic obstructive pulmonary disease patients during different UL exercises associated with respiratory exercises. METHODS: Fifteen chronic obstructive pulmonary disease patients participated in this study. Respiratory pattern analysis by inductance plethysmography was performed during four types of upper limb exercises, two shoulder flexion-extension (one associated with inspiratory time during the concentric phase and the other associated with expiratory time) and two shoulder abduction-adduction (same timing as above). Statistical analysis was performed by the Kolmogorov-Smirnov test and ANOVA with Tukey tests (p< 0.05). RESULTS: The thoracoabdominal coordination measurements increased in the two exercises using both inspiration during shoulder flexion (PhRIB: 172%; PhREB: 131%; PhRTB: 142% and PhAng: 238%) as well as in shoulder horizontal abduction (PhRIB: 145%; PhREB: 109%; PhRTB: 130% and PhAng: 229%), differing from the exercises with expiration at the time of shoulder flexion and horizontal abduction. CONCLUSION: The exercises performed with inverted respiratory time produced less asynchrony and can be used as important strategies during physical exercise programs in these patients.