Avaliação da dessaturação induzida pelo exercício em pacientes com bronquiectasia: testes de laboratório versus testes de campo

Abstract

Introduction: Different modalities exercise lead to different magnitudes of pulse oxygen desaturation (DeSpO2) in lung diseases. Objective: To compare the exercise-induced DeSpO2 between incremental cardiopulmonary exercise test on a treadmill (TECPI-E) and the incremental shuttle walk test (ISWT) and between sub-maximum cardiopulmonary exercise test (TECPS-E) and endurance SWT (ESWT) in patients with bronchiectasis (BCT). Material and methods: 72 patients with BCT (28 men, 48 ± 15 years, FEV1:54 ± 23% of predicted) and not oxygen dependent were assessed. The order of the TECPI-E and SWTI was randomized, but not the TECPS-E and ESWT because they require that incremental tests be performed first. Treadmill and hallway tests were performed on two different visits. A reduction  4 was considered DeSpO2. Results: There was no difference in DeSpO2 between TECPI-E (-7.7% ± 6.3%) and ISWT (-6.3% ± 5.8%) and between TECPS-E (-6,8% ± 5,8%) and ESWT (-7.2% ± 6.3%). In the incremental and endurance tests, there was an agreement to DeSpO2 or not DeSpO2 in 56 and 55 patients, respectively. There was a statistically significant difference in heart rate (percentage of the maximum predicted) between TECPI-E (87.0% ± 9.0%) and ISWT (78.9% ± 11.4%) and between TECPS-E (84.5% ± 9.9%) and ESWT (79.3% ± 11.8%). However, when comparing patients who reached 85% of predicted maximum heart rate or not, there was no difference in the magnitude of DeSpO2. Conclusion: In patients with BCT, our results show that field-based tests may replace the laboratory-based tests when the clinic question is the evaluation of exercise-induced DeSpO2.