Objective: To determine the nocturnal oximetry pattern in chronic obstructive pulmonary disease patients having no sleep apnea and presenting mild daytime hypoxemia, to identify probable daytime parameters capable of predicting nocturnal desaturation, and to evaluate the influence of nocturnal desaturation on the sleep pattern of these patients. Methods: Twenty-five patients were divided into two groups: those with nocturnal desaturation and those without. Results: Comparing the first group (52%) with the second, we found the following: age, 63 + 5 years versus 63 + 6 years; forced expiratory volume in the first second = 53 + 31% versus 56 + 19% predicted; ratio of forced expiratory volume in the first second to forced vital capacity, 49 + 14% versus 52 + 10%; arterial oxygen tension, 68 + 8 mmHg versus 72 + 68 mmHg; and arterial oxygen saturation, 93 + 2% versus 94 + 1%. Patients in the nocturnal desaturation group presented lower daytime arterial oxygen saturation and nocturnal arterial oxygen saturation by pulse oximetry. There was no difference between the two groups in terms of the sleep patterns observed. The ratio of forced expiratory volume in the first second to forced vital capacity was found to correlate with forced vital capacity, daytime arterial oxygen tension and daytime arterial oxygen saturation. In addition, arterial oxygen saturation by pulse oximetry during exercise was found to correlate with nocturnal arterial oxygen saturation by pulse oximetry. However, only daytime arterial oxygen saturation was predictive of nocturnal desaturation. Conclusion: The only variable capable of predicting nocturnal desaturation was daytime arterial oxygen saturation. Nocturnal desaturation did not influence the sleep patterns of patients with chronic obstructive pulmonary disease accompanied by mild daytime hypoxemia.

Keywords: Sleep, REM; Pulmonary disease, chronic obstructive; Anoxemia; Spirometry; Wakefulness

Background: Pulmonary rehabilitation is widely recommended for the treatment of chronic obstructive pulmonary disease. Objective: To evaluate the efficacy of pulmonary rehabilitation in improving exercise capacity, respiratory muscle strength and quality of life of chronic obstructive pulmonary disease patients. Method: This was an open, non-randomized clinical trial involving 27 clinically stable ex-smokers with chronic obstructive pulmonary disease who were enrolled in a pulmonary rehabilitation program. All were evaluated before and after pulmonary rehabilitation. Results: Mean age was 65 ± 5 years, mean body mass index was 25 ± 4 kg/m2, mean forced expiratory volume in one second was 55 ± 25% of predicted, mean ratio between forced expiratory volume in one second and forced vital capacity was 50 ± 12%, and mean arterial oxygen tension was 70 ± 7 mmHg. Comparison of pre- and post-pulmonary rehabilitation values revealed improvement in the distance walked in the 6-minute walk test (513 ± 99 m vs. 570 ± 104 m), maximum upper limb load (2 ± 1 kg vs. 3 ± 1 kg) and maximal inspiratory pressure (-89 ± 23 cmH2O vs. -102 ± 23 cmH2O), as well as in the activity domain, impact domain and total score on the Saint George's Respiratory Questionnaire. Conclusion: Pulmonary rehabilitation, when performed with care and with a focus on physical training, is efficacious in increasing not only the distance walked in the 6-minute walk test but maximum upper limb load, maximal inspiratory pressure and quality of life as well.

Keywords: Key words: Pulmonary rehabilitation. Chronic obstructive pulmonary disease. Quality of life. Respiratory muscles.

Objective: To evaluate the effect that maintaining tracheobronchial sputum at room temperature has on the analysis of ciliary transport and cough, as well as on the contact angle. Methods: Hyaline sputum was collected from 30 individuals without pulmonary diseases, and purulent sputum was collected from patients with bronchiectasis. The samples were analyzed immediately after collection and again after 24 h. Results: After 24 h at room temperature, the purulent sputum presented an increase in cough-induced dislodgment (96 ± 50 vs. 118 ± 61 mm) and a decrease in the contact angle (32 ± 6 vs. 27 ± 6 degrees) (p < 0.05). For the hyaline sputum, there were no alterations in the parameters analyzed. Conclusion:  Hyaline tracheobronchial sputum can be stored in room temperature for 24 h without presenting alterations in ciliary transport or contact angle. However, purulent sputum should not be stored at room temperature for many hours, since ciliary transport and contact angle might be altered as a result.

Keywords: Temperature; Sputum; Cough; Mucociliary clearance

Background: Pulmonary Rehabilitation (PR) improves the quality of life of chronic obstructive pulmonary disease (COPD) patients. However, the influence of PR on the sleep pattern of these patients is unknown. Objective: To evaluate the influence of PR on the sleep patterns of patients with COPD. Method: A total of 27 patients (22 men/5 women) were submitted to polysomnographic, gasometric and anthropometric studies before and after six weeks of PR and were evaluated using the Epworth Sleepiness Scale. The results were analyzed using paired Student's t-test, ANOVA and Newman-Keuls multiple comparison test. Results: Mean age was 63.3 5.3 years, mean FEV1 was 54.8 25.4% of predicted, mean FEV1/FVC was 49.9 12.0% of predicted, mean resting PaO2 was 69.7 7.3 mmHg, and mean resting SaO2 was 93.7 2.1%. Polysomnography revealed sleep patterns to be fragmented, with frequent waking and reduced slow-wave sleep, as well as oxygen desaturation. The most significant drops in oxygen saturation occurred during rapid eye movement sleep. No significant differences were observed between pre- and post-PR values for the other variables studied (p > 0.05).Conclusion: In the group of patients studied, PR did not alter sleep patterns.

Keywords: Sleep. Pulmonary Disease. Chronic Obstructive. Lung Diseases, rehabilitation.

Objective: To determine the effect that re-education of the thoracic and abdominal muscles has on the respiratory muscle strength of patients with cystic fibrosis evaluated over time at the Cystic Fibrosis Outpatient Clinic of the Universidade Católica de Brasília (Catholic University of Brasília). Methods: The sample consisted of 29 cystic fibrosis patients, characterized based on anthropometric, genetic and bacterial colonization data. The patients were submitted to physical therapy sessions, involving re-education of the respiratory muscles, twice a week for four months. Spirometry, pressure manometry and anthropometry were performed before and after each session. Results: Comparing baselines values to those obtained after physical therapy, increases in maximum inspiratory pressure and maximum expiratory pressure were observed in all patients, those without any obstructive respiratory disease and those with mild obstructive respiratory disease (p < 0.05). A positive correlation between age and maximum expiratory pressure was observed for most of the patients. Maximum inspiratory pressure correlated positively with age only in the group with mild obstructive respiratory disease (p = 0.012; r = 0.817). In female patients and in the group of patients without obstructive respiratory disease, a negative correlation was observed between maximum expiratory pressure and colonization with Pseudomonas aeruginosa (p = 0.036; r = -0.585). Conclusion: Use of the thoracic and abdominal muscle re-education technique increased respiratory muscle strength in the cystic fibrosis patients studied, a finding that underscores the importance of including physical therapy in the treatment of these patients.

Keywords: Cystic fibrosis/rehabilitation; Physical therapy technique; Respiratory muscles; Forced expiratory volume; Inspiratory capacity; Vital capacity