Palavras-chave
Valores de referência
Espirometria
Altitude
Adulto
Demografia
Revisão sistemática
Meta Análise
Como Citar
Resumo
Introdução: a espirometria é um teste de função pulmonar utilizado na avaliação de programas de reabilitação para avaliar exposição a tóxicos e alérgenos, em estudos epidemiológicos e no desenvolvimento de equações de referência em populações específicas; estes valores podem variar de acordo com a altura. Objetivo: estabelecer as diferenças entre os valores de referência da espirometria forçada em adultos residentes em alturas maiores e menores a 1500 metros acima do nível do mar. Métodos: revisão sistemática, foram encontrados 536 estudos, foram avaliados 66 em texto completo, 33 em qualidade metodológica com as listas de exame Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies e Quality Assessment of Case-Control Studies; 21 estudos foram selecionados para revisão e 12 produziram metanálise. Resultados: 48 923 participantes tiveram alturas entre 2,4 e 4440 m s. n. m. Existem diferenças iniciais ao relacionar altura (+/-1500 m s. n. m) com VEF1 (homens: DM 0,29; IC: 0,03-0,55; mulheres: DM 0,27; IC: -0,07-0,60) e valores de referência com sexo: CVF (DM 1,31; IC: 1,24-1,37) e VEF1 (DM: 1,03; IC: 0,95-1,11). Foi relatada alta heterogeneidade e risco de enviesamento. Discussão: estas diferenças são dadas em função de aspectos antropométricos e fisiológicos como a aclimatação e o envelhecimento pulmonar. Os mecanismos que influenciam estas alterações são a adaptação genética, molecular, fisiológica e anatômica, que permitem compensar os efeitos da hipóxia aguda ou crônica, o que aumenta a ventilação alveolar e os valores espirométricos. Conclusões: os valores de referência da espirometria variam de acordo com a altura (maiores em alturas > 1500 m s. n. m) e sexo (mais elevados em homens). É necessário ter provas mais amplas e contundentes na temática.
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Copyright (c) 2023 Mónica Paola Quemba-Mesa, Adriana Sofía Valero-Ortiz, Marcela América Roa-Cubaque, Flor Angela Umbacia-Salas, Myriam Rocío Wilches-Wilches, Leidy Carolina Pirachicán-Soto