Papel do exercício físico na isquemia/reperfusão pulmonar e resposta inflamatória
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Data
2009-12-01
Autores
Delbin, Maria Andréia [UNESP]
Antunes, Edson
Zanesco, Angelina [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Sociedade Brasileira de Cirurgia Cardiovascular
Resumo
O avanço tecnológico associado aos novos conhecimentos científicos tem proporcionado melhora na prevenção e/ou tratamento das complicações cardiorrespiratórias advindas de cirurgias cardiotorácicas e procedimentos envolvendo isquemia/reperfusão (IR), mas os riscos destes procedimentos ainda permanecem altos. Assim, medidas profiláticas que possam reduzir o aparecimento das complicações pós-cirúrgicas em pacientes devem ser investigadas. O exercício físico aeróbio de moderada intensidade tem sido recomendado como terapia não farmacológica tanto na prevenção como no tratamento de diversas doenças cardiovasculares e endócrino-metabólicas. Assim, o objetivo desse trabalho foi realizar uma revisão de literatura sobre os mecanismos pelos quais o processo de IR pulmonar promove lesão local e sistêmica de órgãos, e o papel dos mediadores inflamatórios na IR pulmonar. Além disso, essa revisão abordará a influência do exercício físico moderado como abordagem profilática nas complicações advindas da IR pulmonar. Essa revisão evidencia a escassez de trabalhos na área e a necessidade de maiores estudos enfocando o preparo físico dos pacientes a serem submetidos à cirurgia cardiotorácica. Trabalhos pioneiros foram desenvolvidos em modelos animais, demonstrando a importância do exercício físico na redução da resposta inflamatória induzida pelo procedimento de IR pulmonar. Conclui-se que o preparo pré-cirúrgico dos pacientes deve envolver equipe multidisciplinar da área de saúde, com inclusão de profissional de educação física, para que a prescrição do exercício físico seja individualizada e supervisionada. Além disso, esse preparo pré-cirúrgico poderá propiciar redução das complicações advindas do processo operatório, redução do período de internação hospitalar e, consequentemente, melhora na recuperação do paciente, acarretando ainda menores gastos para o sistema de saúde. Foram utilizadas como referências publicações em inglês e português de artigos científicos nas bases de dados SciELO e MEDLINE (de 1987 até 2008) e também textos clássicos relacionados ao tema.
Advances in new technologies associated with improvement of knowledge in medicine have promoted important development in therapeutic and preventive approaches in an attempt to diminish complications following cardiothoracic process involving ischemia/ reperfusion (IR). Nevertheless, postoperative pulmonary injuries remain high and are considered one of the most frequent complications after cardiothoracic surgery. Thus, new strategies with prophylactic actions are crucial in cardiovascular area in an attempt to reduce complications and to improve patient life. It is well documented that exercise training is a non-pharmacological tool to prevent and/or treat cardiovascular and endocrine-metabolic diseases. The aim of this review was to provide an update of several studies pulmonary IR process and its local and systemic complications and the role of inflammatory response. Furthermore, this review focused on the effects of exercise training on the pulmonary IR as an important strategy to diminish its complications. This review shows that few studies exist regarding the health-promoting physical exercise in cardiothoracic surgery and how important is necessary to increase studies in this area. Recently, studies from our laboratory showed beneficial effects of exercise training in experimental model of pulmonary IR. Collectively, data show that physical preconditioning for patients is very important approach to reduce postsurgical complications as well as diminish the time of hospitalization which includes a specialized personal trainer in the health team. Moreover, this preventive strategy might improve patient recovery and would lead to consuming less resources of the health care system. This review included experimental studies in English and Portuguese found in SciELO and MEDLINE (from 1987 to 2008) and also classics texts related to the title.
Advances in new technologies associated with improvement of knowledge in medicine have promoted important development in therapeutic and preventive approaches in an attempt to diminish complications following cardiothoracic process involving ischemia/ reperfusion (IR). Nevertheless, postoperative pulmonary injuries remain high and are considered one of the most frequent complications after cardiothoracic surgery. Thus, new strategies with prophylactic actions are crucial in cardiovascular area in an attempt to reduce complications and to improve patient life. It is well documented that exercise training is a non-pharmacological tool to prevent and/or treat cardiovascular and endocrine-metabolic diseases. The aim of this review was to provide an update of several studies pulmonary IR process and its local and systemic complications and the role of inflammatory response. Furthermore, this review focused on the effects of exercise training on the pulmonary IR as an important strategy to diminish its complications. This review shows that few studies exist regarding the health-promoting physical exercise in cardiothoracic surgery and how important is necessary to increase studies in this area. Recently, studies from our laboratory showed beneficial effects of exercise training in experimental model of pulmonary IR. Collectively, data show that physical preconditioning for patients is very important approach to reduce postsurgical complications as well as diminish the time of hospitalization which includes a specialized personal trainer in the health team. Moreover, this preventive strategy might improve patient recovery and would lead to consuming less resources of the health care system. This review included experimental studies in English and Portuguese found in SciELO and MEDLINE (from 1987 to 2008) and also classics texts related to the title.
Descrição
Palavras-chave
Isquemia, Reperfusão, Mediadores da inflamação, Exercício, Ischemia, Reperfusion, Inflammation mediators, Exercise
Como citar
Revista Brasileira de Cirurgia Cardiovascular. Sociedade Brasileira de Cirurgia Cardiovascular, v. 24, n. 4, p. 552-561, 2009.