A importância da medida da força muscular respiratória na prática da pneumologia

A medida da forca dos musculos respiratorios e um exame nao invasivo, simples, de baixo custo e util napratica clinica. Dentre os metodos utilizados para mensuracao da forca muscular respiratoria, destaca-se, a medida das pressoes respiratorias maximas em nivel da boca: PImax e PEmax. A Pressao inspiratoria maxima (PImax) reflete a forca dos musculos inspiratorios e do diafragma; enquanto a pressao expiratoria maxima (PEmax) reflete a forca dos musculos abdominais e expiratorios. As indicacoes comuns na pratica clinica incluem: a confirmacao da disfuncao muscular respiratoria em doencas neuromusculares; diagnostico diferencial de dispneia, tosse ineficaz; espirometria com disturbio ventilatorio restritivo sem causa aparente; avaliacao de resposta a fisioterapia e a reabilitacao pulmonar; avaliacao pre-operatoria da funcao dos musculos ventilatorios e da possibilidade de desmame da ventilacao mecânica; e, avaliacao do risco de mortalidade e hospitalizacoes em pacientes com DPOC e insuficiencia cardiaca.Esta revisao teve como objetivo apresentar a importância da aplicacao do teste da forca muscular respiratoria na pratica da pneumologia. Descreveremos a tecnica e a interpretacao dos resultados. The measurement of respiratory muscle strength is a noninvasive test, simple, inexpensive and useful in clinical practice. Among the used methods to measure the respiratory muscle strength, the determination ofmaximal respiratory pressures in terms of mouth: MIP and MEP have been showed most important. The MaximumInspiratory Pressure (MIP) reflects the strength of the inspiratory muscles and the diaphragm; while the MaximumExpiratory Pressure (MEP) reflects the strength of the abdominal and expiratory muscles. The common indications in clinical practice include: confirmation of respiratory muscle dysfunction in neuromuscular diseases; differential diagnosis of dyspnea, ineffective cough or restrictive lung disease without apparent cause; response evaluation to physical therapy and pulmonary rehabilitation; preoperative evaluation of thefunction of respiratory muscles and the possibility of ventilation weaning ; and mortality and hospitalization riskassessment in patients with COPD and heart failure. This review aims to present the importance of the application of respiratory muscle strength test in the practice of pulmonology. Furthermore, this review also describes the technique and interpretation of results.