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mais de 3 meses&#44; prescrito para utiliza&#231;&#227;o durante o esfor&#231;o por m&#233;dicos pneumologistas num hospital central do Porto&#44; Portugal&#46; Foram crit&#233;rios de inclus&#227;o&#44; a documenta&#231;&#227;o de hipoxemia com o esfor&#231;o atrav&#233;s da prova de marcha de 6 minutos &#40;PM6<span class="elsevierStyleHsp" style=""></span>M&#41; em ar com evid&#234;ncia de dessatura&#231;&#227;o significativa &#40;para 88&#37; ou inferior&#41;&#44; resposta aguda ao oxig&#233;nio&#44; e actividade di&#225;ria significativa&#46; Foram considerados como sendo significativamente activos&#44; os doentes aut&#243;nomos &#40;n&#227;o dependentes de 3<span class="elsevierStyleSup"><span class="elsevierStyleItalic">a</span>s</span> pessoas para a execu&#231;&#227;o das actividades b&#225;sicas da vida di&#225;ria tais como vestir ou tomar banho&#41;&#44; n&#227;o restritos ao domic&#237;lio exceptuando as visitas m&#233;dicas&#44; e que se encontrassem algum tempo fora do domic&#237;lio para realiza&#231;&#227;o de actividades profissionais ou sociais&#46; Os doentes sob oxig&#233;nio l&#237;quido no contexto de cuidados paliativos foram exclu&#237;dos&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Para uma melhor avalia&#231;&#227;o dos efeitos da OD&#44; e com base no diagn&#243;stico m&#233;dico e na altera&#231;&#227;o ventilat&#243;ria major identificada nas provas de fun&#231;&#227;o respirat&#243;ria de base&#44; os doentes foram classificados em dois grupos&#58; padr&#227;o ventilat&#243;rio obstrutivo&#47; DPOC de acordo com a defini&#231;&#227;o da ATS&#47;ERS 2004<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> &#40;VEF<span class="elsevierStyleInf">1</span>&#47;CVF<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>70 p&#243;s-broncodilata&#231;&#227;o&#41;&#44; e padr&#227;o ventilat&#243;rio restritivo&#47; DPI &#40;rela&#231;&#227;o VEF<span class="elsevierStyleInf">1</span>&#47;CVF normal ou aumentada e capacidade pulmonar total<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>80&#37; do previsto&#41;&#46; O grupo de DPI incluiu doentes com pneumonites de hipersensibilidade&#44; silicose&#44; sarcoidose&#44; fibrose pulmonar idiop&#225;tica e doen&#231;a pulmonar relacionada com doen&#231;as do tecido conjuntivo&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Desenho do estudo</span><p id="par0035" class="elsevierStylePara elsevierViewall">As caracter&#237;sticas basais dos doentes foram obtidas retrospectivamente atrav&#233;s da revis&#227;o dos processos cl&#237;nicos e inclu&#237;ram dados demogr&#225;ficos&#44; resultados pr&#233;-tratamento da espirometria&#44; volumes pulmonares&#44; capacidade de difus&#227;o do CO &#40;Masterscreen Body Diffusion &#8211; Vmax 62&#44; Viasys Healthcare&#41;&#44; gasometria arterial em ar ambiente &#40;RapidLab 1265 &#8211; Siemens&#41; e da PM6<span class="elsevierStyleHsp" style=""></span>M realizada em ar e sob oxig&#233;nio&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Para suportar a prescri&#231;&#227;o da OD&#44; a resposta aguda ao oxig&#233;nio foi avaliada objectivamente em todos os doentes antes da interven&#231;&#227;o atrav&#233;s da PM6<span class="elsevierStyleHsp" style=""></span>M com e sem oxig&#233;nio&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">A satura&#231;&#227;o do oxig&#233;nio &#40;SatO<span class="elsevierStyleInf">2</span>&#41; em repouso e durante a PM6<span class="elsevierStyleHsp" style=""></span>M foi monitorizada atrav&#233;s da oximetria de pulso &#40;Pulsox-3i&#44; Konica Minolta&#41;&#46; O oxig&#233;nio suplementar para a realiza&#231;&#227;o da PM6<span class="elsevierStyleHsp" style=""></span>M foi fornecido atrav&#233;s de um sistema de oxig&#233;nio l&#237;quido com incrementos progressivos de 1L&#47;min at&#233; obten&#231;&#227;o da menor taxa de fluxo que mantivesse a SatO<span class="elsevierStyleInf">2</span> &#8805;90&#37;&#46; A dispneia&#44; em repouso e no final do exerc&#237;cio&#44; foi avaliada por estimativa atrav&#233;s da escala modificada de Borg &#40;0 &#8211; 10&#41;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Durante o m&#234;s de Julho de 2009&#44; um m&#233;dico realizou uma entrevista telef&#243;nica aos doentes&#44; tendo recolhido informa&#231;&#245;es relacionadas com a hist&#243;ria cl&#237;nica&#44; situa&#231;&#227;o profissional&#44; h&#225;bitos tab&#225;gicos&#44; n&#250;mero de horas e circunst&#226;ncias de prescri&#231;&#227;o da OD&#44; ades&#227;o &#40;utiliza&#231;&#227;o da OD fora de casa e durante os esfor&#231;os&#41;&#44; padr&#245;es de utiliza&#231;&#227;o da OD &#40;resultados apresentados na <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#41; e efeitos adversos&#46; Foi ainda aplicado por telefone um question&#225;rio para avalia&#231;&#227;o da QV &#40;o question&#225;rio S<span class="elsevierStyleItalic">hort Form &#40;SF&#41;-36 version 1</span>&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Enquanto a efic&#225;cia da OD foi avaliada objectivamente num exerc&#237;cio agudo&#44; os padr&#245;es de utiliza&#231;&#227;o da OD e a sua efic&#225;cia a longo prazo foram avaliados de uma forma subjectiva atrav&#233;s do question&#225;rio durante a entrevista&#46; Para avaliar a QV ap&#243;s a interven&#231;&#227;o foi pedido aos doentes para se reportarem ao per&#237;odo de estabiliza&#231;&#227;o mais recente&#44; e depois&#44; recuar no tempo para o per&#237;odo antes da utiliza&#231;&#227;o da OD&#44; avaliando assim a sua QV antes da interven&#231;&#227;o&#46; Foi escolhido o question&#225;rio de QV SF-36 v1 dado ser o instrumento de sa&#250;de para avalia&#231;&#227;o da QV mais extensivamente validado e utilizado<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&#46; Este possui dois componentes &#40;f&#237;sico e mental&#41; e analisa oito sub-dom&#237;nios &#40;fun&#231;&#227;o f&#237;sica&#44; desempenho f&#237;sico&#44; dor corporal&#44; sa&#250;de em geral&#44; vitalidade&#44; fun&#231;&#227;o social&#44; desempenho emocional&#44; sa&#250;de mental&#41;&#46; Foi ainda realizada uma quest&#227;o suplementar relacionada com o seu estado global de sa&#250;de comparativamente &#224; fase pr&#233;-OD&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">O estudo foi aprovado pelo comit&#233; de pesquisa local &#40;Unidade Integrada de Gest&#227;o de processos documentais&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">An&#225;lise estat&#237;stica</span><p id="par0065" class="elsevierStylePara elsevierViewall">Para cada vari&#225;vel e para o c&#225;lculo de propor&#231;&#245;es&#44; m&#233;dias e desvios padr&#227;o &#40;DP&#41; foram utilizados m&#233;todos <span class="elsevierStyleItalic">standard</span>&#46; As compara&#231;&#245;es entre grupos das caracter&#237;sticas basais dos doentes e da ader&#234;ncia &#224; OD foram realizadas atrav&#233;s do Teste-t para amostras n&#227;o emparelhadas ou Qui-quadrado&#44; quando apropriado&#46; Compara&#231;&#245;es de outros par&#226;metros antes e depois da prescri&#231;&#227;o da OD foram efectuadas atrav&#233;s do modelo de generaliza&#231;&#227;o linear ANOVA para medidas repetidas&#46; Para al&#233;m da compara&#231;&#227;o entre as duas condi&#231;&#245;es no grupo total de doentes &#40;ar vs&#46; oxig&#233;nio&#41; &#40;efeito intra-sujeitos&#41;&#44; foram exploradas diferen&#231;as entre grupos &#40;efeito inter-sujeitos&#41;&#44; e se os efeitos da OD eram dependentes do grupo diagn&#243;stico &#40;interac&#231;&#227;o&#41;&#46; Os resultados foram considerados estatisticamente significativos se p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; Os dados foram analisados atrav&#233;s do programa estat&#237;stico SPSS-17&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Caracter&#237;sticas basais dos doentes</span><p id="par0070" class="elsevierStylePara elsevierViewall">De um total de 45 doentes satisfazendo os crit&#233;rios de inclus&#227;o&#44; 3 sa&#237;ram da &#225;rea de resid&#234;ncia encontrando-se noutro pa&#237;s a aguardar transplante&#44; e outros 5 estavam incontact&#225;veis&#46; Trinta e sete doentes completaram assim o estudo com a entrevista telef&#243;nica&#46; As suas caracter&#237;sticas basais encontram-se na <a class="elsevierStyleCrossRef" href="#tbl0005">Tabela 1</a>&#46; Os doentes com DPOC apresentavam idade superior &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;013&#41;&#44; hipoxemia mais acentuada &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;025&#41;&#44; e maior hipercapnia &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Relativamente ao diagn&#243;stico dos doentes&#44; a DPOC foi o mais frequente &#40;54&#46;1&#37;&#41;&#44; representando o principal motivo de prescri&#231;&#227;o da OD&#46; A exist&#234;ncia de insufici&#234;ncia card&#237;aca&#44; outras doen&#231;as cardiovasculares ou insufici&#234;ncia dos m&#250;sculos respirat&#243;rios n&#227;o constitu&#237;ram motivos prim&#225;rios de prescri&#231;&#227;o da OD&#46; Por si s&#243;&#44; as sequelas de tuberculose pulmonar e bronquiectasias n&#227;o foram assumidos como crit&#233;rios isolados de prescri&#231;&#227;o&#44; contudo constitu&#237;ram diagn&#243;sticos secund&#225;rios em 18&#46;9&#37; e 13&#46;5&#37; dos casos&#44; respectivamente&#46; Um subgrupo de doentes apresentava s&#237;ndrome de apneia obstrutiva do sono como co-morbilidade &#40;13&#46;5&#37;&#41;&#44; requerendo&#44; em adi&#231;&#227;o &#224; OD&#44; ventiloterapia com press&#227;o positiva cont&#237;nua em regime nocturno&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Dos participantes do estudo&#44; 14 &#40;37&#46;8&#37;&#41; eram n&#227;o fumadores&#44; 22 &#40;59&#46;5&#37;&#41; ex-fumadores&#44; e 1 &#40;2&#46;7&#37;&#41; mantinha h&#225;bitos tab&#225;gicos&#46; Relativamente &#224; situa&#231;&#227;o profissional&#44; 30 &#40;81&#46;1&#37;&#41; encontravam-se reformados&#44; 6 &#40;16&#46;2&#37;&#41; com incapacidade tempor&#225;ria para o trabalho&#44; e 1 &#40;2&#46;7&#37;&#41; desempregado&#46; A maioria dos doentes vivia acompanhada &#40;por familiares ou prestadores de cuidados&#41;&#44; em 89&#46;2&#37; dos casos&#46; Dos 37 doentes&#44; 29 &#40;78&#46;4&#37;&#41; encontravam-se sob OLD&#44; sendo predominantemente do grupo DPOC &#40;95&#46;0&#37; vs&#46; 58&#46;8&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41;&#46; Cinco &#40;13&#46;5&#37;&#41; doentes frequentavam programas de reabilita&#231;&#227;o aquando da entrevista telef&#243;nica&#44; e 3 &#40;8&#46;1&#37;&#41; apresentavam hist&#243;ria de visitas m&#233;dicas n&#227;o programadas ou hospitaliza&#231;&#245;es nos 2 meses pr&#233;vios &#224; entrevista&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resposta aguda ao oxig&#233;nio &#8211; par&#226;metros objectivos da PM6<span class="elsevierStyleHsp" style=""></span>M</span><p id="par0085" class="elsevierStylePara elsevierViewall">Relativamente &#224; PM6<span class="elsevierStyleHsp" style=""></span>M realizada em ar ambiente comparada com oxig&#233;nio&#44; foram verificadas melhorias significativas na dist&#226;ncia percorrida &#40;285&#46;3m vs&#46; 357&#46;1m&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; na SatO<span class="elsevierStyleInf">2</span> em repouso &#40;91&#37; vs&#46; 98&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; na SatO<span class="elsevierStyleInf">2</span> m&#237;nima &#40;76&#46;0&#37; vs&#46; 86&#46;5&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; e na percentagem de dessatura&#231;&#227;o &#40;15&#46;2&#37; vs&#46; 10&#46;2&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#46; A melhoria destes par&#226;metros foi independente do diagn&#243;stico &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Tabela 2</a>&#41;&#46; N&#227;o foram verificadas diferen&#231;as estatisticamente significativas entre os grupos DPOC e DIP em qualquer dos par&#226;metros da PM6<span class="elsevierStyleHsp" style=""></span>M&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resposta aguda ao oxig&#233;nio &#8211; Escala de dispneia de Borg durante a PM6<span class="elsevierStyleHsp" style=""></span>M</span><p id="par0090" class="elsevierStylePara elsevierViewall">Os resultados da escala de dispneia de Borg apenas se encontravam dispon&#237;veis em 14 dos 37 doentes&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">N&#227;o foram observadas diferen&#231;as significativas inter-sujeitos&#44; intra-sujeitos ou efeitos de interac&#231;&#227;o&#44; na escala de dispneia de Borg pr&#233; e p&#243;s-PM6<span class="elsevierStyleHsp" style=""></span>M em ar ambiente comparada com oxig&#233;nio&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Adicionalmente&#44; foi efectuada a an&#225;lise da varia&#231;&#227;o da escala de dispneia de Borg durante a PM6<span class="elsevierStyleHsp" style=""></span>M &#40;p&#243;s-pr&#233;&#41;&#44; n&#227;o tendo sido encontradas diferen&#231;as significativas &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Tabela 2</a><span class="elsevierStyleBold">&#41;</span>&#46; Os doentes que diminu&#237;ram pelo menos 1 ponto na escala de dispneia de Borg sob oxig&#233;nio n&#227;o pertenciam predominantemente a nenhum dos grupos definidos&#44; nem na pr&#233;-PM6<span class="elsevierStyleHsp" style=""></span>M &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;310&#41; nem na p&#243;s-PM6<span class="elsevierStyleHsp" style=""></span>M &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;533&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Padr&#245;es de utiliza&#231;&#227;o da OD e ades&#227;o</span><p id="par0105" class="elsevierStylePara elsevierViewall">A prescri&#231;&#227;o m&#233;dica relativamente ao n&#250;mero de horas que o doente devia utilizar a OD foi vari&#225;vel&#44; no entanto todos os doentes foram instru&#237;dos acerca do seu uso durante o esfor&#231;o e sempre que sa&#237;ssem de casa&#46; Quando foi colocada a quest&#227;o &#8220;quantas horas por dia usa o oxig&#233;nio l&#237;quido atrav&#233;s do sistema port&#225;til&#63;&#8221; os doentes responderam que o utilizavam em m&#233;dia 4&#46;1<span class="elsevierStyleHsp" style=""></span>h&#47;dia &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Tabela 3</a>&#41;&#46; N&#227;o foram observadas diferen&#231;as entre os grupos DPOC e DIP &#40;4&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;0<span class="elsevierStyleHsp" style=""></span>h vs&#46; 3&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;3<span class="elsevierStyleHsp" style=""></span>h&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;236&#41;&#44; nem entre doentes sob OLD comparativamente aos que usavam apenas OD &#40;4&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;6<span class="elsevierStyleHsp" style=""></span>h vs 3&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;1<span class="elsevierStyleHsp" style=""></span>h&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;301&#41;&#46; O n&#250;mero de horas de OD n&#227;o foi significativamente superior nos doentes que apresentaram melhoria na resposta aguda ao oxig&#233;nio na escala de dispneia de Borg &#40;4&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;9<span class="elsevierStyleHsp" style=""></span>h vs&#46; 3&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;5<span class="elsevierStyleHsp" style=""></span>h&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;787&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">Relativamente ao tempo dispendido na realiza&#231;&#227;o de actividades no exterior&#44; os doentes passaram menos horas por dia fora de casa ap&#243;s o tratamento com OD &#40;3&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;6<span class="elsevierStyleHsp" style=""></span>h vs&#46; 5&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;5<span class="elsevierStyleHsp" style=""></span>h&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;025&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Tabela 3</a>&#41;&#46; Este facto n&#227;o foi influenciado pela melhoria ou n&#227;o da escala de dispneia de Borg&#46; N&#227;o foram detectadas diferen&#231;as significativas no n&#250;mero de dias fora de casa por semana e no n&#250;mero de sa&#237;das di&#225;rias&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Seis &#40;16&#46;2&#37;&#41; doentes n&#227;o demonstraram ades&#227;o &#224; prescri&#231;&#227;o&#44; utilizando a OD em m&#233;dia 0&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;5<span class="elsevierStyleHsp" style=""></span>h&#47; dia&#46; Adicionalmente&#44; 54&#46;1&#37; mencionaram efeitos adversos&#44; tais como desconforto nasal&#44; excesso de peso do aparelho ou constrangimento&#46; A ades&#227;o foi independente do diagn&#243;stico&#44; do uso ou n&#227;o de OLD &#40;89&#46;7&#37; e 62&#46;5&#37; dos doentes respectivamente&#44; eram aderentes&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;065&#41; e n&#227;o apresentou rela&#231;&#227;o com a idade do doente &#40;61&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;1 anos vs&#46; 65&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>18&#46;3 anos&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;583&#44; dos doentes aderentes e n&#227;o aderentes&#44; respectivamente&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Avalia&#231;&#227;o da qualidade de vida</span><p id="par0120" class="elsevierStylePara elsevierViewall">Ap&#243;s tratamento e relativamente aos subdom&#237;nios do question&#225;rio de QV SF-36&#44; verificaram-se baixas pontua&#231;&#245;es na quase totalidade dos dom&#237;nios&#44; essencialmente no desempenho f&#237;sico &#40;6&#46;9&#37;&#41;&#44; vitalidade &#40;23&#46;4&#37;&#41;&#44; fun&#231;&#227;o f&#237;sica &#40;28&#46;4&#37;&#41;&#44; sa&#250;de em geral &#40;30&#46;8&#37;&#41; e desempenho emocional &#40;48&#46;6&#37;&#41;&#44; com os melhores resultados na sa&#250;de mental &#40;63&#37;&#41;&#44; fun&#231;&#227;o social &#40;66&#46;6&#37;&#41; e dor corporal &#40;67&#46;6&#37;&#41;&#46; Melhorias estatisticamente significativas foram apenas observadas no desempenho emocional &#40;32&#46;4&#37; vs&#46; 48&#46;6&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;032&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Tabela 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">Uma melhoria no estado de sa&#250;de global comparativamente &#224; fase pr&#233;-tratamento foi descrita por 46&#37; dos doentes&#44; em oposi&#231;&#227;o a 35&#37; referindo agravamento&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discuss&#227;o</span><p id="par0130" class="elsevierStylePara elsevierViewall">O objectivo deste estudo consistiu em avaliar a efic&#225;cia e padr&#245;es de utiliza&#231;&#227;o da OD atrav&#233;s de oxig&#233;nio l&#237;quido em pacientes com doen&#231;as respirat&#243;rias cr&#243;nicas&#44; independentemente da prescri&#231;&#227;o de OLD&#46; Os benef&#237;cios da OLD t&#234;m sido demonstrados em estudos que envolvem essencialmente doentes com DPOC<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3</span></a>&#44; e os resultados extrapolados para doentes hipox&#233;micos com outros diagn&#243;sticos<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&#46; Consequentemente&#44; a terap&#234;utica com oxig&#233;nio tornou-se tratamento de rotina em todos os doentes com hipoxia grave&#46; O mesmo se aplica para doentes que n&#227;o cumpram os crit&#233;rios de OLD mas que dessaturam com o exerc&#237;cio&#44; emergindo assim a indica&#231;&#227;o para OD&#46; Um estudo demonstrou melhoria da dispneia e da capacidade de exerc&#237;cio com OD&#44; tanto em doentes com DPOC como DIP<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&#46; Os doentes do presente estudo apresentavam assim diversos diagn&#243;sticos agrupados de acordo com o seu padr&#227;o ventilat&#243;rio&#46; Embora a melhoria da capacidade de exerc&#237;cio constitua um bom factor de progn&#243;stico da taxa de sobrevida em doentes com DPOC<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&#44; n&#227;o podem ser antecipados benef&#237;cios na sobrevida dos doentes sob OD &#224; luz dos conhecimentos actuais&#44; dada a aus&#234;ncia de conclus&#245;es inequ&#237;vocas acerca da efic&#225;cia e benef&#237;cios a longo prazo da OD<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Quando a OLD &#233; prescrita&#44; pretende-se a sua utiliza&#231;&#227;o por longos per&#237;odos&#44; a qual &#233; geralmente fornecida atrav&#233;s de 2 tipos de sistemas estacion&#225;rios de grandes dimens&#245;es&#58; um cilindro de oxig&#233;nio gasoso ou um concentrador de oxig&#233;nio&#46; Com o objectivo de facilitar a movimenta&#231;&#227;o do doente dentro e em redor do domic&#237;lio&#44; pode ser estabelecida uma conex&#227;o ao sistema estacion&#225;rio atrav&#233;s de um tubo de at&#233; 15 metros de comprimento<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&#46; No entanto torna-se necess&#225;rio um sistema de oxig&#233;nio port&#225;til para deambular quer no domic&#237;lio quer no exterior al&#233;m desta dist&#226;ncia&#46; Os principais objectivos da OD s&#227;o desta forma a possibilidade do doente se ausentar do domic&#237;lio por per&#237;odos mais longos de tempo&#44; a melhoria do seu estado de sa&#250;de e a promo&#231;&#227;o das actividades di&#225;rias&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">A OD tamb&#233;m pode ser fornecida atrav&#233;s de 2 formas&#58; pequenos cilindros de oxig&#233;nio gasoso que podem ser transportados num pequeno carro&#44; mas que possuem uma capacidade de oxig&#233;nio limitada<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a>&#59; ou um sistema de oxig&#233;nio l&#237;quido&#44; o qual foi utilizado pelos doentes do estudo&#46; O &#250;ltimo sistema engloba uma unidade base estacion&#225;ria com o seu recipiente &#40;referido como &#8220;contentor&#8221;&#41; que armazena o oxig&#233;nio no seu estado l&#237;quido a &#8722;170<span class="elsevierStyleHsp" style=""></span>&#176;C&#44; e um pequeno sistema port&#225;til de fornecimento do oxig&#233;nio que o doente pode peencher a partir do contentor estacion&#225;rio previamente &#224; deambula&#231;&#227;o&#46; A op&#231;&#227;o por sistemas port&#225;teis apresenta v&#225;rias vantagens&#44; nomeadamente o seu pequeno tamanho e maior capacidade&#44; com superioridade em termos de custo-efic&#225;cia para doentes com actividade di&#225;ria significativa<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a>&#46; Se os doentes se encontrarem simultaneamente sob OLD&#44; o contentor estacion&#225;rio pode tamb&#233;m ser utilizado&#44; similarmente ao sistema de oxig&#233;nio gasoso&#44; para fornecimento do oxig&#233;nio em repouso&#46; Desta forma&#44; e por ambos os motivos&#44; o oxig&#233;nio l&#237;quido pode constituir a &#250;nica fonte de oxig&#233;nio suplementar&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Os resultados obtidos demonstraram uma resposta aguda ao oxig&#233;nio&#44; avaliada atrav&#233;s da PM6<span class="elsevierStyleHsp" style=""></span>M&#44; validando a prescri&#231;&#227;o da OD<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#46; No entanto&#44; n&#227;o houve melhoria da sensa&#231;&#227;o subjectiva de dispneia avaliada pela escala de Borg&#44; ainda que apenas durante a prova em laborat&#243;rio&#46; Estudos pr&#233;vios relativamente aos benef&#237;cios do fornecimento agudo de oxig&#233;nio na toler&#226;ncia ao exerc&#237;cio e dispneia associada t&#234;m sido contradit&#243;rios&#46; Uma revis&#227;o sistem&#225;tica de 31 estudos randomizados e controlados demonstrou que a OD foi eficaz no aumento da capacidade de exerc&#237;cio e na redu&#231;&#227;o da dispneia em doentes com dessatura&#231;&#227;o com o exerc&#237;cio<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#46; Mais recentemente&#44; H&#233;raud e colaboradores constataram que o fornecimento de oxig&#233;nio n&#227;o melhora sistematicamente a toler&#226;ncia ao exerc&#237;cio em todos os doentes&#46; Observou-se que cerca de um ter&#231;o apresentou uma resposta negativa com aumento paradoxal da frequ&#234;ncia respirat&#243;ria e da dispneia<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Relativamente aos benef&#237;cios a longo prazo na QV e no tempo dispendido na realiza&#231;&#227;o de actividades no exterior&#44; os resultados obtidos n&#227;o suportam inequivocamente a prescri&#231;&#227;o de OD&#46; N&#227;o foram observadas melhorias na pontua&#231;&#227;o dos subdom&#237;nios do question&#225;rio de QV&#44; excepto no desempenho emocional &#40;32&#46;4&#37; vs&#46; 48&#46;6&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;032&#41;&#44; e os doentes passavam menos horas por dia fora de casa aquando da realiza&#231;&#227;o do estudo&#44; comparativamente &#224; fase pr&#233;-tratamento com OD&#46; A descri&#231;&#227;o de efeitos adversos&#44; tais como&#44; constrangimento ou excesso de peso do aparelho&#44; poder&#227;o condicionar alguma inibi&#231;&#227;o da sua utiliza&#231;&#227;o no exterior&#44; no entanto&#44; o agravamento da doen&#231;a &#40;35&#37; dos doentes descreveram pioria do seu estado de sa&#250;de global&#41; &#233; tamb&#233;m uma raz&#227;o poss&#237;vel&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Tem sido reportado o insucesso da OD na promo&#231;&#227;o de actividades e melhoria da QV <a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;21&#8211;23</span></a>&#46; Um estudo recente e randomizado acerca do uso domicili&#225;rio de OD &#40;cilindro de ar vs&#46; cilindro de oxig&#233;nio&#41;&#44; em doentes com DPOC e dispneia mas sem hipoxemia&#44; tamb&#233;m n&#227;o demonstrou benef&#237;cios entre os grupos em termos de dispneia&#44; QV&#44; estado funcional e utiliza&#231;&#227;o do cilindro&#46; Foi observada uma melhoria cl&#237;nica ligeira&#44; estatisticamente significativa&#44; na dispneia e depress&#227;o&#44; na amostra total dos doentes ao longo das 12 semanas do estudo&#44; representando um prov&#225;vel efeito placebo<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a>&#46; Em contraste&#44; Eaton e colaboradores&#44; num estudo envolvendo 41 doentes com DPOC e dessatura&#231;&#227;o com o exerc&#237;cio&#44; reportaram beneficio estatisticamente significativo&#44; embora diminuto&#44; na QV&#44; ansiedade e depress&#227;o<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">25&#44;26</span></a>&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">No entanto&#44; salientam-se alguns aspectos positivos relacionados com a QV&#46; Apesar da interac&#231;&#227;o complexa entre as limita&#231;&#245;es funcionais e psicossociais que afectam estes doentes&#44; verificou-se uma melhoria do desempenho emocional&#44; e melhoria global subjectiva do estado de sa&#250;de em 46&#37; dos doentes&#46; As perspectivas do doente acerca da utiliza&#231;&#227;o da OD tamb&#233;m merecem considera&#231;&#227;o&#44; dado que 4 doentes afirmaram que nunca sairiam de casa se este n&#227;o estivesse dispon&#237;vel&#44; embora este item n&#227;o constasse do question&#225;rio aplicado&#46; A experi&#234;ncia dos doentes poder&#225; ser atribu&#237;da &#224; sensa&#231;&#227;o apreendida de diminui&#231;&#227;o da dispneia de esfor&#231;o durante as actividades di&#225;rias realizadas com oxig&#233;nio&#44; apesar da aus&#234;ncia de al&#237;vio da dispneia na PM6<span class="elsevierStyleHsp" style=""></span>M<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a><span class="elsevierStyleBold">&#46;</span> Conforme sugerido por outros estudos&#44; um efeito placebo tamb&#233;m n&#227;o pode ser exclu&#237;do<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a>&#46; O n&#250;mero de horas de utiliza&#231;&#227;o di&#225;ria da OD &#40;4&#46;1<span class="elsevierStyleHsp" style=""></span>h&#41; foi similar &#224;s horas dispendidas fora do domic&#237;lio &#40;3&#46;5<span class="elsevierStyleHsp" style=""></span>h&#41;&#44; salientando-se ser uma m&#233;dia bastante elevada&#46; Notavelmente&#44; os doentes passaram a sair de casa quase todos os dias&#44; apesar da sua morbilidade respirat&#243;ria&#46; Outros estudos reportaram a utiliza&#231;&#227;o irregular<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a>&#44; ou inapropriada em repouso da OD<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a>&#44; factos que pareceram n&#227;o ocorrer nos doentes estudados&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Adicionalmente&#44; a taxa de n&#227;o ades&#227;o foi baixa&#44; e dos doentes aderentes apenas 3 referiram uma utiliza&#231;&#227;o inferior a 1<span class="elsevierStyleHsp" style=""></span>h&#47;dia&#44; o que contudo ainda pode ser aceite como uma utiliza&#231;&#227;o razo&#225;vel<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a>&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">P&#233;pin e colaboradores demonstraram uma utiliza&#231;&#227;o mais eficaz do oxig&#233;nio relacionada com a dura&#231;&#227;o do tratamento<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a>&#44; que sugeriram ser resultante da deteriora&#231;&#227;o da fun&#231;&#227;o respirat&#243;ria ao longo do tempo&#44; bem como dos efeitos da educa&#231;&#227;o m&#233;dica e t&#233;cnica do doente&#46; Vergeret e colaboradores<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> tamb&#233;m demonstraram a associa&#231;&#227;o entre ades&#227;o ao tratamento e gravidade da condi&#231;&#227;o cl&#237;nica do doente&#46; Consideramos que os doentes estudados apresentaram uma boa ades&#227;o ao tratamento &#40;83&#46;8&#37;&#41;&#44; podendo este facto ter v&#225;rias explica&#231;&#245;es&#44; nomeadamente a gravidade da doen&#231;a &#40;78&#46;4&#37; encontrava-se sob OLD&#41;&#44; maior utiliza&#231;&#227;o ao longo do tempo &#40;tempo m&#233;dio de prescri&#231;&#227;o da OD de 14&#46;7 meses&#41;&#44; e educa&#231;&#227;o continuada do doente por parte dos profissionais de sa&#250;de&#46; Contudo&#44; dado a ades&#227;o ter sido avaliada de uma forma subjectiva&#44; n&#227;o pode ser rejeitada a hip&#243;tese de sobrevaloriza&#231;&#227;o da utiliza&#231;&#227;o da OD pelos doentes<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">28&#44;29</span></a>&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">N&#227;o foram notadas diferen&#231;as significativas na efic&#225;cia da OD &#40;horas de utiliza&#231;&#227;o e ades&#227;o&#41; entre doentes sob OLD comparativamente &#224; utiliza&#231;&#227;o isolada da OD&#46; Em outros estudos&#44; a prescri&#231;&#227;o de OD pareceu condicionar uma utiliza&#231;&#227;o mais eficaz<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> e uma maior ades&#227;o<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> &#224; OLD&#44; no entanto o n&#250;mero de doentes do presente estudo n&#227;o permite retirar conclus&#245;es consistentes relativamente a este aspecto&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Como limita&#231;&#245;es deste estudo&#44; apontamos o facto de alguns resultados da escala de dispneia de Borg n&#227;o estarem dispon&#237;veis&#44; condicionando a identifica&#231;&#227;o de respostas significativas &#224; OD&#46; Tendo em conta os estudos pr&#233;vios referindo resultados discordantes no que concerne ao al&#237;vio da dispneia<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a>&#44; colocamos a hip&#243;tese de os doentes com melhoria mais acentuada na escala de dispneia de Borg poderem ser mais propensos a utilizar e a beneficiar da OD&#44; contudo n&#227;o foi poss&#237;vel comprovar tal ila&#231;&#227;o&#46; Sob outro ponto de vista&#44; n&#227;o foram avaliados os d&#233;bitos de O<span class="elsevierStyleInf">2</span> usados&#44; o que poder&#225; tamb&#233;m interferir na resposta &#224; OD&#44; dado que baixos d&#233;bitos poder&#227;o condicionar um al&#237;vio inadequado da dispneia de esfor&#231;o<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>&#46; O tipo de protocolo utilizado para avaliar a capacidade de exerc&#237;cio tamb&#233;m pode explicar alguma da variabilidade reportada nos benef&#237;cios do oxig&#233;nio suplementar<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Davidson e colaboradores<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> conclu&#237;ram que o teste de marcha de <span class="elsevierStyleItalic">endurance</span> foi igualmente sens&#237;vel &#224; avalia&#231;&#227;o mais formal em cicloerg&#243;metro&#44; e com maior acuidade que a PM6<span class="elsevierStyleHsp" style=""></span>M&#44; mais frequentemente utilizada&#46; Todos estes aspectos devem ser considerados em futuros estudos&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">A avalia&#231;&#227;o do tempo passado fora de casa e do n&#237;vel basal da QV foram efectuadas retrospectivamente&#44; implicando que alguns doentes tivessem que se recordar desses aspectos at&#233; 4 anos antes&#44; com introdu&#231;&#227;o de um vi&#233;s de mem&#243;ria&#46; Um estudo prospectivo pode ultrapassar tal limita&#231;&#227;o e ainda permitir a explora&#231;&#227;o do efeito do tempo e da educa&#231;&#227;o do doente sobre a utiliza&#231;&#227;o da OD&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">No conhecimento dos autores&#44; este &#233; o primeiro estudo nacional que avalia a utiliza&#231;&#227;o e efic&#225;cia da OD&#46; Dado que a terap&#234;utica com OD n&#227;o &#233; desprovida de custos e efeitos adversos&#44; tais informa&#231;&#245;es s&#227;o de import&#226;ncia fundamental para os doentes&#44; m&#233;dicos e programas eficientes de gest&#227;o em sa&#250;de&#44; tal como &#233; a capacidade de identificar os doentes que de facto poder&#227;o beneficiar desta forma de terap&#234;utica&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Observamos que a melhoria aguda constatada nos par&#226;metros da PM6<span class="elsevierStyleHsp" style=""></span>M n&#227;o foi preditiva de benef&#237;cios a longo prazo relacionados com a promo&#231;&#227;o de actividades no exterior e de melhoria da QV&#44; conforme seria expect&#225;vel&#46; A dessatura&#231;&#227;o na PM6<span class="elsevierStyleHsp" style=""></span>M tamb&#233;m n&#227;o parece ser um crit&#233;rio consistente na selec&#231;&#227;o dos doentes para prescri&#231;&#227;o da OD&#46; Para al&#233;m da resposta aguda ao oxig&#233;nio&#44; outros factores&#44; tais como a melhoria da dispneia na escala de Borg&#44; a gravidade da doen&#231;a&#44; e a motiva&#231;&#227;o e educa&#231;&#227;o do doente&#44; podem influenciar a utiliza&#231;&#227;o e benef&#237;cios da OD&#46; Desta forma&#44; uma avalia&#231;&#227;o mais detalhada da resposta individual do doente com um seguimento padronizado&#44; incluindo uma monitoriza&#231;&#227;o m&#233;dica e t&#233;cnica frequente&#44; poder&#225; permitir alcan&#231;ar benef&#237;cios da OD baseados na evid&#234;ncia&#46; Os resultados obtidos apontam para a necessidade de estudos mais abrangentes e detalhados&#44; envolvendo os par&#226;metros mencionados e incluindo uma avalia&#231;&#227;o com maior acuidade das actividades dos doentes&#44; utiliza&#231;&#227;o&#44; e efic&#225;cia da OD&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflito de interesse</span><p id="par0205" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflito de interesse&#46;</p></span></span>"
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            3 => "Chronic Obstructive Pulmonary Disease"
            4 => "Patient Compliance"
            5 => "Quality of Life"
            6 => "Disease Management"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span><span class="elsevierStyleSectionTitle">Objectivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determinar os padr&#245;es de utiliza&#231;&#227;o da Oxigenoterapia de Deambula&#231;&#227;o &#40;OD&#41; em doentes com doen&#231;a pulmonar obstrutiva cr&#243;nica &#40;DPOC&#41; e doen&#231;as pulmonares intersticiais&#44; e analisar os efeitos dessa terap&#234;utica nas actividades di&#225;rias e na qualidade de vida &#40;QV&#41;&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Pacientes e m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Foram inclu&#237;dos consecutivamente 37 doentes adultos sob OD com oxig&#233;nio l&#237;quido h&#225; mais de 3 meses&#44; prescrita por m&#233;dicos pneumologistas hospitalares&#46; A resposta aguda ao oxig&#233;nio foi avaliada atrav&#233;s da prova de marcha de 6 minutos &#40;PM6<span class="elsevierStyleHsp" style=""></span>M&#41; e do grau de dispneia de Borg&#44; durante o teste com oxig&#233;nio pr&#233;-interven&#231;&#227;o&#46; O tempo passado fora de casa&#44; a ades&#227;o &#224; terap&#234;utica&#44; os efeitos adversos e a QV &#40;question&#225;rio SF-36 v1&#41; foram avaliados atrav&#233;s de uma entrevista telef&#243;nica durante o per&#237;odo de seguimento&#46; A an&#225;lise comparativa do tempo passado fora de casa e da QV antes e depois da interven&#231;&#227;o foi efectuada retrospectivamente&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A DPOC foi o diagn&#243;stico mais frequente &#40;54&#37;&#41;&#44; e 29 &#40;78&#37;&#41; doentes encontravam-se sob oxigenoterapia de longa dura&#231;&#227;o&#46; Relativamente &#224; resposta aguda ao oxig&#233;nio avaliada atrav&#233;s da PM6<span class="elsevierStyleHsp" style=""></span>M&#44; houve melhoria significativa na dist&#226;ncia percorrida &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; na SatO<span class="elsevierStyleInf">2</span> em repouso &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; na SatO<span class="elsevierStyleInf">2</span> m&#237;nima &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; e na percentagem de dessatura&#231;&#227;o &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#44; independente do diagn&#243;stico&#46; N&#227;o foram observadas diferen&#231;as no grau de dispneia de Borg&#46; A m&#233;dia de horas de uso da OD foi de 4&#46;1<span class="elsevierStyleHsp" style=""></span>h&#47;dia&#46; Os doentes passaram menos horas por dia fora de casa ap&#243;s tratamento com OD &#40;3&#46;5<span class="elsevierStyleHsp" style=""></span>h vs&#46; 5&#46;0<span class="elsevierStyleHsp" style=""></span>h&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;025&#41;&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Seis doentes &#40;16&#37;&#41; n&#227;o cumpriram a terap&#234;utica de acordo com a prescri&#231;&#227;o&#44; e 54&#37; mencionaram efeitos adversos&#46; Relativamente aos subdom&#237;nios do question&#225;rio de QV&#44; verificaram-se baixas pontua&#231;&#245;es em quase todos&#44; com uma melhoria significativa observada apenas no desempenho emocional &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;032&#41;&#46; Uma melhoria no estado global de sa&#250;de foi descrita por 49&#37; dos doentes&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Conclus&#245;es</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A melhoria aguda constatada nos par&#226;metros da PM6<span class="elsevierStyleHsp" style=""></span>M n&#227;o foi preditiva de promo&#231;&#227;o de actividades no exterior e de melhoria da QV com a OD&#46; S&#227;o necess&#225;rios estudos mais detalhados para se constatarem benef&#237;cios da OD baseados na evid&#234;ncia&#46;</p></span>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span><span class="elsevierStyleSectionTitle">Aims</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">To determine patterns of ambulatory oxygen &#40;AO&#41; use among patients with chronic obstructive pulmonary disease &#40;COPD&#41; and interstitial lung diseases&#44; and analyze the effects of this therapy on daily activities and quality of life &#40;QoL&#41;&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We included 37 consecutive adult patients on AO by liquid O<span class="elsevierStyleInf">2</span> for more than three months prescribed by hospital pulmonologists&#46; The acute response to O<span class="elsevierStyleInf">2</span> was evaluated through the standardized 6-minutes walk test &#40;6MWT&#41; and the Borg dyspnea scale during the O<span class="elsevierStyleInf">2</span> pre-intervention trial&#46; Time spent away from home&#44; compliance&#44; side effects and QoL &#40;SF-36 v1 questionnaire&#41; were evaluated by a telephone interview during the follow-up period&#46; Time spent away from home and QoL comparisons after and before the intervention were assessed retrospectively&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">COPD was the most frequent diagnosis &#40;54&#37;&#41;&#44; and 29 &#40;78&#37;&#41; patients were already on long-term oxygen therapy&#46; In relation to the acute response to O<span class="elsevierStyleInf">2</span> evaluated through the 6MWT&#44; there were significant improvements in the distance walked &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; in resting SatO<span class="elsevierStyleInf">2</span> &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; in minimal SatO<span class="elsevierStyleInf">2</span> &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; and in percentage of desaturation &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#44; independently of the diagnosis&#46; No differences were observed in Borg dyspnea scale&#46; AO was used for a mean of 4&#46;1<span class="elsevierStyleHsp" style=""></span>h&#47;day&#46; Patients spent fewer hours per day away from home after AO treatment &#40;3&#46;5<span class="elsevierStyleHsp" style=""></span>h vs&#46; 5&#46;0<span class="elsevierStyleHsp" style=""></span>h&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;025&#41;&#46; Six patients &#40;16&#37;&#41; were not compliant to the prescription&#44; and 54&#37; mentioned side effects&#46; We verified low scores in almost all of the sub-domains of SF-36 QoL questionnaire&#44; with a significant improvement noted only in role emotional &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;032&#41;&#46; Improvement in health global state was described by 49&#37; of patients&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Acute improvement in 6MWT parameters was not predictive of enhancement of outdoor activities and QoL with AO&#46; More detailed studies are needed to achieve evidence based AO benefits&#46;</p></span>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabela 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Resultados apresentados em m&#233;dia<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>desvio padr&#227;o&#44; ou n&#250;mero &#40;&#37;&#41;&#44; salvo indica&#231;&#227;o contr&#225;ria&#59; &#42; &#8211; Diferen&#231;as estatisticamente significativas entre grupos&#59; DPOC &#8211; doen&#231;a pulmonar obstrutiva cr&#243;nica&#59; DIP &#8211; doen&#231;as do interst&#237;cio pulmonar&#59; OLD &#8211; oxigenoterapia de longa dura&#231;&#227;o&#59; OD &#8211; oxigenoterapia de deambula&#231;&#227;o&#59; CVF &#8211; capacidade vital for&#231;ada&#59; VEF<span class="elsevierStyleInf">1</span> &#8211; volume expirat&#243;rio for&#231;ado no primeiro segundo&#59; CPT &#8211; capacidade pulmonar total&#59; VR &#8211; volume residual&#59; DLCO &#8211; capacidade de difus&#227;o pulmonar do mon&#243;xido de carbono&#59; VA &#8211; volume alveolar&#59; pO<span class="elsevierStyleInf">2</span> &#8211; press&#227;o arterial de oxig&#233;nio&#59; pCO<span class="elsevierStyleInf">2</span> &#8211; press&#227;o arterial de di&#243;xido de carbono&#59; SatO<span class="elsevierStyleInf">2</span> &#8211; satura&#231;&#227;o arterial de oxig&#233;nio&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Caracter&#237;sticas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DPOC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DIP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">TOTAL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">N</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;54&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;45&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Idade&#44; anos</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;7&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;4&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Sexo masculino</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;90&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;64&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 &#40;78&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">H&#225;bitos tab&#225;gicos</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>N&#227;o fumadores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;20&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;58&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;37&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ex-fumadores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;75&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;41&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;59&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fumadores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;5&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">OLD</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;95&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;58&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 &#40;78&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Prescri&#231;&#227;o de OD&#44; meses &#40;m&#237;nimo &#8211; m&#225;ximo&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#46;7 &#40;3 &#8211; 48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#46;1 &#40;3 &#8211; 39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#46;7 &#40;3 &#8211; 48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Espirometria&#44; &#37; do previsto</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>CVF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">57&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>18&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>VEF<span class="elsevierStyleInf">1</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;6&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#46;8&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>24&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>VEF<span class="elsevierStyleInf">1</span>&#47;CVF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;7&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">76&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;3&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>23&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Volumes pulmonares&#44; &#37; do previsto</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>CPT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">111&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>30&#46;1&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>18&#46;0&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">89&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>35&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>VR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">189&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>79&#46;6&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>30&#46;6&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">139&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>84&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>VR&#47;CPT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>55&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>48&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>53&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Capacidade de difus&#227;o do CO&#44; &#37; do previsto</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DLCO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>18&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DLCO&#47;VA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>34&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>26&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Gasometria arterial em repouso</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>pH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>pO<span class="elsevierStyleInf">2</span>&#44; mmHg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#46;8&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;6&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>pCO<span class="elsevierStyleInf">2</span>&#44; mmHg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;0&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;5&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>SatO<span class="elsevierStyleInf">2</span>&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">90&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">PM6<span class="elsevierStyleHsp" style=""></span>M &#8211; prova de marcha de 6 minutos&#59; DPOC &#8211; doen&#231;a pulmonar obstrutiva cr&#243;nica&#59; DIP &#8211; doen&#231;as do interst&#237;cio pulmonar&#59; SatO<span class="elsevierStyleInf">2</span> &#8211; satura&#231;&#227;o arterial de oxig&#233;nio&#59; var &#8211; varia&#231;&#227;o&#44; &#42; &#8211; resultados estatisticamente significativos&#46;</p>"
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Par&#226;metros&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">DPOC</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">DIP</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">TOTAL</th><th class="td" title="table-head  " align="center" valign="top" scope="col">Efeito intra-sujeitos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Ar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">O<span class="elsevierStyleInf">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Ar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">O<span class="elsevierStyleInf">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Ar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">O<span class="elsevierStyleInf">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="10" align="left" valign="top"><span class="elsevierStyleItalic">PM6M padronizada</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dist&#226;ncia percorrida &#40;metros&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">249&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>151&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">316&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>123&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">323&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>155&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">400&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>149&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">285&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>155&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">357&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>141&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;000&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;125&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;748&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>SatO<span class="elsevierStyleInf">2</span> em repouso &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">95&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">91&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;000&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;014&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;477&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>SatO<span class="elsevierStyleInf">2</span> m&#237;nima &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">86&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">86&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">86&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;000&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;763&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;833&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dessatura&#231;&#227;o &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;233&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;825&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="10" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="10" align="left" valign="top"><span class="elsevierStyleItalic">Escala de dispneia de Borg &#40;0-10&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pr&#233; PM6M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;396&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;497&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>P&#243;s PM6M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;192&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;503&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Var p&#243;s-pr&#233; PM6M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;655&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;426&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;131&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Par&#226;metros&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">DPOC</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">DIP</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">TOTAL</th><th class="td" title="table-head  " align="center" valign="top" scope="col">Efeito intra-sujeitos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Antes da AO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Depois da AO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Antes da AO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Depois da AO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Antes da AO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Depois da AO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Utiliza&#231;&#227;o de OD&#44; horas&#47; dia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;236&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60; 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;48&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8805;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;51&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="10" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">OLD&#44; horas&#47; dia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;110&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;13&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8805;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;86&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#95;&nbsp;\t\t\t\t\t\t\n
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      "titulo" => "Bibliografia"
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        0 => array:2 [
          "identificador" => "bibs0005"
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              "identificador" => "bib0005"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Long term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema"
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                        0 => array:2 [
                          "colaboracion" => "Medical Research Council Working Party"
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                    0 => array:2 [
                      "doi" => "10.1016/S2213-2600(13)70179-6"
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                        "tituloSerie" => "Lancet"
                        "fecha" => "1981"
                        "volumen" => "1"
                        "paginaInicial" => "681"
                        "paginaFinal" => "686"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24429269"
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              "identificador" => "bib0010"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Does long-term oxygen therapy reduce hospitalisation in hypoxaemic chronic obstructive pulmonary disease&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46;J&#46; Ringbaek"
                            1 => "K&#46; Viskum"
                            2 => "P&#46; Lange"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
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                        "paginaInicial" => "38"
                        "paginaFinal" => "42"
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                      "titulo" => "Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease&#58; a clinical trial"
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                          "colaboracion" => "Nocturnal Oxygen Therapy Trial Group"
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                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "1980"
                        "volumen" => "93"
                        "paginaInicial" => "391"
                        "paginaFinal" => "398"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6776858"
                            "web" => "Medline"
                          ]
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                      ]
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                ]
              ]
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              "identificador" => "bib0020"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increased exercise capacity in hypoxemic patients after long-term oxygen therapy"
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                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;A&#46; Morrison"
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
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                        "tituloSerie" => "Chest"
                        "fecha" => "1992"
                        "volumen" => "102"
                        "paginaInicial" => "542"
                        "paginaFinal" => "550"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1643945"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term oxygen therapy improves health-related quality of life"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "T&#46; Eaton"
                            1 => "C&#46; Lewis"
                            2 => "P&#46; Young"
                            3 => "Y&#46; Kennedy"
                            4 => "J&#46;E&#46; Garrett"
                            5 => "J&#46; Kolbe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "2004"
                        "volumen" => "98"
                        "paginaInicial" => "285"
                        "paginaFinal" => "293"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15072168"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Domiciliary Oxygen Therapy Services"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Royal College of Physicians of London"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Clinical guidelines and advice for prescribers"
                        "fecha" => "1999"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
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                          "colaboracion" => "British Thoracic Society &#40;BTS&#41; Working Group on Home Oxygen Services"
                          "etal" => false
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Clinical Component for the Home Oxygen Service in England and Wales"
                        "fecha" => "2006"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Supplemental oxygen and exercise ability in chronic obstructive airways disease"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;C&#46; Davidson"
                            1 => "R&#46; Leach"
                            2 => "R&#46;J&#46; George"
                            3 => "D&#46;M&#46; Geddes"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "1988"
                        "volumen" => "43"
                        "paginaInicial" => "965"
                        "paginaFinal" => "971"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3238640"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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            8 => array:3 [
              "identificador" => "bib0045"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patterns of domestic activity and ambulatory oxygen usage in COPD"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;J&#46; Sandland"
                            1 => "M&#46;D&#46; Morgan"
                            2 => "S&#46;J&#46; Singh"
                          ]
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.07-1848"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2008"
                        "volumen" => "134"
                        "paginaInicial" => "753"
                        "paginaFinal" => "760"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18625674"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Standards for the diagnosis and treatment of patients with COPD&#58; a summary of the ATS&#47;ERS position paper"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46;R&#46; Celli"
                            1 => "W&#46; MacNee"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2004"
                        "volumen" => "23"
                        "paginaInicial" => "932"
                        "paginaFinal" => "946"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15219010"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Psychophysical scaling with applications in physical work and the perception of exertion"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "G&#46; Borg"
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Scand J Work Environ Health"
                        "fecha" => "1990"
                        "volumen" => "16"
                        "numero" => "Suppl 1"
                        "paginaInicial" => "55"
                        "paginaFinal" => "58"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2345867"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reporting and interpretation of SF-36 outcomes in randomised trials&#58; systematic review"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46;G&#46; Contopoulos-Ioannidis"
                            1 => "A&#46; Karvouni"
                            2 => "I&#46; Kouri"
                            3 => "J&#46;P&#46; Ioannidis"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2009"
                        "volumen" => "338"
                        "paginaInicial" => "a3006"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19139138"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term oxygen therapy in conditions other than chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Zielinski"
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Care"
                        "fecha" => "2000"
                        "volumen" => "45"
                        "paginaInicial" => "172"
                        "paginaFinal" => "176"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10771788"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Portable liquid oxygen and exercise ability in severe respiratory disability"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46;M&#46; Leach"
                            1 => "A&#46;C&#46; Davidson"
                            2 => "S&#46; Chinn"
                            3 => "C&#46;H&#46; Twort"
                            4 => "I&#46;R&#46; Cameron"
                            5 => "N&#46;T&#46; Bateman"
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "1992"
                        "volumen" => "47"
                        "paginaInicial" => "781"
                        "paginaFinal" => "789"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1481177"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Analysis of the factors related to mortality in chronic obstructive pulmonary disease&#58; role of exercise capacity and health status"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
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                            2 => "M&#46; Tsukino"
                            3 => "S&#46; Sato"
                            4 => "T&#46; Hajiro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.200206-583OC"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2003"
                        "volumen" => "167"
                        "paginaInicial" => "544"
                        "paginaFinal" => "549"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12446268"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ambulatory oxygen for chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "F&#46;S&#46; Ram"
                            1 => "J&#46;A&#46; Wedzicha"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2002"
                        "paginaInicial" => "CD000238"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The clinical impact of new long-term oxygen therapy technology"
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                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46;J&#46; Dunne"
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Care"
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                        "paginaInicial" => "1100"
                        "paginaFinal" => "1111"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19650950"
                            "web" => "Medline"
                          ]
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                      ]
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                ]
              ]
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            17 => array:3 [
              "identificador" => "bib0090"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of liquid and gaseous oxygen for domiciliary portable use"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
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                        "paginaInicial" => "98"
                        "paginaFinal" => "100"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1549830"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A systematic review of randomized controlled trials examining the short-term benefit of ambulatory oxygen in COPD"
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                          "etal" => false
                          "autores" => array:5 [
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                            2 => "S&#46; Elborn"
                            3 => "J&#46; Macmahon"
                            4 => "B&#46; O&#8217;Neill"
                          ]
                        ]
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                    ]
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                  "host" => array:1 [
                    0 => array:2 [
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                        "tituloSerie" => "Chest"
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                        "volumen" => "131"
                        "paginaInicial" => "278"
                        "paginaFinal" => "285"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17218587"
                            "web" => "Medline"
                          ]
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                      ]
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                  ]
                ]
              ]
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            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Does correction of exercise-induced desaturation by O&#40;2&#41; always improve exercise tolerance in COPD&#63; A preliminary study"
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                        0 => array:2 [
                          "etal" => false
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                            3 => "A&#46; Varray"
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                        ]
                      ]
                    ]
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                    0 => array:2 [
                      "doi" => "10.1016/j.rmed.2008.04.005"
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                        "tituloSerie" => "Respir Med"
                        "fecha" => "2008"
                        "volumen" => "102"
                        "paginaInicial" => "1276"
                        "paginaFinal" => "1286"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18619828"
                            "web" => "Medline"
                          ]
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                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of oxygen on health quality of life in patients with chronic obstructive pulmonary disease with transient exertional hypoxemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;L&#46; Nonoyama"
                            1 => "D&#46; Brooks"
                            2 => "G&#46;H&#46; Guyatt"
                            3 => "R&#46;S&#46; Goldstein"
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                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.200702-308OC"
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                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2007"
                        "volumen" => "176"
                        "paginaInicial" => "343"
                        "paginaFinal" => "349"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17446339"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Exertional oxygen of limited benefit in patients with chronic obstructive pulmonary disease and mild hypoxemia"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46;F&#46; McDonald"
                            1 => "C&#46;M&#46; Blyth"
                            2 => "M&#46;D&#46; Lazarus"
                            3 => "I&#46; Marschner"
                            4 => "C&#46;E&#46; Barter"
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                    ]
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                  "host" => array:1 [
                    0 => array:2 [
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                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1995"
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                        "paginaInicial" => "1616"
                        "paginaFinal" => "1619"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7582304"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Randomised trial of ambulatory oxygen in oxygen-dependent COPD"
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                          "etal" => false
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                            2 => "C&#46; Pelletier"
                            3 => "R&#46; Begin"
                            4 => "F&#46; Maltais"
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                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.05.00113504"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2005"
                        "volumen" => "25"
                        "paginaInicial" => "1032"
                        "paginaFinal" => "1038"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15929958"
                            "web" => "Medline"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "A randomised trial of domiciliary&#44; ambulatory oxygen in patients with COPD and dyspnoea but without resting hypoxaemia"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
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                          ]
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                      "doi" => "10.1136/thx.2009.132522"
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                        "tituloSerie" => "Thorax"
                        "fecha" => "2011"
                        "volumen" => "66"
                        "paginaInicial" => "32"
                        "paginaFinal" => "37"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20880870"
                            "web" => "Medline"
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                    0 => array:2 [
                      "titulo" => "Benefits of oxygen on exercise performance and pulmonary hemodynamics in patients with COPD with mild hypoxemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46; Fujimoto"
                            1 => "Y&#46; Matsuzawa"
                            2 => "S&#46; Yamaguchi"
                            3 => "T&#46; Koizumi"
                            4 => "K&#46; Kubo"
                          ]
                        ]
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                    ]
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                        "tituloSerie" => "Chest"
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                        "paginaInicial" => "457"
                        "paginaFinal" => "463"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12171817"
                            "web" => "Medline"
                          ]
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                  ]
                ]
              ]
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              "etiqueta" => "26"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Ambulatory oxygen improves quality of life of COPD patients&#58; a randomised controlled study"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46; Eaton"
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                            2 => "P&#46; Young"
                          ]
                        ]
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2002"
                        "volumen" => "20"
                        "paginaInicial" => "306"
                        "paginaFinal" => "312"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12212960"
                            "web" => "Medline"
                          ]
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                      ]
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              "etiqueta" => "27"
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                    0 => array:2 [
                      "titulo" => "Factors contributing to relief of exertional breathlessness during hyperoxia in chronic airflow limitation"
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                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46;E&#46; O&#8217;Donnell"
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                            2 => "K&#46;A&#46; Webb"
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                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.155.2.9032190"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1997"
                        "volumen" => "155"
                        "paginaInicial" => "530"
                        "paginaFinal" => "535"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9032190"
                            "web" => "Medline"
                          ]
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              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Compliance with LTOT and consumption of mobile oxygen"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Ringbaek"
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                            2 => "K&#46; Viskum"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "1999"
                        "volumen" => "93"
                        "paginaInicial" => "333"
                        "paginaFinal" => "337"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10464899"
                            "web" => "Medline"
                          ]
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                      ]
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                  ]
                ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Long-term oxygen therapy at home&#46; Compliance with medical prescription and effective use of therapy&#46; ANTADIR Working Group on Oxygen Therapy&#46; Association Nationale de Traitement a Domicile des Insuffisants Respiratories"
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                        0 => array:2 [
                          "etal" => false
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                            1 => "C&#46;E&#46; Barjhoux"
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                            3 => "C&#46; Brambilla"
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                        "fecha" => "1996"
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                        "paginaInicial" => "1144"
                        "paginaFinal" => "1150"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8625658"
                            "web" => "Medline"
                          ]
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                      ]
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                ]
              ]
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                    0 => array:2 [
                      "titulo" => "Home oxygen therapy"
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                    ]
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                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Chest Med"
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                        "volumen" => "18"
                        "paginaInicial" => "535"
                        "paginaFinal" => "545"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9329875"
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