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para }\par\pard\li986\ri0\sl-400\slmult0 \fs22\cf0\f1\charscalex100 {descrever um
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\fs24\cf0\f1\charscalex100 {�xido n�trico e o di�xido de nitrog�nio, que associados
ao frio podem favorecer a }\par\pard\li986\ri0\sl-413\slmult0
\fs24\cf0\f1\charscalex100 {hiperreatividade br�nquica. Em
piscinas }\fs24\cf0\f1\charscalex100 {aquecidas, a inala��o de cloro
poderia }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {facilitar a
broncoconstri��o em prat}\fs24\cf0\f1\charscalex100 {icantes de nata��o, nestas
condi��es}\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {(Langdeau
et al, 2000). }\par\pard\li1546\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {Al�m
de atletas ol�mpicos, atletas paraol�mpicos podem desenvolver
BIE.}\par\pard\li986\ri0\sl-413\slmult0 \fs24\cf0\f1\charscalex100 {Trabalho
realizado pelo nosso laborat�rio mostrou preval�ncia de 23,9% de
BIE}\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {em atletas
paraol�mpicos brasileiros que realizaram exerc�cio na
intensidade }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100
{correspondente a 90-95% da freq��ncia card�aca m�xima (FCmax)
(Ortenzi-}\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {Nunes,
Silva, 2004)}\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {
A fisiopatologia exata de tal fen�meno ainda n�o est� totalmente
elucidada,}\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {mas um
dos principais fatores desencadeante do BIE parece ser a perda de
�gua}\par\pard\li986\ri0\sl-413\slmult0 \fs24\cf0\f1\charscalex100 {das vias a�reas
associada a hiperventila��o do exerc�cio intenso. Esta
perda }\par\pard\sect\sectd\sbkpage\pgwsxn11893\pghsxn16840\marglsxn666\margrsxn133
\margtsxn666\margbsxn600\pard\li986\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li986\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-
213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li986\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-
213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-413\slmult0 \fs24\cf0\f1\charscalex100
{contribui para a diminui��o da osmolari}\fs24\cf0\f1\charscalex100 {dade local,
contribuindo para libera��o de}\par\pard\li986\ri0\sl-413\slmult0
\fs24\cf0\f1\charscalex100 {mediadores inflamat�rios, forma��o de edema e contra��o
da musculatura lisa }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100
{dos br�nquios (Rundell, Jenkinson, 2002).}\par\pard\li986\ri0\sl-400\slmult0
\fs24\cf0\f1\charscalex100 { Para um diagn�stico
precis}\fs24\cf0\f1\charscalex100 {o do broncoespamo induzido pelo
exerc�cio,}\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100
{recomenda-se a realiza��o de medidas objetivas na detec��o da
obstru��o }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100
{br�nquica, por meio da avalia��o da fun��o pulmonar, com
manobras }\par\pard\li986\ri0\sl-413\slmult0 \fs24\cf0\f1\charscalex100
{espirom�tricas reprodut�veis, antes e ap�s }\fs24\cf0\f1\charscalex100 {o esfor�o
f�sico. A vari�vel fisiol�gica }\par\pard\li986\ri0\sl-400\slmult0
\fs24\cf0\f1\charscalex100 {fundamental para a detec��o do BIE � o volume
expirat�rio for�ado no primeiro }\par\pard\li986\ri0\sl-413\slmult0
\fs24\cf0\f1\charscalex100 {segundo (VEF}{\sub \fs16\cf0\f1\charscalex100
{1}}\fs24\cf0\f1\charscalex100 {)}{ }\fs24\cf0\f1\charscalex100 {da manobra de
capacidade vital for�ada, por ser mais est�vel e }\par\pard\li986\ri0\sl-
400\slmult0 \fs24\cf0\f1\charscalex100 {reprodut�vel. Uma redu��o maior que 10% na
vari�vel VEF}{\sub \fs16\cf0\f1\charscalex100 {1}}\fs24\cf0\f1\charscalex100 { ap�s
o exerc�cio,}\par\pard\li986\ri0\sl-386\slmult0 \fs24\cf0\f1\charscalex100 {pode
ser considerada positiva para a detec��o do BIE. Para tanto, �
recomendado}\par\pard\li986\ri0\sl-413\slmult0 \fs24\cf0\f1\charscalex100 {que o
esfor�o f�sico seja din�mico, com protocolo de carga constante e o
estresse }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100
{ventilat�rio seja elevado. Muitos autores recomendam, durante o exerc�cio,
manter }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {a frequ�ncia
card�aca entre 80 a 95% da FCmax, estimado pela f�rmula
220-}\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {idade, por um
per�odo de 6 a 8 minutos, em ambiente frio e seco (Rundell et
al,}\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {2000; Gotshall,
2002; Rundell, Jenkinson, 2002; Fonseca Guedes et al, 2003;}\par\pard\li986\ri0\sl-
413\slmult0 \fs24\cf0\f1\charscalex100 {Rundell, Spiering, 2003; Storms,
2003). }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 { A
detec��o do BIE torna-se importante, pois, a hiperreatividade
br�nquica }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {durante o
exerc�cio pode limitar o desempenho esportivo, j� que o quadro
� }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {caracterizado por
dispn�ia intensa, pres}\fs24\cf0\f1\charscalex100 {en�a de tosse ou expectora��o. O
objetivo }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {de avaliar
a presen�a do BIE consiste em identificar, orientar e tratar o
atleta, }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {aliviando
os sintomas e melhor}\fs24\cf0\f1\charscalex100 {ando, assim o seu desempenho
(Rundell, }\par\pard\li986\ri0\sl-413\slmult0 \fs24\cf0\f1\charscalex100
{Jenkinson, 2002). }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {
O tratamento da BIE visa limitar a exacerba��o da broncoconstri��o
e}\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {permitir aos
atletas competirem livre de sintomas relacionados. O tratamento
inclui }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {medicamentos
di�rios para controlar o processo inflamat�rio da vias a�reas,
uso }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {profil�tico de
medica��es antes das competi��es (como broncodilatadores,
por }\par\pard\li986\ri0\sl-413\slmult0 \fs24\cf0\f1\charscalex100 {exemplo) al�m
de um per�odo de aquecim}\fs24\cf0\f1\charscalex100 {ento (Rundell, Jenkinson,
2002). Por�m}\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {o
tratamento do BIE, devido � sua complexidade, deve ser individualizado e
sob }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {orienta��o
m�dica. }\par\pard\sect\sectd\sbkpage\pgwsxn11893\pghsxn16840\marglsxn666\margrsxn1
33\margtsxn666\margbsxn666\pard\li986\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li986\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-
213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li986\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-
213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-413\slmult0 \fs24\cf0\f1\charscalex100
{Refer�ncias Bibliogr�ficas}\par\pard\li986\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li986\ri0\sl-333\slmult0 \fs24\cf0\f1\charscalex100 {Fonseca
Guedes CH, Cabral AL, Martin}\fs24\cf0\f1\charscalex100 {s MA. Exercise-induced
bronchospasm in }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100
{children: comparison of FEV1 and FEF 25-75% responses. Pediatr Pulmonol
2003; }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {36: 49-
54.}\par\pard\li986\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-
213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-386\slmult0 \fs24\cf0\f1\charscalex100
{Gotshall RW. Exercise-induced bronchoco}\fs24\cf0\f1\charscalex100 {nstriction.
Drugs 2002; 62: 1725-39.}\par\pard\li986\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li986\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-
373\slmult0 \fs24\cf0\f1\charscalex100 {Guidelines for Methacoline and Exercise
Challenge Testing- 1999. Am J Respir }\par\pard\li986\ri0\sl-400\slmult0
\fs24\cf0\f1\charscalex100 {Crit Care Med 2000;161: 309-
29. }\par\pard\li986\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li986\ri0\sl-373\slmult0 \fs24\cf0\f1\charscalex100 {Langdeau
JB, Turcotte H, Bowie DM, Jobin J, Desgane P, Boulet LP.
Airway }\par\pard\li986\ri0\sl-413\slmult0 \fs24\cf0\f1\charscalex100
{hyperreponsive in elite athletes. Am J Respir Crit Care Med 2000; 161: 1479-
84. }\par\pard\li986\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li986\ri0\sl-373\slmult0 \fs24\cf0\f1\charscalex100 {Ortenzi
Nunes L, Silva AC. A broncoconstri��o induzida pelo exerc�cio em
atletas}\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100
{paraol�mpicos. In: Mello MC. Avalia��o cl�nica e da aptid�o f�sica em
atletas}\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100
{paraol�mpicos brasilieiros: conceitos, m�todos e resultados. 1ed. S�o
Paulo: }\par\pard\li986\ri0\sl-413\slmult0 \fs24\cf0\f1\charscalex100 {Atheneu;
2004. p. 263-66.}\par\pard\li986\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li986\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-
373\slmult0 \fs24\cf0\f1\charscalex100 {Rundell KW, Wilber RL, Szmedra L,
Je}\fs24\cf0\f1\charscalex100 {nkinson DM, Mayers LB, Joohee
IM.}\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {Exercise-induced
asthma screening of elite athletes: field versus laboratory}\par\pard\li986\ri0\sl-
400\slmult0 \fs24\cf0\f1\charscalex100 {exercise challenge. Med. Sci. in Sports
Exerc 2000; 32: 309-16. }\par\pard\li986\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li986\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-
386\slmult0 \fs24\cf0\f1\charscalex100 {Rundell KW, Jenkinson DM. Exercise-
induced }\fs24\cf0\f1\charscalex100 {bronchospasm in the elite
athlete, }\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {Sports Med
2002; 32.}\par\pard\li986\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-
213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-373\slmult0 \fs24\cf0\f1\charscalex100
{Rundell KW, Spierling BA. Inspiratory stridor in elite athletes. Chest 2003; 23 2:
}\par\pard\li986\ri0\sl-413\slmult0 \fs24\cf0\f1\charscalex100 {468-
74.}\par\pard\li986\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-
213\slmult0 \fs18\cf0\par\pard\li986\ri0\sl-373\slmult0 \fs24\cf0\f1\charscalex100
{Storms WW. Rewiew of exercise-induced asthma. Med Sci Spotrs Exerc 2003;
35:}\par\pard\li986\ri0\sl-400\slmult0 \fs24\cf0\f1\charscalex100 {1464-70.}\par}