Mecânica pulmonar de pacientes em suporte ventilatório na unidade de terapia intensiva. Conceitos e monitorização

Faustino, Eduardo Antonio

doi:10.1590/s0103-507x2007000200004

Cited by 11 publications

(8 citation statements)

References 24 publications

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“…The increased peripheral saturation at the 0º position can be explained by the movement of blood to areas with a better ventilation/perfusion ratio that have proportionately greater vascularity at the posterior region of the lung, which remains dependent in the supine position at 0º. ( 22 ) However, the 0.6% difference was not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…The quasi-static method used to measure respiratory mechanics with occlusion at the end of inspiration was chosen due to the ease of bedside application in critically ill patients, but this method cannot differentiate between the chest wall and lung components. ( 22 ) For this purpose, the use of invasive methods that can quantify pleural pressure is necessary. ( 23 )…”

Section: Discussionmentioning

confidence: 99%

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Influence of different degrees of head elevation on respiratory mechanics in mechanically ventilated patients

Martinez¹,

Marques²,

Santos³

et al. 2015

Revista Brasileira De Terapia Intensiva

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Objective The positioning of a patient in bed may directly affect their respiratory mechanics. The objective of this study was to evaluate the respiratory mechanics of mechanically ventilated patients positioned with different head angles hospitalized in an intensive care unit.Methods This was a prospective physiological study in which static and dynamic compliance, resistive airway pressure, and peripheral oxygen saturation were measured with the head at four different positions (0° = P1, 30° = P2, 45° = P3, and 60° = P4). Repeated-measures analysis of variance (ANOVA) with a Bonferroni post-test and Friedman analysis were used to compare the values obtained at the different positions.Results A comparison of the 35 evaluated patients revealed that the resistive airway pressure values in the 0° position were higher than those obtained when patients were positioned at greater angles. The elastic pressure analysis revealed that the 60° position produced the highest value relative to the other positions. Regarding static compliance, a reduction in values was observed from the 0° position to the 60° position. The dynamic compliance analysis revealed that the 30° angle produced the greatest value compared to the other positions. The peripheral oxygen saturation showed little variation, with the highest value obtained at the 0° position.ConclusionThe highest dynamic compliance value was observed at the 30° position, and the highest oxygenation value was observed at the 0° position.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Influence of different degrees of head elevation on respiratory mechanics in mechanically ventilated patients

Martinez¹,

Marques²,

Santos³

et al. 2015

Revista Brasileira De Terapia Intensiva

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“…The sedatives was used with the utmost caution, due to complications that it can cause. Taught, however, as it was necessary, as the industry's routine of Fentanyl or Midazolam 9 . The comparison between the newborn control groups, furosemide and beclomethasone, in reference to chronological age variable, was accomplished using non-parametric test of Kruskal-Wallis test, while the variables: age, weight, lung, airway resistance and oxygenation index was accomplished using ANOVA test of a via.…”

Section: Methodsmentioning

confidence: 99%

Efeitos da inalação de beclometasona e furosemida sobre a função pulmonar e índice de oxigenação de recém-nascidos prematuros

Foerster¹,

Xavier²,

Palhares³

2013

Fisioter. Pesqui.

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| The objective of this study was to evaluate lung function and oxygenation index of preterm infants undergoing endotracheal inhaling of beclomethasone and furosemide. We studied 30 newborn preterms with gestational age ≤36 weeks, undergoing conventional mechanical ventilation for at least 12 hours. Three sequential inhalations with their medications were executed with an interval of three hours between each. We collected samples of arterial blood for gas analysis, and after endotracheal aspiration, the measurement of respiratory variables was performed in two stages, two hours before and after the last inhalation. Dynamic compliance and the oxygenation index showed no statistically significant difference between before and after the medication, however, the airway resistance group demonstrated a reduction in beclomethasone between the moments before and after the intervention (p=0.03). These results cannot imply that inhaled beclomethasone and furosemide exerted significant influence on lung function and oxygenation in the newborn infants studied.

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“…Currently, there is growing concern regarding MV-induced lung injury caused by mechanical stress on the lung parenchyma, which can have consequences at both the pulmonary and systemic levels. ( 1 , 2 )…”

Section: Introductionmentioning

confidence: 99%

Reproducibility of respiratory mechanics measurements in patients on invasive mechanical ventilation

Júnior¹,

Silva²,

Santos

et al. 2020

Revista Brasileira De Terapia Intensiva

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Objective To evaluate the intra- and interexaminer reproducibility of measurements of the resistance and static and dynamic compliance of the respiratory system in patients on mechanical ventilation. Methods This was an analytical study conducted with individuals aged ≥ 18 years who were on invasive mechanical ventilation and had no clinical diagnosis of respiratory system disease and/or chest abnormality. Three measurements of respiratory mechanics were performed with a 1-minute interval between them. The first and third measurements were performed by examiner A, the second by examiner B. The values for the resistance and static and dynamic compliance of the respiratory system were compared using the intraclass correlation coefficient. Results A total of 198 measurements of respiratory mechanics were performed for 66 patients on mechanical ventilation. The patients had a mean age of 52.6 ± 18.6 years and a mean body mass index of 21.6 ± 2.1kg/m 2 ; a surgical profile (61.5%) and female sex (53.8%) were predominant. Mean values were obtained for the three measurements of respiratory system resistance (A1: 15.7 ± 6.8cmH 2 O/L/s; B1: 15.7 ± 6.4cmH 2 O/L/s and A2: 15.9 ± 6.2cmH 2 O/L/s), respiratory system static compliance (A1: 42.1 ± 13.7mL/cmH 2 O; B1: 42.4 ± 14.6mL/cmH 2 O and A2: 42.2 ± 14.5mL/cmH 2 O) and respiratory system dynamic compliance (A1: 21.3 ± 7.3mL/cmH 2 O; B1: 21.4 ± 7.5mL/cmH 2 O and A2: 21.3 ± 6.2mL/cmH 2 O). The intraclass correlation coefficient was also calculated for respiratory system resistance (R = 0.882 and p = 0.001; R = 0.949 and p = 0.001 - interexaminer A1 versus B and B versus A2, respectively; R = 0.932 and p = 0.001 - intraexaminer); respiratory system static compliance (R = 0.951 and p = 0.001; R = 0.958 and p = 0.001 - interexaminer A1 versus B and B versus A2, respectively; R = 0.965 and p = 0.001 - intraexaminer) and respiratory system dynamic compliance (R = 0.957 and p = 0.001; R = 0.946 and p = 0.001 - interexaminer A1 versus B and B versus A2, respectively; R = 0.926 and p = 0.001 - intraexaminer). Conclusion The measurements of resistance and static and dynamic compliance of the respiratory system show good intra- and interexaminer reproducibility for ventilated patients.

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Mecânica pulmonar de pacientes em suporte ventilatório na unidade de terapia intensiva. Conceitos e monitorização

Cited by 11 publications

References 24 publications

Influence of different degrees of head elevation on respiratory mechanics in mechanically ventilated patients

Influence of different degrees of head elevation on respiratory mechanics in mechanically ventilated patients

Efeitos da inalação de beclometasona e furosemida sobre a função pulmonar e índice de oxigenação de recém-nascidos prematuros

Reproducibility of respiratory mechanics measurements in patients on invasive mechanical ventilation

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