Ventilação mecânica na lesão pulmonar aguda / síndrome do desconforto respiratório agudo

Lesão pulmonar e ventilação mecânica em cirurgia cardíaca: revisão

“…This inflammatory response may contribute to the development of postoperative complications including myocardial dysfunction, respiratory failure, renal and neurological dysfunction, liver function impairment and multiple organ failure. (20) The acute respiratory distress syndrome (ARDS) is defined by the Brazilian Consensus on Mechanical Ventilation as an acute onset respiratory failure syndrome characterized by bilateral chest radiography infiltrate, severe hypoxemia (defined as PaO 2 / FiO 2 ratio < 200), pulmonary capillary wedge pressure < 18 mmHg, or lack of left atrial hypertension clinical and echography signs (presence of a lung injury risk factor). The term acute lung injury (ALI) is equally defined as ARDS, only differing for a less marked hypoxemia, PaO 2 /Fio 2 < 300.…”

“…The term acute lung injury (ALI) is equally defined as ARDS, only differing for a less marked hypoxemia, PaO 2 /Fio 2 < 300. (20) Most ARDS studies use the Murray et al (21) severity score. It involves quantification of hypoxemia level, static respiratory complacency, involved pulmonary quadrants, and end-expiratory pressure (PEEP) level.…”

“…(21) ARDS pathophysiology is characterized by increased alveolar-capillary permeability, with protein transudation associated with systemic and local inflammation. (5) It is considered an extreme ALI form, leading to a mortality rate between 36% and 60%, (20) and reported by some authors as above 50%. (4) SIRS and ARDS have been described after cardiorespiratory bypass cardiac surgery, and in this context, has a significant impact on patients' survival rate.…”

“…From a physiologic stand point, just a ventilation modality change without changing tidal volume, respiratory rate, PEEP and plateau pressure, have little impact on patients' prognosis. (20) However, the III Consensus on Mechanical Ventilation states that, irrespective the modality chosen, when the ventilatory parameters are set, high tidal volumes and plateau pressures should be avoided.…”

Insuficiência múltipla de órgãos relacionada a acidente ofídico: relato de caso

“…Being a safe but less effective method, it would not be the best choice for an increased catabolism case. On the other hand, the prescription of daily hemodialysis sessions, early enteral diet and ventilation within the parameters recommended by the Brazilian Consensus on Mechanical Ventilation (12) were decisive factors for the favorable outcome.…”