Análise da mecânica pulmonar em modelo experimental de sepse

Carvalho, Rodrigo Storck; Pinho, André Gustavo Magalhães de; Andrade, Ana Paula Alves de; Silva, César Augusto Melo e; Gaio, Eduardo; Tavares, Paulo

doi:10.1590/s1806-37132006000400010

Cited by 3 publications

(1 citation statement)

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“…O impacto na função respiratória em decorrência de alterações da mecânica respiratória causadas por inflamação aguda ou crônica causa o aumento da permeabilidade vascular pulmonar originando um edema pulmonar, que gera alterações da complacência pulmonar, bem como da elastância pulmonar 13 .…”

Section: P a O 2 F I O 2 G 1 P R E G 1 A P ó S G 1 1 H G 2 P R E G 2 A P ó S G 2 1 H G 3 P R é G 3 A P ó Sunclassified

Manobra de recrutamento alveolar na lesão pulmonar aguda

Steffens

Campos

2013

Saúde e meio ambient.: rev. interdisciplin.

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A lesão pulmonar aguda (LPA) é considerada uma reação inflamatória dos pulmões, que ocasiona a diminuição do volume pulmonar e aumento dos shunts intrapulmonares, comprometendo a troca gasosa. Diante disso, a manobra de recrutamento alveolar (MRA) tem a finalidade de promover a abertura do maior número possível de alvéolos, e assim melhorar a distribuição do gás alveolar. Objetivo: Identificar os efeitos da MRA nos pacientes com LPA e secundariamente avaliar qual o melhor nível de PEEP a ser utilizado. Materiais e métodos: A MRA foi realizada em oito pacientes internados em uma unidade de terapia intensiva do planalto norte catarinense com diagnóstico gasométrico de LPA, sendo divididos randomicamente em três grupos, sendo que o G1 recebeu 10 cmH2O de PEEP, o G2 15 cmH2O de PEEP e G3 20 cmH2O de PEEP. Foram realizadas 3 avaliações sendo pré, pós e uma hora após a realização da MRA. Foram analisados os sinais vitais, estado ácido-básico, relação PaO2/FiO2, parâmetros ventilatórios e complacência estática. Resultados: Embora a MRA tenha sido realizada em três grupos, o G1 apresentou os melhores resultados, melhorando a relação PaO2/FiO2 e saindo do estado de LPA; as pressões de pico e platô apresentaram valores menores no G1 após a MRA, porém em todos os grupos as mesmas permaneceram nos valores de referência. O uso da MRA não causou variações hemodinâmicas nos grupos estudados. Conclusão: Verificou-se que a PEEP de 10 cmH2O foi suficiente para melhorar a LPA mesmo uma hora após a MRA.

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Section: P a O 2 F I O 2 G 1 P R E G 1 A P ó S G 1 1 H G 2 P R E G 2 A P ó S G 2 1 H G 3 P R é G 3 A P ó Sunclassified

Manobra de recrutamento alveolar na lesão pulmonar aguda

Steffens

Campos

2013

Saúde e meio ambient.: rev. interdisciplin.

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The olfactory system is affected by steroid aerosol treatment in mice

Mucignat‐Caretta¹,

Bondı̀²,

Rubini³

et al. 2009

American Journal of Physiology-Lung Cellular and Molecular Phys

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Asthma needs continuous treatment often for years. In humans, some drugs are administered via aerosol, therefore they come in contact with both respiratory and olfactory mucosa. We explored the possibility that antiasthma corticosteroid treatment could influence the olfactory function by passage through the nose. A group of mice was exposed twice daily for 42 days to fluticasone propionate aerosol and was compared with a control group. Olfactory behavior, respiratory mechanics, histology, and immunoreactivity in the olfactory system were assessed. Fluticasone-treated mice were slower in retrieving a piece of hidden food, but both groups were similarly fast when the food was visible. When a clearly detectable odor was present in the environment, all mice behaved in a similar way. Respiratory mechanics indices were similar in all mice except for the viscose resistance, which was reduced in fluticasone-treated mice. Olfactory mucosa of fluticasone-treated mice was thicker than that of controls. Slight but consistent differences in staining were present for Olfactory Marker Protein but not for other proteins. A mild impairment of olfactory function is present in mice chronically treated with fluticasone aerosol, apparently accompanied by slight modifications of the olfactory receptor cells, and suggests monitoring of olfactory function modifications in long-term steroid users.corticosteroid; behavior THE OLFACTORY SYSTEM IS CHARACTERIZED by a rapid turnover of receptor neurons, for which lifespan is ϳ1 mo, and a neuron turnover in the first relay station, the olfactory bulb (OB). The receptor axons make synapses with dendrites of mitral cells in the glomeruli (11). OB interneurons are continuously renewed by cells that differentiate from neural stem cells residing in the subventricular zone. They arrive into the OB via the rostral migratory stream and are subsequently integrated in OB circuits (25, 33). Other chemosensory organs are present in the nasal cavity, concurring to chemosensory perception (8,39). This dynamic network is sensitive to environmental challenges, which often result in mucosal damage that is subsequently reflected in OB, affecting olfactory sensitivity (9, 29).Pathological conditions of the airways may affect the olfactory performance. Both upper and lower airways diseases, for example allergic rhinitis and asthma, are treated with topical administration of corticosteroids. Fluticasone propionate (FP) is one of the most popular and safe treatments for both conditions (2) due to its hepatic metabolism that allows only a topic anti-inflammatory effect without adrenal suppression (31). Whereas the improvement in the pathological state is well-documented (in humans, see, for example, Refs. 13,24,30,34,37; in mice, Refs. 12,32), little is known about its possible effect on olfactory cells and in the subsequent olfactory performance.Corticosteroid inhalatory treatments are often long-lasting, therefore they may influence the quality of life of patients even if they induce only slight side effect. Inha...

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