Avaliação da função pulmonar em pacientes submetidos à cirurgia cardíaca com circulação extracorpórea

Papel da eletroanalgesia na função respiratória de pacientes submetidos à operação de revascularização do miocárdioThe role of electroanalgesia in patients undergoing coronary artery bypass surgery Abstract Objective: To assess the electroanalgesia as an effective method in the reduction of pain and consequent improvement in lung function in patients undergoing coronary artery bypass graft surgery.Methods: During the period of one year were studied 30 patients undergoing surgery for treatment of the ischemic coronary disease. After randomization, 15 patients were allocated in the study group (that received electroanalgesia) and 15 patients from the control group (placebo). From the 1 st until the 5 th postoperative day were performed two applications of eletroanalgesia or the placebo current, according to the group where the patient was allocated.Results: There was a reduction in the levels of pain in the study group compared to the control group, evidenced by the value P<0,05; however, there is no evidence of statistical difference of the spirometric variables between them.Conclusion: The group that did eletroanalgesia presented reduction in the intensity of postoperative pain, which however did not mean improvement in respiratory function of these patients. Rev Bras Cir Cardiovasc 2009; 24(3): 391-396 Descriptors

Section: Discussionmentioning

confidence: 99%

Papel da eletroanalgesia na função respiratória de pacientes submetidos à operação de revascularização do miocárdio

Luchesa

Greca

Guarita-Souza

et al. 2009

“…The duration of CPB presented a correlation with postoperative respiratory complications. The severity of interstitial edema observed is proportional to the duration of CPB; severe acute pulmonary injury with pulmonary edema occurs more frequently when the period of CPB exceeds 150 minutes [6][7][8]. In valve surgeries, hospital mortality is associated to intra-operative variables including CPB times greater than 120 minutes [7,8].…”

Section: Discussionmentioning

confidence: 99%

Benefícios da ventilação não-invasiva após extubação no pós-operatório de cirurgia cardíaca

Lopes¹,

Brandão²,

Nozawa³

et al. 2008

Benefícios da ventilação não-invasiva após extubação no pós-operatório de cirurgia cardíacaBenefits of non-invasive ventilation after extubation in the postoperative period of heart surgery Abstract Objective: to show the benefits of the use of non-invasive positive pressure ventilation (NPPV) in the process of weaning from mechanical ventilation in the immediate postoperative period of heart surgery.Methods: A prospective, randomized and controlled study was performed involving 100 consecutive patients submitted to coronary artery bypass grafting or valve surgery. The subjects were admitted into the Intensive Care Unit (ICU) under mechanical ventilation and randomized in a study group (n=50), which used NPPV with bilevel pressure for 30 minutes after extubation, and a control group (n=50) which only used a nasal O 2 catheter. Anthropometric variables and the times of the intra-operative periods corresponding to anesthesia, surgery and cardiopulmonary bypass, as well as the time required for weaning from invasive mechanical ventilation were analysed. The arterial blood gases and hemodynamic variables were also assessed before and after extubation.Results: The evolution was similar for the control and study groups without statistically significant differences of the variables analyzed except for the PaO 2 . On comparing the groups, the PaO 2 improved significantly (p = 0.0009) with the use of NPPV for 30 minutes after extubation, but there was no statistically significant difference in the PaCO 2 (p = 0.557).Conclusion: The use of NPPV for 30 minutes after extubation improved oxygenation in the immediate postoperative period of heart surgery. Descriptors 345LOPES, CR ET AL -Benefits of non-invasive ventilation after extubation in the postoperative period of heart surgery Bras Cir Cardiovasc 2008; 23(3): 344-350 Rev

“…Polese et al [15] studying airway resistance and elastance, that is, the inverse of compliance, also found a reduction in the compliance and an increase in airway resistance after heart surgery with CPB. It is known that patients submitted the CABG surgery present with a reduction in the gas exchange index when compared to preoperative values [16]. Patients after heart surgery are benefited from alveolar recruitment with the utilization of PEEP improving the gas exchange index [13].…”

Section: Discussionmentioning

confidence: 99%

“…This fact would explain the reduction of the compliance in both groups. CPB may cause respiratory dysfunctions frequently with atelectasis [16], a situation aggravated by the manipulation of the chest and by the decubitus. These lead to a reduction of compliance that can persist up to six days [18].…”

Section: Discussionmentioning

confidence: 99%

“…These lead to a reduction of compliance that can persist up to six days [18]. Barbosa and Carmona [16] evaluated the StaC in patients submitted the heart surgery and also found a reduction in the immediate postoperative period. The deleterious effects of CPB on the mechanical respiration of patients with a history of pulmonary disease are summed to the increase in the expected StaC of these patients.…”

Section: Discussionmentioning

confidence: 99%

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Aspectos da função pulmonar após revascularização do miocárdio relacionados com risco pré-operatório

Ambrozin¹,

Catâneo²

2005