Inalação de solução salina hipertônica como coadjuvante da fisioterapia respiratória para reversão de atelectasia no pós-operatório de cirurgia cardíaca pediátrica

A dor interfere na função respiratória após cirurgias cardíacas?Does the pain disturb the respiratory function after heart surgeries? Abstract Objective: The postoperative pain after heart surgeries had been often reported. Meager reports about respiratory function and pain correlation had been reported. The aim of this study is to assess the pain intensity and location during hospital stay and its effect on respiratory function in patients undergone elective heart surgery.Methods: Respiratory function (lung volumes, respiratory muscle strength and peak expiratory flow) was assessed at the preoperative and postoperative times (1, 3 and 5 days) by ventilometer, manovacuometer and peak flow meter measurements. The assessment of pain intensity was performed with a visual analogue scale for pain.Results: The majority of pain site was on sternotomy incision (50% of patients) and the intensity was higher at the first postoperative day (8.32 by visual scale measurement). All respiratory variables remained lower than to preoperative period at fifth postoperative time (P > 0.05), with exception for respiratory rate. The pain and maximal inspiratory pressure showed a negative correlation at the first postoperative day (P = 0.019).Conclusion: Postoperative pain decreased respiratory function in patients precluding deep inspirations, in special, at the first postoperative day. Descriptors: Pain. Cardiovascular surgical procedures. Respiratory function tests. ResumoObjetivo: A dor no pós-operatório de cirurgia cardíaca é frequente. Poucos relatos existem sobre a sua relação com a função respiratória e o local mais frequentemente relatado. O objetivo é avaliar a intensidade e a localização da dor durante o período de internação e suas repercussões na função respiratória de pacientes submetidos à cirurgia cardíaca eletiva. PhD in Surgery at

Section: Resultsmentioning

confidence: 98%

“…The alveolar hypoventilation due to pain in the sternotomy location is a common cause of atelectasis in the postoperative period [21,22]. The use of anesthetics and the absence of alveolar ventilation during CPB cause decreased ciliary function.…”

Section: Resultsmentioning

confidence: 99%

A dor interfere na função respiratória após cirurgias cardíacas?

Sasseron¹,

Figueirêdo²,

Trova³

et al. 2009

“…Physiotherapy treatment of difficult resolution of atelectasis during pediatric cardiac surgery had better mucociliary clearance after inhalation of hypertonic saline with 6% NaCl [27].…”

Section: Reviewmentioning

confidence: 99%

Fisioterapia respiratória e sua aplicabilidade no período pré-operatório de cirurgia cardíaca

Miranda¹,

Padulla²,

Bortolatto³

2011

ResumoProcedimentos cirúrgicos torácicos podem alterar a mecânica respiratória, repercutindo na função pulmonar. A presença de profissionais fisioterapeutas é fundamental no preparo e na reabilitação dos indivíduos que são submetidos à cirurgia cardíaca, visto que dispõem de um grande arsenal de técnicas. O objetivo foi verificar a efetividade de exercícios respiratórios, com e sem a utilização de dispositivos, e o treinamento muscular respiratório pré-cirurgia cardíaca na redução das complicações pulmonares pós-operatórias. Mesmo existindo controvérsias a respeito de qual técnica utilizar, estudos demonstram a eficácia da fisioterapia respiratória pré-cirúrgica na prevenção e na redução de complicações pulmonares pós-operatórias. Descritores

“…With the use of anesthetics, narcotic drugs and interruption of ventilation during on-pump surgery associated with pain, there is decrease of the ciliary function, limitation in inspiratory effort and impairing in the effectiveness of cough reflex, favoring the accumulation of pulmonary secretion [24]. The cough stimulation has been used as a Bronchial Hygiene Therapy for the removal of bronchial secretions in patients in the postoperative period of cardiac surgery [6][7].…”

Section: Physiotherapeutic Approach After Extubationmentioning

confidence: 99%

“…The cough stimulation has been used as a Bronchial Hygiene Therapy for the removal of bronchial secretions in patients in the postoperative period of cardiac surgery [6][7]. Inhalation of hypertonic saline solution with NaCl at 6% associated with respiratory conventional physiotherapy proves to be effective in mucociliar clearance, inducing a productive cough [24].…”

Section: Physiotherapeutic Approach After Extubationmentioning

confidence: 99%

Cuidados pré e pós-operatórios em cirurgia cardiotorácica: uma abordagem fisioterapêutica

Arcêncio¹,

Souza²,

Bortolin³

et al. 2008

It is well known that anesthesia and certain surgeries predispose patients to changes in respiratory function, pulmonary volumes, and gas exchange. Cardiac surgery, which is considered a major surgery, may trigger respiratory complications in the postoperative period. These complications have various causes, such as heart and lung functions in the pre-operative, the use of cardiopulmonary bypass (CPB), and the level of sedation. In these extensive thoracic procedures, respiratory dysfunction may be significant, persisting in the postoperative period. Physiotherapy is offered to patients in the ICU as part of a multidisciplinary treatment plan. It is a time-consuming treatment, and is possible at various times during the patient's stay in the ICU. However, it is particularly valuable in postoperative recovery in order to avoid respiratory and motor complications. Thus, a literature review was performed, aiming to arrange current and relevant information on available resources for respiratory monitoring, as well as its importance in evaluating and treating lung function impairment, as this complication is a frequent cause of death in surgical patients. Bras Cir Cardiovasc 2008; 23(3): 400-410 For acquisition data in this study, scientific articles and an electronic research strategy was used for bibliographic reviews, mainly aiming to identify studies and guidelines that relate to physiotherapeutic performance and cardiothoracic surgery. The study was carried out based on articles that were published in the last 20 years, were available in the MEDLINE database, and used the terms "Physiotherapy", "cardiac surgery", "respiratory monitoring" and/or "respiratory complications". Relevant studies from Brazilian authors were also considered, particularly those published by the Brazilian Journal of Cardiovascular Surgery and the Brazilian Archives of Cardiology (official journals of dissemination of Brazilian cardiology) if the articles contained the key words "physiotherapy" and "monitoring". In addition to this research, additional data from postgraduate studies was found at the Division of Thoracic and Cardiovascular Surgery, FMRP-USP.ARCÊNCIO, L ET AL -Pre-and postoperative care in cardiothoracic surgery: a physiotherapeutic approach RevThe findings included randomized clinical trials, metaanalysis, review articles and consensus guidelines, and were related to physiotherapy, respiratory monitoring, and cardiac surgery and its complications. As the diagram of Figure 1 shows, 623 potentially relevant publications in MEDLINE were found, of which 55 fulfilled all of the scientific criteria.