Manuseio da ventilação mecânica no trauma cranioencefálico: hiperventilação e pressão positiva expiratória final

Mecânica respiratória de pacientes neurocríticos sob ventilação mecânica submetidos à umidificação aquosa aquecida e a um modelo de filtro trocador de calor

“…Special attention should be available to the control of alveolar ventilation in this population, and in hypercapnic patients while using HMEF, particularly COPD patients and those with a history of bronchospasm, in order to avoid unwanted PaCO 2 fluctua- tions and cerebral hemodynamics changes. (26)(27)(28) Patients undergoing weaning from MV may have respiratory muscles overload while using HMEF due to increased resistance. Several studies compared the effects of HMEF in patients weaning from MV, observing reduced TV, increased PaCO 2 and respiratory rate, and minute volume.…”

“…(29) Auto-PEEP is associated with increased intrathoracic pressure and reduced cerebral venous return, (32) predisposing to intracranial pressure increase in extensive brain injury patients. (27,28) Conti et al, evaluating healthy volunteers that spontaneous breathing, noted that HMEF lead to increased R sr , and that the respiratory muscles workload may be reduced by expiratory time prolongation. (33) In this study we found no clinical signs of increased respiratory work, as all patients were under sedation and/or anesthesia, and controlled ventilation.…”

Association between the rapid shallow breathing index and extubation success in patients with traumatic brain injury

“…(1,2) A study conducted in 2001 found that 555 of 11,028 TBI victims admitted to the emergency department of a public hospital in Salvador (BA) required hospitalization for specialized care. (3) …”

“…Traumatic brain injury (TBI) is a non-degenerative, non-congenital lesion caused by trauma or triggered by high-energy acceleration or deceleration of the brain inside the skull that causes anatomical damage to or has functional effects on the scalp, skull, meninges or encephalon. ( 1 , 2 ) A study conducted in 2001 found that 555 of 11,028 TBI victims admitted to the emergency department of a public hospital in Salvador (BA) required hospitalization for specialized care. ( 3 )…”