Repositório Digital

A- A A+

Short-term effects of positive expiratory airway pressure in patients being weaned from mechanical ventilation

.

Short-term effects of positive expiratory airway pressure in patients being weaned from mechanical ventilation

Mostrar registro completo

Estatísticas

Título Short-term effects of positive expiratory airway pressure in patients being weaned from mechanical ventilation
Autor Rieder, Marcelo de Mello
Costa, Alexandre Doval da
Vieira, Silvia Regina Rios
Abstract OBJECTIVE: To investigate the feasibility and the cardiorespiratory effects of using positive expiratory airway pressure, a phys¬iotherapeutic tool, in comparison with a T-tube, to wean patients from mechanical ventilation. METHODS/DESIGN: A prospective, randomized, cross-over study. SETTING: Two intensive care units. PATIENTS AND INTERVENTIONS: We evaluated forty patients who met weaning criteria and had been mechanically-ventilated for more than 48 hours, mean age 59 years, including 23 males. All patients were submitted to the T-tube and Expiratory Positive Airway Pressure devices, at 7 cm H2O, during a 30-minute period. Cardiorespiratory variables including work of breathing, respira¬tory rate (rr), peripheral oxygen saturation (SpO2), heart rate (hr), systolic, diastolic and mean arterial pressures (SAP, DAP, MAP) were measured in the first and thirtieth minutes. The condition was analyzed as an entire sample set (n=40) and was also divided into subconditions: chronic obstructive pulmonary disease (n=14) and non-chronic obstructive pulmonary disease (non- chronic obstructive pulmonary disease) (n=26) categories. Comparisons were made using a t-test and Analysis of Variance. The level of significance was p < 0.05. RESULTS: Our data showed an increase in work of breathing in the first and thirtieth minutes in the EPAP condition (0.86+ 0.43 and 1.02+1.3) as compared with the T-tube condition (0.25+0.26 and 0.26+0.35) (p<0.05), verified by the flow-sensor monitor (values in J/L). No statistical differences were observed when comparing the Expiratory Positive Airway Pressure and T-tube conditions with regard to cardiorespiratory measurements. The same result was observed for both chronic obstructive pulmonary disease and non- chronic obstructive pulmonary disease subconditions. CONCLUSIONS: Our study demonstrated that, in weaning patients from mechanical ventilation, the use of a fixed level of Expiratory Positive Airway Pressure caused an increase in work of breathing that was not accompanied by any other significant cardiorespiratory changes. Therefore, we have to be cautious when using Expiratory Positive Airway Pressure as a physiotherapeutic tool during weaning from mechanical ventilation.
Contido em Clinics. São Paulo. Vol. 64, n. 5 (maio 2009), p. 403-408
Assunto Desmame
Modalidades de fisioterapia
Pressão positiva contínua nas vias aéreas
Respiração artificial
Unidades de terapia intensiva
[en] Intensive care unit
[en] Mechanical ventilation
[en] Physiotherapy
[en] Positive expiratory airway pressure
[en] Weaning
Origem Nacional
Tipo Artigo de periódico
URI http://hdl.handle.net/10183/49783
Arquivos Descrição Formato
000701577.pdf (149.1Kb) Texto completo (inglês) Adobe PDF Visualizar/abrir

Este item está licenciado na Creative Commons License

Este item aparece na(s) seguinte(s) coleção(ões)


Mostrar registro completo

Percorrer



  • O autor é titular dos direitos autorais dos documentos disponíveis neste repositório e é vedada, nos termos da lei, a comercialização de qualquer espécie sem sua autorização prévia.
    Projeto gráfico elaborado pelo Caixola - Clube de Criação Fabico/UFRGS Powered by DSpace software, Version 1.8.1.