Acute respiratory distress syndrome is characterized by diffuse inflammatory lung injury and is classified as mild, moderate, and severe. Clinically, hypoxemia, bilateral opacities in lung images, and decreased pulmonary compliance are observed. Sepsis is one of the most prevalent causes of this condition (30 - 50%). Among the direct causes of acute respiratory distress syndrome, chlorine inhalation is an uncommon cause, generating mucosal and airway irritation in most cases. We present a case of severe acute respiratory distress syndrome after accidental inhalation of chlorine in a swimming pool, with noninvasive ventilation used as a treatment with good response in this case. We classified severe acute respiratory distress syndrome based on an oxygen partial pressure/oxygen inspired fraction ratio <100, although the Berlin classification is limited in considering patients with severe hypoxemia managed exclusively with noninvasive ventilation. The failure rate of noninvasive ventilation in cases of acute respiratory distress syndrome is approximately 52% and is associated with higher mortality. The possible complications of using noninvasive positive-pressure mechanical ventilation in cases of acute respiratory distress syndrome include delays in orotracheal intubation, which is performed in cases of poor clinical condition and with high support pressure levels, and deep inspiratory efforts, generating high tidal volumes and excessive transpulmonary pressures, which contribute to ventilation-related lung injury. Despite these complications, some studies have shown a decrease in the rates of orotracheal intubation in patients with acute respiratory distress syndrome with low severity scores, hemodynamic stability, and the absence of other organ dysfunctions.
Objetivo: Constatar as evidências científicas sobre a embolia gasosa como complicação ligada ao cateter venoso central. Métodos: Trata-se de uma revisão bibliográfica integrativa, com a seleção dos artigos realizada nas plataformas Lilacs, Scielo, Biblioteca Virtual de Saúde e Pubmed, publicados. A análise dos dados foi através de pré-análise, exploração do material, tratamento dos dados e interpretação dos dados, com resultados sendo expostos em quadro. Resultados: Foram encontrados nove artigos correspondente ao nosso objetivo. Segundo a literatura o Cateter Venoso Central (CVC) apresenta alta frequência de instalação em pacientes na prática hospitalar, representando por conseguinte alto potencial de complicações como a embolia gasosa, que é pouco reconhecida, mas que ocorre tanto na inserção do CVC como na sua retirada. Alguns fatores de risco podem contribuir para o desenvolvimento de uma embolia gasosa, como o mau posicionamento do paciente, hipovolemia, inalação espontânea durante o procedimento e não aplicação de selos de cateter. A sintomatologia vai desde uma dispneia súbita até a morte caso não haja conduta terapêutica adequada. Considerações finais: Cateteres venosos centrais são amplamente utilizados na prática clínica hospitalar e apesar de não ser a complicação mais evidente, a embolia gasosa é rara e potencialmente fatal advinda do cateterismo venoso central.
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