Objective To compare the effectiveness of the alveolar recruitment maneuver and the breath stacking technique with respect to lung mechanics and gas exchange in patients with acute lung injury. Methods Thirty patients were distributed into two groups: Group 1 - breath stacking; and Group 2 - alveolar recruitment maneuver. After undergoing conventional physical therapy, all patients received both treatments with an interval of 1 day between them. In the first group, the breath stacking technique was used initially, and subsequently, the alveolar recruitment maneuver was applied. Group 2 patients were initially subjected to alveolar recruitment, followed by the breath stacking technique. Measurements of lung compliance and airway resistance were evaluated before and after the use of both techniques. Gas analyses were collected before and after the techniques were used to evaluate oxygenation and gas exchange. Results Both groups had a significant increase in static compliance after breath stacking (p=0.021) and alveolar recruitment (p=0.03), but with no significant differences between the groups (p=0.95). The dynamic compliance did not increase for the breath stacking (p=0.22) and alveolar recruitment (p=0.074) groups, with no significant difference between the groups (p=0.11). The airway resistance did not decrease for either groups, i.e., breath stacking (p=0.91) and alveolar recruitment (p=0.82), with no significant difference between the groups (p=0.39). The partial pressure of oxygen increased significantly after breath stacking (p=0.013) and alveolar recruitment (p=0.04), but there was no significant difference between the groups (p=0.073). The alveolar-arterial O2 difference decreased for both groups after the breath stacking (p=0.025) and alveolar recruitment (p=0.03) interventions, and there was no significant difference between the groups (p=0.81). Conclusion Our data suggest that the breath stacking and alveolar recruitment techniques are effective in improving the lung mechanics and gas exchange in patients with acute lung injury.
A Região de Volta Redonda apresenta grande demanda na utilização de pneus comuns e pneus OTR’s o que acarreta num aumento de geração de resíduos deste material. Com o aumento do descarte incorreto na região há uma grande preocupação em reduzir este passivo ambiental. O presente estudo teve por finalidade diagnosticar a destinação dos pneus, através de sua trajetória levando em consideração o fluxo do berço ao túmulo. A metodologia utilizada caracteriza-se como qualitativa, de cunho exploratório e quanto aos procedimentos subdivide-se em: Pesquisa Bibliográfica, Estudo de Caso, Levantamento de dados em campo de pesquisa. Tais procedimentos foram utilizados para a aquisição de dados do sistema de gerenciamento dos pneus inservíveis de Volta Redonda, bem como para identificação da sistemática de gerenciamento vigente dos mesmos. Os resultados apontaram todos os aspectos positivos e negativos em relação à destinação final do pneu, para o Município de Volta Redonda e os problemas enfrentados para cumprir a forma correta desta destinação. Nos aspectos positivos pode-se observar que apesar do Município não possuir um sistema de gerenciamento a Guarda Municipal assumiu o controle, já no ponto de vista negativo há um plano de gerenciamento ineficaz por estar sendo realizado por um órgão que não possui esta competência, outro fator negativo é que por não possuir uma empresa de reciclagem há um gasto financeiro maior para o transporte e destinação.
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