Alterações nos parâmetros fisiológicos dos recém-nascidos sob oxigenoterapia na coleta de gasometria

Abstract

Objective: To identify the changes that occur in the physiological parameters of newborns under oxygen therapy during the collection of arterial blood gases, comparing the moments immediately before, immediately after, and five minutes after the procedure. Methods: A longitudinal study, of the before and after research design. The sample was composed of 67 newborns under oxygen therapy that had an arterial puncture for blood gas analysis. Results: The group of newborns in an Oxyhood experienced significant alterations (p<0.05) in heart rate, pulse and oxygen saturation. Newborns on mechanical ventilation had alterations in respiratory rate and pulse, while those with nasal CPAP showed no instability in physiological parameters. Conclusion: The painful stimulus caused by the collection of blood gases in newborns showed changes in all physiological parameters, however, for such a procedure, the changes were different for each mode of oxygen therapy. ResumoObjetivo: Identificar as alterações que ocorrem nos parâmetros fisiológicos dos recém-nascidos sob oxigenoterapia na coleta de gasometria arterial, comparando os momentos imediatamente antes, imediatamente depois, e cinco minutos depois do procedimento. Métodos: Estudo longitudinal, do tipo antes e depois,. Amostra composta por 67 recém-nascidos sob oxigenoterapia que receberam punção arterial para gasometria. Resultados: O grupo de recém-nascidos em Oxi-Hood sofreu alterações significativas (p<0,05) na frequência cardíaca, pulso e saturação de oxigênio. Os recém-nascidos em ventilação mecânica obtiveram alterações de frequência respiratória e pulso e aqueles sob CPAP nasal não mostraram instabilidade dos parâmetros fisiológicos. Conclusão: O estímulo doloroso causado pela coleta de gasometria nos recém-nascidos mostrou variações de todos os parâmetros fisiológicos, porém, para tal procedimento, as alterações foram diferentes em cada modalidade de oxigenoterapia.

Influência Das Intercorrências Neonatais No Desenvolvimento Motor De Crianças Prematuras

“…O sistema respiratório do prematuro encontra-se em desenvolvimento, sendo necessário, muitas vezes, o uso da VM por um tempo prolongado. Portanto, quanto menor a IG, maior a necessidade de parâmetros ventilatórios 21 . Corroborando a análise do presente estudo, o qual encontrou correlação significativa e negativa entre o tempo de uso da VM e a IG.…”

Efeitos da oxigenoterapia em neonatologia: revisão integrativa de literatura

“…Apesar dos riscos inerentes a utilização de oxigenoterapia em RN, a mesma deve ser utilizada de maneira segura e eficaz, desde que haja indicação, manutenção, sistematização de rotinas pelas instituições de saúde. A instalação de modernas UTIN com recursos humanos e tecnologias de média e alta complexidade, foi um dos marcos decisivos na diminuição da mortalidade neonatal (36) . Contudo, tais recursos devem ser usados de maneira racional e responsável pelos profissionais envolvidos no cuidado ao RN.…”

Nurses’ understanding of newborn care in oxygen therapy / Compreensão do enfermeiro sobre o cuidado ao recém-nascido em oxigenoterapia

“…It is an essential therapy for the treatment of hypoxia and/or correction of respiratory failure, which can be perceived through various signs and symptoms, such as nose-flapping, hypotension, costal retraction, apnea, dyspnea, increased respiratory effort, among others. 4 The types of ventilatory supports involve devices such as Oxi-Hood (halo), a kind of helmet that provides a mixture of O 2 with compressed air to NB that breathe spontaneously and that show respiratory discomfort of mild to moderate intensity; 5,6 Continuous Positive Airway Pressure (nasal CPAP), in which O 2 is administered associated with compressed air through the nasal prong, with continuous pressure and flow; 7 Mechanical Ventilation (MV), an invasive therapeutic modality indicated in cases of either respiratory failure or severe respiratory insufficiency, among others. 8 Oxygen therapy is a procedure that presents a risk to the patient and requires that the multidisciplinary and interdisciplinary team, before giving the necessary care to the NB under ventilatory assistance, knows the conduits, the equipment, and devices related to it, in a standardized and specific way for each one.…”

“…3 Therefore, you need to be able and safe to provide quality care, with due knowledge about the factors and complications related to this therapy. 5 In this sense, this research has the potential to favor the improvement of the quality of NB care in O 2 therapy, since it will allow knowing the possible limitations in the conduct of nursing assistants in the neonatal unit. From this, the approach of the problem studied was based on the following questions: What is the nurse's understanding of oxygen therapy and its possible complications?…”

“…3,11 Despite the innumerable benefits associated with oxygen therapy, the O 2 administration, when performed improperly, can also cause toxic effects and complications that, in turn, may increase NB hospitalization time and alter the prognosis and quality of life of the patient. 4,5 Such complications can be caused by high concentrations of O 2 without necessity, prolongation of its administration or individual sensitivity of NB, causing lung damage or even chronic diseases of prematurity, such as Retinopathy of Prematurity and Bronchopulmonary Dysplasia. 4,12 It was observed in the speeches that the nurses recognize that this therapy can present adverse effects and greater complications, if used unduly and without precautions: Prolonged use of oxygen therapy may lead to some deleterious effects on NB, such as respiratory system depression, decreased pulmonary surfactant, pneumothorax, absorption atelectasis, barotrauma, bronchopulmonary dysplasia, retinopathy of prematurity, reduction of vital capacity, musculoskeletal dehydration, among others.…”