Padrões de ventilação em anestesia: estudo retrospectivo

Vieira, Joaquim Edson; Silva, Basílio Afonso Ribeiro; Júnior, Daniel Garcia

doi:10.1590/s0034-70942002000600013

Cited by 9 publications

(13 citation statements)

References 6 publications

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“…This leads us to believe that intraoperative factors were the main cause of alterations in mechanical respiration in the immediate postoperative period. Mechanical ventilation of patients with obstructions in the intraoperative period with low flow volumes and low PEEP levels, avoids hyperinsufflation and auto-PEEP processes; but, favors the formation of atelectasis and ventilation-perfusion disorders [17]. This fact would explain the reduction of the compliance in both groups.…”

Section: Discussionmentioning

confidence: 99%

Aspectos da função pulmonar após revascularização do miocárdio relacionados com risco pré-operatório

Ambrozin¹,

Catâneo²

2005

Rev Bras Cir Cardiovasc

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Section: Discussionmentioning

confidence: 99%

Aspectos da função pulmonar após revascularização do miocárdio relacionados com risco pré-operatório

Ambrozin¹,

Catâneo²

2005

Rev Bras Cir Cardiovasc

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“…Almost half of patients needed some therapy to reverse hypoxemia such as alveolar recruitment, PEEP level elevation or oxygen therapy [20]. Laizo et al [21] analyzed complications that increased ICU lengh of stay and found as cause those related to pulmonary function (COPD and smoking, pulmonary congestion, prolonged mechanical ventilation), besides infections, kidney failure, stroke and hemodynamic instability (as arterial hypotension, arrhythmia and AMI).…”

Section: Discussionmentioning

confidence: 99%

Factors associated to hypoxemia in patients undergoing coronary artery bypass grafting

Santos¹,

Mitsunaga²,

Borges³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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Introduction: Hypoxemia is a frequent pulmonary complication in the postoperative coronary artery bypass graft. Detection of factors associated with their occurrence may indicate patients at risk for this complication, which allows tracing specific therapeutic and consequently reduce morbidity and mortality.Objective: To identify related factors to hypoxemia occurrence in immediate coronary artery bypass graft postoperative.Methods: In this retrospective cohort study, we studied 100 patients submitted to elective om-pump artery bypass graft , between April 2010 and December 2011, at a reference university hospital for cardiac surgery in the state of Maranhão. It was considered hypoxemia gas exchange ratio less than or equal to 300 mmHg. Associated variables with perioperative hypoxemia were defined by the Student T test, G or Mann-Whitney tests, Chi-square, or Fisher's exact test and multiple linear regression.Results: Among studied variables, high body mass index (P=0.036) and smoking (P=0.024) were significantly associated with hypoxemia in the immediate coronary artery bypass graft postoperative. Hypoxemia incidence in this period was 55% and did not affects mechanical ventilation duration and Intensive Care Unit lengh of stay.Conclusion: In this sample, body mass index and smoking were associated to hypoxemia. These data reinforce the importance of clinical assessment to identify patients at risk for this complication, considering its high incidence in immediate postoperative period. Descriptors: Oxygen level. Postoperative period. Myocardial revascularization.Resumo Introdução: A hipoxemia é uma complicação pulmonar frequente no pós-operatório de revascularização miocárdica. A detecção de fatores associados a sua ocorrência pode indicar pacientes de risco para essa complicação, o que possibilita traçar terapêuticas específicas e, consequentemente, diminuir a morbimortalidade.Objetivo: Identificar fatores relacionados à ocorrência de hipoxemia no pós-operatório imediato de revascularização miocárdica.Métodos: Nesta coorte retrospectiva, foram estudados 100 365Rev Bras Cir Cardiovasc | Braz J Cardiovasc Surg Rev Bras Cir Cardiovasc 2013;28(3):364-70Santos NP, et al. -Factors associated to hypoxemia in patients undergoing coronary artery bypass graftingAccording to a recent study [7], predictor factors detection may indicate patients at high risk for postoperative hypoxemia that demand mechanical ventilation strategies, in order to prevent and treat pulmonary collapse during intra-operatory period, to minimize hypoxemia impact on mechanical ventilation duration, to reduce mobidity and mortality related to cardiac intervention, to reduce length of stay at Intensive Care Unit (ICU), and hospital costs.This study is designed to analyze factors related to hypoxemia in a specific population of patients undergoing CABG surgery, to determine its incidence in immediate post-operative period, and to evaluate if hypoxemia interfered on mechanical ventilation duration and lengh of stay in ICU.

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“…Intraoperative hypoxemia is ascribed to poor gas distribution due to changed pulmonary volumes and respiratory system mechanical properties, and ventilatory control. (25) According to Ramos et al (26) general anesthesia causes several respiratory physiological effects as: atelectasis formation, residual functional capacity (RFC) reduction, ventilation-perfusion ratio change, and mucociliary function impairment. (26) Anesthesia may also promote respiratory system complacency reduction and increased gases flow airway resistance, from reduced pulmonary volume.…”

Section: Cardiac Surgery Postoperative Period Respiratory Failurementioning

confidence: 99%

“…These findings indicate that postoperative pulmonary complications may onset even during anesthesia. (25) Positive pressure mechanical ventilation hemodynamical changes…”

Section: Cardiac Surgery Postoperative Period Respiratory Failurementioning

confidence: 99%

“…(7) Although current anesthesia devices and ventilators have more effective low tidal volume offer, and have incorporated some ventilatory assistance tools such as PEEP and pressure controlled ventilation (PCV), these are still little used in anesthesia. (30) Overall, there is no consensus on intraoperative mechanical ventilation, (25) requiring additional investigation. Traditional cardiac surgery ventilatory support recommends high tidal volumes (10-15 mL/kg) mechanical ventilation in order to minimize atelectasis, and minimal positive pressure to improve ar-terial oxygenation.…”

Section: Intraoperative Mechanical Ventilationmentioning

confidence: 99%

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