Mechanical insufflation/exsufflation improves respiratory mechanics in critical care: Randomized crossover trial.

Autor: Nunes LC; Health Integrated Residency Program, Grupo Hospitalar Conceição. Av. Francisco Trein, 596, Cristo Redentor, Porto Alegre, Rio Grande do Sul, 91350-200, Brazil. Electronic address: fisiolaisnunes@yahoo.com.br., Rizzetti DA; Physiotherapy Department, Universidade Federal do Pampa. BR 472 - Km 585 - Postal Code 118, Rio Grande do Sul, 97501-970, Brazil. Electronic address: danize.rizzetti@gmail.com., Neves D; Health Integrated Residency Program, Grupo Hospitalar Conceição. Av. Francisco Trein, 596, Cristo Redentor, Porto Alegre, Rio Grande do Sul, 91350-200, Brazil. Electronic address: nevesfisioup@hotmail.com., Vieira FN; Physiotherapy Outpatient Clinic, Grupo Hospitalar Conceição. Av. Francisco Trein, 596, Cristo Redentor, Porto Alegre, Rio Grande do Sul, 91350-200, Brazil. Electronic address: fnvieira@gmail.com., Kutchak FM; Physiotherapy Outpatient Clinic, Grupo Hospitalar Conceição. Av. Francisco Trein, 596, Cristo Redentor, Porto Alegre, Rio Grande do Sul, 91350-200, Brazil. Electronic address: fekutchak@gmail.com., Wiggers GA; Physiotherapy Department, Universidade Federal do Pampa. BR 472 - Km 585 - Postal Code 118, Rio Grande do Sul, 97501-970, Brazil. Electronic address: giuliapecanha@unipampa.edu.br., Peçanha FM; Physiotherapy Department, Universidade Federal do Pampa. BR 472 - Km 585 - Postal Code 118, Rio Grande do Sul, 97501-970, Brazil. Electronic address: franckpecanha@unipampa.edu.br.
Jazyk: angličtina
Zdroj: Respiratory physiology & neurobiology [Respir Physiol Neurobiol] 2019 Aug; Vol. 266, pp. 115-120. Date of Electronic Publication: 2019 May 13.
DOI: 10.1016/j.resp.2019.05.008
Abstrakt: This study evaluated the ventilatory and haemodynamic effects of the mechanical insufflator-exsufflator (MI-E) in critically ill patients. Sixteen mechanically ventilated patients performed three protocols: MI-E (-30/+30 cmH 2 O) plus endotracheal suctioning; 50S: MI-E (-50/+50 cmH2O) plus endotracheal suctioning; and isolated endotracheal suctioning (IES). The protocols were applied randomly in all subjects, with 3 -h intervals in between. Peak airway pressure (Ppeak), plateau pressure (Pplat), airway resistance (Raw), static compliance (Cst), heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure, peripheral oxygen saturation (SpO 2 ) and amount of removed secretions were evaluated before (PRE), immediately after (POST) and 10 min after (10' POST) each protocol. The 50S protocol reduced Ppeak and Raw and increased Cst immediately after its application. Moreover, this protocol provided the largest amount of removed secretions and held SBP, DBP and SpO 2 at basal values. The MI-E at high pressures promotes benefits to respiratory mechanics, is more effective in removing pulmonary secretions and it does not lead to hemodynamic repercussions.
(Copyright © 2019 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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