Efeitos da manobra de compressão e descompressão torácica em pacientes submetido à ventilação mecânica / Effects of manual chest compression and decompression in patients receiving mechanical ventilation

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

14/12/2011

RESUMO

INTRODUCTION: Patients in Intensive Care Units (ICU) requiring mechanical ventilation (MV) are more likely to develop respiratory complications, especially atelectasis and bronchopneumonia. Reversing or even prevention of these areas of atelectasis, physiotherapeutic techniques are used for lung expansion, chief among which is the maneuver of chest compression and decompression (MCCD). OBJECTIVE: To evaluate the respiratory and hemodynamic changes after application of MCCD in patients submitted to mechanical ventilation (MV). METHOD: It´s a prospective and interventionist study of 65 patients submitted to MV after 24 hours. All patients received a bronchial hygiene and after 30 minutes, they were submitted to 20 repetitions of the MCCD during ten consecutive respiratory cycles on right hemithorax and than ten in left hemithorax. The data were collected before, after immediately and after one, five, ten, 15, 20, 25, 30, 35 and 40 minutes following application of the MCCD. RESULTS: There were an significant improvement in the following parameters after MCCD during all phases of data collection until 40 minutes: inspiratory tidal volume (baseline: 458,2ml ± 132,1; post 1 min: 557,3 ± 139,1; post 40 min: 574,4 ± 151 ), minute volume (baseline: 7,0L/min ± 2,7; post 1 min: 8,7 ± 3,3; post 40 min: 8,8 ± 3,8), and pulse oximetry (baseline: 97,4% ± 22; post 1 min: 97,9 ± 1,8; post 40 min: 98,2 ± 1,6) . A reduction occurred in expiratory PetCO2 (baseline: 35,1mmHg ± 9,0; post 1 min: 31,5 ± 8,2; post 40 min: 31,5 ± 8,29). No alteration occurred in heart rate (baseline: 94,5bpm ± 20,5; post 1 min: 94,7 ± 20,5; post 40 min: 94,92 ± 20,20) and mean arterial pressure (baseline: 91,2mmHg ± 19,1; post 1 min: 89,5 ± 17,7; post 40 min: 89 ± 16,8). CONCLUSION: There were positive effects on the MCCD maneuver with increased lung volumes, pulse oximetry and reduction in expiratory PetCO2, without hemodynamic changes in patients submitted to mechanical ventilation.

ASSUNTO(S)

ventilação mecânica atelectasia pulmonar fisioterapia mechanical ventilation pulmonary atelectasis physioterapy

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