Deslizamento de fluidos da cavidade orofaringea para traqueia influenciado pela fisioterapia respiratoria em pacientes sob ventilação mecanica

AUTOR(ES)
DATA DE PUBLICAÇÃO

2004

RESUMO

Respiratory physiotherapymay improve the respiratory function, fostering oxygenation and lung ventilation on patients who are bedridden, sedated and depending on mechanical ventilation. The secretions retained on the superior side of the cuff can be contaminated by pathogenic microorganismsand if the oropharingeal colonies arrive at the lungs, it could be a potential cause of aspiration pneumonia. This work has the purpose of checking if the respiratory physiotherapy movements could influence on the sliding of secretions between the external surface of the inflated cuff of the tracheal tube and the trachea wall, indicating the passage of secretion from oropharingeal cavity to the inferior airways, which was identified through the use of dye. It was a prospective experimental study using the longitudinal model. It was composed by 25 patients over 18 years old, mechanical ventilation dependents, sedated, orotracheally intubated for a period of 120 hours, who could be put on the 30 fowler position and be maintained on assisted/controlled mechanical ventilation, ventilated by volume (8 m1/kg of weight) with positive and expiratory pressure (PEEP) on the value of 5 to 8 cm H20 and inspiratory/expiratory relation 1:2. They were subdivided into two groups: the Non-Experimental Group (ONE), constituted by patients who did not receive physiotherapeutical treatment and the Experimental Group (OE), composed by patients who received it . Organic dye solution made from the paste of copper chlorophyl - B5006 - was directly dripped into the oropharingeal cavity to identify the sliding (or not) of this mixture to the inferior airways. The sliding of the mixture to the airways was identified in 10 (40%) of 25 patients, regardless of the use of physiotherapy procedures or other movements. The passage of the dye from the oropharynx cavity was observed after physiotherapy procedures on one (7%) out of 15 of the patients studied. It was concluded that the cuff might not be the safest way to stop the oropharynx secretion from sliding, since it allowed the sliding of that secretion to the airways at times. Therefore the physiotherapy cannot be considered an aggravating factor of the passage of liquids from oropharynx to the trachea on the model studied

ASSUNTO(S)

fisioterapia traqueia - intubação corantes respiração artificial

ACESSO AO ARTIGO

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