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Doctoral Thesis
DOI
10.11606/T.5.2003.tde-24092014-143844
Document
Author
Full name
Valdelis Novis Okamoto
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2003
Supervisor
Committee
Amato, Marcelo Britto Passos (President)
Carvalho, Carlos Roberto Ribeiro de
Demarzo, Sergio Eduardo
Rocco, Patricia Rieken Macedo
Terzi, Renato Giuseppe Giovanni
Title in Portuguese
Segurança e eficácia da manobra de recrutamento com pressurização progressiva em pacientes com síndrome do desconforto respiratório agudo / lesão pulmonar aguda
Keywords in Portuguese
Barotrauma
Doença aguda
Hemodinâmica
Respiração artificial/métodos
Síndrome do desconforto respiratório em adultos/terapia
Abstract in Portuguese
Uma manobra de recrutamento com pressurização progressiva, visando a minimizar o colapso pulmonar, foi desenvolvida em um estudo tomográfico em pacientes com síndrome do desconforto respiratório agudo / lesão pulmonar aguda O recrutamento pulmonar total, avaliado pelas imagens tomográficas relacionou-se à soma PaO2 + PaCO2 >= 400 mmHg, de acordo com a gasometria intra - arterial. Para avaliar a segurança e eficácia da manobra de recrutamento com pressurização progressiva quanto aos seus efeitos sobre a troca gasosa e sobre parâmetros hemodinâmicos de importância clínica, 12 pacientes, extensamente monitorizados, foram submetidos à manobra até o recrutamento total, ocorrência de efeitos adversos ou pressão de platô = 60cmH2O. Todos os pacientes atingiram PaO2 + PaCO2 >= 400 mmHg com a manobra de recrutamento, que foi bem tolerada, não causou barotrauma e sustentou alta PaO2/ FIO2 em 6 h
Title in English
Safety and efficacy of a stepwise recruitment maneuver in patients with acute respiratory distress syndrome/acute lung injury
Keywords in English
Acute disease
Barotrauma
Hemodinamic
Respiration artifitial/methods
Respiratory distress syndrome adult/terapy
Abstract in English
A stepwise recruiting maneuver targeting minimal lung collapse was developed in a tomographic study in patients with acute respiratory distress syndrome/ acute lung injury (ARDS / ALI). PaO2 + PaCO2 >= 400 mmHg assessed by intrarterial blood gases was consistent with full recruitment on tomographic sections. To assess the safety and efficacy of a stepwise recruitment maneuver in terms of its effect on gas exchange and hemodynamic variables of clinical relevance, twelve ARDS/ALI patients, extensively monitored, were submitted to the maneuver until full recruitment, adverse effects or plateau pressure = 60cmH2O. All patients achieved PaO2 + PaCO2 >= 400 mmHg with the recruitment protocol, which was well tolerated, did not cause barotrauma and resulted in the maintenance of high PaO2/ FIO2 within 6 h
 
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Publishing Date
2014-09-25
 
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