Efeitos da tosse manualmente assistida sobre a mecanica do sistema respirat車rio de pacientes em suporte ventilat車rio total

作者:Avena; Katia de Miranda; Duarte; Antonio Carlos Magalhes; Cravo; Sergio Luiz Domingues; Sologuren; Maria Jose Junho; Gastaldi; Ada Clarice
来源:Jornal Brasileiro de Pneumologia, 2008.
DOI:10.1590/S1806-37132008000600008

摘要

objective: manually assisted coughing (mac) consists of a vigorous thrust applied to the chest at the beginning of a spontaneous expiration or of the expiratory phase of mechanical ventilation. due to routine use of mac in intensive care units, the objective of this study was to assess the effects of mac on respiratory system mechanics in patients requiring full ventilatory support. methods: we assessed 16 sedated patients on full ventilatory support (no active participation in ventilation). respiratory system mechanics and oxyhemoglobin saturation were measured before and after mac, as well as after endotracheal aspiration. bilateral mac was performed ten times on each patient, with three respiratory cycle intervals between each application. results: data analysis demonstrated a decrease in resistive pressure and respiratory system resistance, together with an increase in oxyhemoglobin saturation, after mac combined with endotracheal aspiration. no evidence of alterations in peak pressures, plateau pressures or respiratory system compliance change was observed after mac. conclusions: the use of mac alters respiratory system mechanics, increasing resistive forces by removing secretions. the technique is considered safe and efficacious for postoperative patients. using mac in conjunction with endotracheal aspiration provided benefits, achieving the proposed objective: the displacement and removal of airway secretions.

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