Repercussões nos gases sanguíneos de recém-nascidos prematuros com síndrome do desconforto respiratório e sob ventilação mecânica convencional após ajuste no tempo inspiratório em função da constante de tempo

AUTOR(ES)

Tatiana dos Santos Russi

DATA DE PUBLICAÇÃO

2006

RESUMO

Were evaluated twenty-five neonates with less than 2000 grams of birth weight and gestational age lesser than thirty-five weeks, diagnosed with respiratory distress syndrome, on conventional mechanical ventilation, treated with exogenous surfactant and were at first seventy-two hours of life. With the use of a pneumotachometer associated to ventilator were performed measures of respiratory mechanics (time constant, airway resistance and pulmonary compliance) and then adjusted inspiratory time. After that, were taken arterial blood samples to analyze blood gases and these were compared to those before the modification of ventilatory setting. Statiscal analyses were performed with Student t test and the significant p value was less than 0.05. The results showed necessity of adjustment of inspiratory time in all patients and in 76% of cases to a lower value. The mean inspiratory time was 0.3 0.09 second and was significatively lower than that one before. After adjustment, there were alterations in pH to a lower value (mean 7.28 0.10) as also in PaCO2 to higher values (mean 40,26 11,59), but these differences werent statiscal significative. At this moment, one of the new strategies of ventilatory assistance to premature neonates with respiratory distress syndrome is called gentle ventilation to prevent ventilator-induced lung injury, with the use of lower tidal volumes, avoid high peak inspiratory pressure, shorter inspiratory time, permissive hypercarbia and controlled offers of oxygen. The observations showed the necessity of reduction of inspiratory time in this group of patients and proposed that this strategy can be used with no adverse effects.

ASSUNTO(S)

tempo inspiratório recém-nascido prematuro saude materno-infantil tempo inspiratório recém-nascido prematuro ventilação mecânica ventilação mecânica

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