Efeito da pressão positiva contínua nas vias aéreas sobre a função pulmonar no pós-operatório de cirurgia de ressecção pulmonar

• Ano de defesa: 2010
• Autor(a) principal: Nery, Flávio de Pádua Oliveira Sá
• Orientador(a): Saito, Eduardo Haruo
• Banca de defesa: Nunes, Rodolfo Acatauassú , Lopes, Agnaldo José , Giani, Tânia Santos
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade do Estado do Rio de Janeiro
• Programa de Pós-Graduação: Programa de Pós-Graduação em Ciências Médicas
• Departamento: Centro Biomédico::Faculdade de Ciências Médicas
• País: BR
• Palavras-chave em Português: Pressão positiva contínua nas vias aéreas; Pulmões-fisiologia; Pulmões-cirurgia; Período pós-operatório; CPAP; Função pulmonar; Ressecção pulmonar
• Palavras-chave em Inglês: CPAP; Lung function; Lung refection
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL
• Link de acesso: http://www.bdtd.uerj.br/handle/1/8821

Pulmonary resection surgery belongs to the postoperative surgery group with predispositions respiratory complications, as enhance of bronchial secretions, atelectasis, pneumonia, that are at most related to low pulmonary function at this period. The continuous positive airway pressure (CPAP) has been used therapeutically at these patients to minimize the deleterious effects at lung function in this period. The goal of this study is quantify the effects of CPAP at lung function in the postoperative lung resection period. 30 (thirty) patients wereselected from the Thoracic Surgery discipline of Pedro Ernesto University Hospital. The selection to standard group and control were randomized. Preoperative phase was composed by pulmonary function evaluation (expiratory peak flow, respiratory muscle force, 6 minutes walk test/ TC6, arterial blood gas analysis, lung function test). Postoperative period was established as follow: experimental group: 15 (fifteen) patients were conducted under non invasive ventilation intermittently by a CPAP system (ACRIFLUX-CPAP®, Criticalmed, Industries Inc, Brasil) since the first postoperative day (at the first 24 hours after extubation), twice a day, for 30 minutes; control group: 15 (fifteen) patients under supervised and oriented respiratory physiotherapy program applied since the first postoperative day (at the first 24 hours after extubation), twice a day. Postoperative evaluation was the same as preoperative phase and was taken at two moments: Postoperative first day (PO-I) with new evaluation of expiratory peak flow, respiratory muscle force, arterial blood gas analysis; postoperative second day with new lung function. Postoperative seventh day (PO-II) was composed by the same parameters of (POI) and the TC6. The results of expiratory peak flow, respiratory muscle force, arterial blood gas analysis between the groups were the same, with no significance difference, however, TC6 parameter has shown statistically significance at the group submitted at early CPAP program therapy, with p= 0,0001. No airway leak by thoracic drain was observed at this CPAP therapy group, showing the efficacy of the therapy. Both therapies were efficient, but earlier CPAP therapy has shown more effective, suggesting that it can be applied earlier at the postoperative lung resection with benefits.