Análise regional da ventilação e aeração pulmonar através da técnica de tomografia com impedância elétrica em pacientes submetidos a anestesia geral - série de casos
Data
2021-11-25
Autores
Moreira, Thaize de Melo 
Orientadores
Falcão, Luiz Fernando dos Reis
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Realizar análise regional da função pulmonar (aeração e ventilação) no
intra-operatório em pacientes com pulmões saudáveis submetidos a anestesia geral,
descrevendo o comportamento regional da aeração pulmonar em pacientes
anestesiados em ventilação mecânica com pressão positiva submetidos a anestesia
geral. Métodos: Foram analisados 15 pacientes durante o período perioperatório,
considerando a ventilação e aeração pulmonar, em duas regiões (anterior e posterior)
e em 8 tempos distintos: basal, pós IOT (Intubação Orotraqueal), 3 tempos intra-
operatórios (T1, T2 e T3), pré EOT (Extubação Orotraqueal), pós EOT e na RPA
(Recuperação pós anestésica), sendo que 6 (40,0%) pacientes realizaram cirurgias
por videolaparoscopia, utilizando o pneumoperitonio como técnica cirúrgica e, por
isso, não foram considerados os valores mensurados nos tempos intra-operatórios e
pré EOT. Resultados: No nosso estudo foi observado uma queda da CRF,
principalmente em regiões dependentes, mesmo com a utilização da PEEP de
5cmH20. E após reversão do BNM e ventilação espontânea ocorreu uma importante
recuperação do volume pulmonar aproximando-se dos valores basais. Conclusão:
Pacientes submetidos a anestesia geral com o uso da ventilação mecânica e a
utilização de PEEP constante apresentam redução da aeração e ventilação pulmonar
em regiões dependentes. Nos levando a concluir que a mecânica pulmonar volta ao
normal após reverter o efeito do BNM.
Objective: To perform regional analysis of lung function (aeration and ventilation) intraoperatively in patients with healthy lungs undergoing general anesthesia, describing the regional behavior of lung aeration in patients anesthetized on positive pressure mechanical ventilation undergoing general anesthesia. Methods: Fifteen patients were analyzed during the perioperative period, considering ventilation and pulmonary aeration, in two regions (anterior and posterior) and at 8 different times: basal, post OTI (Orotracheal Intubation), 3 intraoperative times (T1, T2 and T3), pre OTE (Orotracheal Extubation), post OTE and PAR (Post-anesthetic recovery), with 6 (40.0%) patients undergoing videolaparoscopy surgery, using pneumoperitoneum as the surgical technique and, therefore, they were not considered the values measured in the intraoperative and pre-OTE times. Results: In our study, a decrease in FRC was observed, especially in dependent regions, even with the use of PEEP of 5cmH20. And after reversal of NMB (neuromuscular block) and spontaneous ventilation, there was an important recovery in lung volume, approaching baseline values. Conclusion: Patients undergoing general anesthesia with the use of mechanical ventilation and the use of constant PEEP have reduced aeration and pulmonary ventilation in dependent regions. Leading us to conclude that lung mechanics return to normal after passing the effect of NMB.
Objective: To perform regional analysis of lung function (aeration and ventilation) intraoperatively in patients with healthy lungs undergoing general anesthesia, describing the regional behavior of lung aeration in patients anesthetized on positive pressure mechanical ventilation undergoing general anesthesia. Methods: Fifteen patients were analyzed during the perioperative period, considering ventilation and pulmonary aeration, in two regions (anterior and posterior) and at 8 different times: basal, post OTI (Orotracheal Intubation), 3 intraoperative times (T1, T2 and T3), pre OTE (Orotracheal Extubation), post OTE and PAR (Post-anesthetic recovery), with 6 (40.0%) patients undergoing videolaparoscopy surgery, using pneumoperitoneum as the surgical technique and, therefore, they were not considered the values measured in the intraoperative and pre-OTE times. Results: In our study, a decrease in FRC was observed, especially in dependent regions, even with the use of PEEP of 5cmH20. And after reversal of NMB (neuromuscular block) and spontaneous ventilation, there was an important recovery in lung volume, approaching baseline values. Conclusion: Patients undergoing general anesthesia with the use of mechanical ventilation and the use of constant PEEP have reduced aeration and pulmonary ventilation in dependent regions. Leading us to conclude that lung mechanics return to normal after passing the effect of NMB.