Efeito Da Utilização Da Hiperinsuflação Pulmonar Com Ventilador Mecânico Mais Aspiração Versus Aspiração Traqueal Isolada Em Pacientes Cardiopatas

Abstract

Objectives: To evaluate the safety and efficacy of the lung hyperinflation maneuver with a mechanical ventilator in patients with heart disease. Methods: This is a randomized crossover clinical trial, which included 31 individuals, ventilated for more than 48 hours, hemodynamically stable and excluded individuals with a diagnosis of ventilator-associated pneumonia, pneumothorax and non-drained hemothorax, subcutaneous emphysema, peak > 40 cmH2O, diagnosis of recent neurological disease (˂72h). In the control group, patients were ventilated for 1 minute with a fraction of inspired oxygen (FiO2) at 100%, followed by three aspirations for 15 seconds with an interval of 30 seconds. In the participants at the intervention moment, the inspiratory pressure was increased to 10 cmH2O or the volume was increased by 50% of the tidal volume for a period of 10 minutes and then a new aspiration was performed in the same way as in the control group. Results: Participants had an average age of 71 years, 58% were women. Hemodynamic variables showed no significant change in the clinical context. There was an increase in static (p=0.006) and dynamic (p=0.013) compliance, and a decrease in peak (p=0.040) and plateau (p=0.020) pressures. Conclusion: We conclude that mechanical lung hyperinflation is safe for removing secretions in patients with heart disease.