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Authors
Advisor(s)
Abstract(s)
Introdução: A cirurgia abdominal acarreta grande risco de
complicações pulmonares pós-operatórias. As alterações pós-cirúrgicas
abdominais, reflectem-se na dinâmica ventilatória, de modo particular nos
volumes e capacidades pulmonares, e na capacidade de tosse.
Objectivos: Compreender qual a variação dos volumes e capacidades
pulmonares e da capacidade de tosse antes e depois da cirurgia abdominal
(estômago e cólon), e qual a correlação dessa variação com o nível de dor
percepcionada.
Desenho do estudo: Unicêntrico, prospectivo e observacional.
Amostra: 10 indivíduos, propostos para cirurgia abdominal – estômago
e cólon.
Metodologia: Dois momentos de avaliação: um nas 24h préoperatórias
em que se mediu a capacidade vital forçada (CVF) e o volume
expirado máximo no primeiro segundo (VEMS1) com espirometria, e do pico de
fluxo de tosse (PCF); e um segundo momento nas 24h pós-operatórias onde se
repetiram as medições do primeiro momento com o acréscimo da avaliação da
dor.
Resultados: No pós-operatorio imediato há uma diminuição
significativa da CVF de 44,30%±17,24 (p=0,005), do VEMS1 de 35,50%±28,47
(p=0,009) e do PCF de 38,97%±38,66 (p=0,012). Não se verificou nenhuma
relação entre a dor percepcionada na realização das manobras de espirometria
e tosse com diminuição a da CVF e do VEMS1 e do PCF respectivamente. O
sexo apresentou uma relação significativa com a variação da CRF e do VEMS1
(p=0,046 e p=0,008 respectivamente). A frequência respiratória apresentou um aumento significativo no pós-operatório de 10±11,22 cpm (p=0,019). A
saturação periférica de oxigénio apresentou uma diminuição significativa no
pós-operatório de 3,52±2,47 (p=0,011)
Conclusão: No estudo efectuado fica demonstrado o impacto negativo
da cirurgia abdominal na dinâmica respiratória. A diminuição dos valores da
CVF, do VEMS1 e do PCF podem contribuir de forma significativa para o
aumento do risco de complicações respiratória pós-operatórias. No entanto seria
importante a realização deste estudo com uma amostra maior.
Background: Abdominal surgery carries a high risk of postoperative pulmonary complications. The post-surgery abdominal changes reflected in respiratory dynamics, especially in lung volumes and capacities, and in the ability to cough. Objective: Understand the variations in lung volumes and capacities and the ability to cough before and after abdominal surgery (stomach and colon) and the correlation of pain with that variation. Design: Unicentric, prospective and observational trial. Patients: 10 patients undergoing abdominal surgery- gastric and colon. Methods: One measurement at 24 hours pre-operative of forced vital capacity (FVC) and forcer expiratory volume in one second (FEV1) by spirometry, and peak cough flow (PCF). And 24 hours postoperative the same parameters plus pain assessment. Results: Postoperative a significant reduction in FVC of 44.30%±17,24 (p = 0.005), FEV1 of 35.50%±28,47 (p = 0.009) and the PCF of 38.97%±38,66 (p = 0.012). There was no significant relationship between the pain in spirometry and cough maneuvers and the reduction of FVC and FEV1 and PCF respectively. The gender showed a significant relationship with changes in FRC and FEV1 (p = 0.046 and p = 0.008 respectively). The respiratory rate showed a significant increase at postoperative of 10±11,22 bpm (p = 0.019). The oxygen saturation showed a significant decrease at postoperative period of 3,52±2,47 (p = 0.011). Conclusion: The trial shows the negative impact of abdominal surgery in respiratory dynamics. The reduction of FVC, FEV1 and the PCF can contribute significantly to the increased risk of postoperative respiratory complications. However it would be important to conduct this study with a larger sample.
Background: Abdominal surgery carries a high risk of postoperative pulmonary complications. The post-surgery abdominal changes reflected in respiratory dynamics, especially in lung volumes and capacities, and in the ability to cough. Objective: Understand the variations in lung volumes and capacities and the ability to cough before and after abdominal surgery (stomach and colon) and the correlation of pain with that variation. Design: Unicentric, prospective and observational trial. Patients: 10 patients undergoing abdominal surgery- gastric and colon. Methods: One measurement at 24 hours pre-operative of forced vital capacity (FVC) and forcer expiratory volume in one second (FEV1) by spirometry, and peak cough flow (PCF). And 24 hours postoperative the same parameters plus pain assessment. Results: Postoperative a significant reduction in FVC of 44.30%±17,24 (p = 0.005), FEV1 of 35.50%±28,47 (p = 0.009) and the PCF of 38.97%±38,66 (p = 0.012). There was no significant relationship between the pain in spirometry and cough maneuvers and the reduction of FVC and FEV1 and PCF respectively. The gender showed a significant relationship with changes in FRC and FEV1 (p = 0.046 and p = 0.008 respectively). The respiratory rate showed a significant increase at postoperative of 10±11,22 bpm (p = 0.019). The oxygen saturation showed a significant decrease at postoperative period of 3,52±2,47 (p = 0.011). Conclusion: The trial shows the negative impact of abdominal surgery in respiratory dynamics. The reduction of FVC, FEV1 and the PCF can contribute significantly to the increased risk of postoperative respiratory complications. However it would be important to conduct this study with a larger sample.
Description
Keywords
Cirurgia abdominal Complicações pós-operatórias Capacidade vital forçada Volume expiratório máximo Tosse Abdominal surgery Post-surgery complications Forced vital capacity Forced expiratory volume Cough
Citation
Publisher
Instituto Politécnico do Porto. Escola Superior de Tecnologia da Saúde do Porto