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Advisor(s)
Abstract(s)
Introdução: A realização de broncofibroscopia (BF) a doentes com insuficiência
Respiratória grave tem riscos e muitas vezes está contra-indicada. A aplicação de
ventilação mecânica não invasiva (VMNI) para assistir a ventilação espontânea
durante a BF pode ser constituir uma boa alternativa .
Objectivo: Comparar a utilização de VMNI e do CPAP Boussignac (CB), durante a
BF, em doentes hipoxémicos e/ou hipercápnicos.
Materiais e Metodos: 9 pacientes (1feminino) com hipoxemia definida por
PaO2/FiO2<200 com necessidade de (BF) foram elegíveis para o estudo. Cinco
indivíduos foram randomizados para o grupo VMNI (G1) e 4 para o grupo CB (G2).
Resultados: A pressão parcial arterial de oxigénio (PaO2) melhorou no grupo total:
65,9 (21,9) vs de 94,4 (75,9) pós BF, p=0,03, assim como a relação PaO2/FiO2:
131,7 (129,0) e 150,7 (161, 3), pós BF, p=0,04. A saturação periférica de O2 média
durante a BF não foi significativamente diferente comparando os dois grupos: 96,1
(6,9) no G1 vs 97,3 (0,3) no G2, (p=0,62). No G1, 1 paciente foi intubado.
Conclusão: Estes resultados sugerem que a pressão positiva tem um papel
importante como técnica coadjuvante da BF em pacientes hipoxémicos graves
(PaO2/FiO2<200). Neste estudo preliminar nenhuma vantagem da VMNI vs CB.
Background: Fiberoptic bronchoscopy (FOB) in severe acute respiratory failure patients may have risks and several times is contraindicated. Noninvasive Mechanical Ventilation (NIMV) application to assist spontaneous breathing during (FOB) can be an alternative. Objective: Compare the application of NIMV vs CPAP Boussignac (CB) during FOB, in hypoxemic and/or hypercapnic patients. Patients and Methods: Nine patients (1 female) with severe hypoxemia defined by PaO2/FiO2<200, who required FOB were eligible to the study. Five patients were randomized to NIMV group (G1) and 4 to group CB (G2). Results: The arterial oxygen partial pressure (PaO2) improved after FOB in the whole group: 65,9 (21,9) vs 94,4 (75,9) post FBO, p=0,03, as well as PaO2/FiO2: 131,7 (129,0) and 150,7 (161, 3) post FBO, p=0,04. Average SpO2 during FBO was not significantly different in both groups, 96,1 (6,9) in G1 vs 97,3 (0,3) in G2, (p=0,62). In G1 one patient was intubated. Conclusion: These results suggest that positive pressure has an important role as adjunctive technique during FOB in severe hypoxemic patients (PaO2/FiO2<200). In this preliminary study no advantage of NIMV vs CB.
Background: Fiberoptic bronchoscopy (FOB) in severe acute respiratory failure patients may have risks and several times is contraindicated. Noninvasive Mechanical Ventilation (NIMV) application to assist spontaneous breathing during (FOB) can be an alternative. Objective: Compare the application of NIMV vs CPAP Boussignac (CB) during FOB, in hypoxemic and/or hypercapnic patients. Patients and Methods: Nine patients (1 female) with severe hypoxemia defined by PaO2/FiO2<200, who required FOB were eligible to the study. Five patients were randomized to NIMV group (G1) and 4 to group CB (G2). Results: The arterial oxygen partial pressure (PaO2) improved after FOB in the whole group: 65,9 (21,9) vs 94,4 (75,9) post FBO, p=0,03, as well as PaO2/FiO2: 131,7 (129,0) and 150,7 (161, 3) post FBO, p=0,04. Average SpO2 during FBO was not significantly different in both groups, 96,1 (6,9) in G1 vs 97,3 (0,3) in G2, (p=0,62). In G1 one patient was intubated. Conclusion: These results suggest that positive pressure has an important role as adjunctive technique during FOB in severe hypoxemic patients (PaO2/FiO2<200). In this preliminary study no advantage of NIMV vs CB.
Description
Keywords
Broncofibroscopia Ventilação mecânica não invasiva CPAP boussignac Hipoxémia grave Fiberoptic bronchoscopy Noninvasive mechanical ventilation Severe hypoxemia
Pedagogical Context
Citation
Publisher
Instituto Politécnico do Porto. Escola Superior de Tecnologia da Saúde do Porto