Repercussões hemodinâmicas e ventilatórias do paciente em ventilação mecânica invasiva na mudança de decúbito / Hemodynamic and ventilatory repercussions of the invasive mechanical ventilation patient in decubit change / Repercusiones hemodinámicas y ventilatorias del invasivo paciente de ventilación mecánica en cambio de decubitación

Objetivos: Avaliar as repercussões hemodinâmicas e ventilatórias do paciente em ventilação mecânica invasiva frente a mudança de decúbito e elaborar um instrumento para avaliação das variações hemodinâmicas e ventilatórias de pacientes submetidos a ventilação mecânica invasiva] na mudança de decúbito. Metodologia: Estudo transversal, experimental e quantitativo em duas unidades de assistência ao paciente gravemente enfermo de Cabo Frio-RJ com 09 pacientes selecionados. Resultados: Todos (100%) do gênero masculino, com faixa etária acima de 60 anos (66,7%), como principais patologias as cerebrovasculares (33,3%) e pulmonares (33,3%), com tempo de internação de de 1 a 10 dias (66,7%), assim como o de ventilação mecânica (88,9%), em modo ventilatório assito-controlada (66,7%) e modalidade pressure controlled ventilation (PCV) com 100%. Conclusão: Houve uma alteração no parâmetro hemodinâmico com a mudança de decúbito, com taquicardia, oscilação na pressão arterial média, frequência respiratória e saturação periférica de oxihemoglobina, porém estas se mantiveram entre os níveis de normalidade.(AU)

Objectives: To assess the hemodynamic and ventilatory repercussions of the patient on invasive mechanical ventilation in the face of changing positions and to develop an instrument for assessing the hemodynamic and ventilatory variations of patients undergoing invasive mechanical ventilation] in the changing position. Methodology: Cross-sectional, experimental and quantitative study in two care units for seriously ill patients in Cabo Frio-RJ with 09 selected patients. Results: All (100%) were male, aged over 60 years (66.7%), with cerebrovascular (33.3%) and pulmonary (33.3%) as main pathologies, with length of hospital stay. from 1 to 10 days (66.7%), as well as mechanical ventilation (88.9%), in asymmetric controlled ventilation (66.7%) and pressure-controlled ventilation (PCV) with 100%. Conclusion: There was a change in the hemodynamic parameter with the change in decubitus, with tachycardia, fluctuation in mean arterial pressure, respiratory rate and peripheral oxyhemoglobin saturation, however these remained within normal levels.(AU)

Objetivos: evaluar las repercusiones hemodinámicas y ventilatorias del paciente en la ventilación mecánica invasiva ante cambios de posición y desarrollar un instrumento para evaluar las variaciones hemodinámicas y ventilatorias de los pacientes sometidos a ventilación mecánica invasiva] en la posición cambiante. Metodología: Estudio transversal, experimental y cuantitativo en dos unidades de atención para pacientes gravemente enfermos en Cabo Frio-RJ con 09 pacientes seleccionados. Resultados: Todos (100%) eran hombres, mayores de 60 años (66,7%), con patologías cerebrovasculares (33,3%) y pulmonares (33,3%) como patologías principales, con duración de la estancia hospitalaria. de 1 a 10 días (66.7%), así como ventilación mecánica (88.9%), en ventilación asimétrica controlada (66.7%) y ventilación controlada por presión (PCV) con 100%. Conclusión: Hubo un cambio en el parámetro hemodinámico con el cambio en el decúbito, con taquicardia, fluctuación en la presión arterial media, frecuencia respiratoria y saturación de oxihemoglobina periférica, sin embargo, estos se mantuvieron dentro de los niveles normales.(AU)

Raça e hipertrofia do ventrículo esquerdo na ausência de hipertensäo e de doenças cardiopulmonares / Race and Left Ventricular Hypertrophy in the Absence of Hypertension and Cardiopulmonar Diseases

PURPOSE--To analyze the association between black people and left ventricular hypertrophy (LVH) in the absence of hypertension and/or other cardiopulmonar disease. METHODS--Data were collected from necropsies carried out in the Anatomopathologic Service (APS). Hospital Edgard Santos from 1970 to 1986, Salvador. It were included only subjects at ages > or = 20 years and free of hypertension and any cardiopulmonar disease. A LV wall > 1.6cm was considered as LVH (standardized criteria of the APS). Controls variables were age, sex, and absence of the mentioned diseases. It was used a case-control epidemiological study design and the association measured by ®odds ratio® (OR) for no matched case-control study. RESULTS--From the 208 subjects studied, 48 (23.1 per cent) had LVH. There was no difference in the frequency of right ventricular hypertrophy between cases and controls (p > 0.05). The mean of heart weight was higher for LVH cases (p < 0.001), but there was no evidence of association between blacks and LVH (OR = 1.05, p > 0.05 and confidence interval at 95 per cent = 0.8, 1.31. The highest odds possible for the association in this study (assuming that all 3 LVH losses were black subjects) would be 1.5, also no statistically significant. CONCLUSION--In the absence of hypertension and other cardiopulmonar diseases, LHV is common in necropsies in Salvador, Brazil, with similar frequencies in blacks, whites and mullatos and seems not be a risk factor for hypertension in black people