ABSTRACT
Objetivo. O objetivo dos autores foi avaliar o efeito da ventilaçäo com CPAP oferecida por meio de máscara nasofacial como método de suporte ventilatório em pacientes com insuficiência respiratória aguda com critérios de indicaçäo para intubaçäo traqueal. Casuística e Método. Foram estudados 11 pacientes com idade média de 41,3 anos em insuficiência respiratória aguda internados na Unidade Respiratória do Hospital Säo Paulo - Escola Paulista de Medicina. A admissäo, era colhida gasometria arterial em ar ambiente e monitorizava-se freqüência respiratória (f), freqüência cardíaca (FC) e pressäo arterial (PA). Os mesmos parâmetros eram avaliados após oxigenoterapia via máscara facial aberta e com máscara facial de CPAP usando PEEP de 5cm H2O. Resultados. Com o uso de CPAP através de máscara nasofacial, houve melhora significativa dos níveis de PaO2 e diminuiçäo da freqüência respiratória (<0,05), quando comparados aos valores em ar ambiemte e com máscara facial aberta. Conclusäo. Este trabalho permitiu concluir que a máscara facial de CPAP com 5cm H2O foi eficiente em melhorar a oxigenaçäo arterial e diminuir a freqüência respiratória dos pacientes com insuficiência respiratória aguda, proporcionando-lhes maior conforto, constituindo uma medida terapêutica capaz de evitar o suporte ventilatório invasivo.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Masks , Positive-Pressure Respiration/methods , Respiratory Insufficiency/therapy , Acute Disease , Aged, 80 and over , Blood Gas Analysis , Blood Pressure , Heart Rate , Respiratory Insufficiency/bloodABSTRACT
OBJECTIVE: To evaluate the efficacy of continuous positive airway pressure (CPAP) administered by face mask in patients with acute respiratory failure with indication of mechanical ventilation. MATERIALS AND METHOD: Eleven patients (mean age 41.3 years) in acute respiratory failure were admitted in the Respiratory Unit--Hospital São Paulo--Escola Paulista de Medicina. At the admission pH, PaO2, PaCO2, respiratory rate (f), arterial pressure and heart rate were measured. The measurements were repeated with administration of oxygen with a high flow face mask at ambient airway pressure and then with 5 cm H2O of CPAP by face mask. RESULTS: The use of CPAP by face mask significantly improved the arterial blood oxygenation and decreased the respiratory rate (p < 0.05). CONCLUSION: These data allow the conclusion that CPAP administered by face mask improves gas exchange and decreases respiratory rate in patients with acute respiratory failure and may reduce the need for invasive mechanical ventilation.
Subject(s)
Masks , Positive-Pressure Respiration/methods , Respiratory Insufficiency/therapy , Acute Disease , Adolescent , Adult , Aged , Aged, 80 and over , Blood Gas Analysis , Blood Pressure , Female , Heart Rate , Humans , Male , Middle Aged , Respiratory Insufficiency/bloodABSTRACT
Report a case of a patient suffering from acute pancreatitis with renal failure, who needed peritoneal dialysis and developed acute hydrothorax as a complication of the procedure. The diagnosis was made by the high levels of glucose on pleural effusion (455 mg/dL) and glycemia of 81 mg/dL). This complication probably occurs because of a pathological diaphragmatic defect, communicating peritoneal and pleural cavities. The treatment consists of prompt interruption of peritoneal dialysis with improvement of symptomatology.
