A utilização de FiO2 inferior a 100% para hiperoxigenação de pacientes estáveis submetidos à aspiração endotraqueal
Utilization of fraction of inspired oxygen lower than 100% to hyperoxygenate stable patients who underwent endotracheal suctioning
Gisele do Carmo Leite Machado Diniz, Aline Oliveira Souza, Hellen Maia Dornelas Oliveira, Rafaela Cristina de Souza Arrais, Bruno Porto Pessoa, Pedro Henrique Scheidt Figueiredo
Resumo
Introdução e objetivo: Pouco se sabe sobre a utilização de frações inspiradas de oxigênio (FiO2 ) inferiores a 100% para prevenir hipoxemia após aspiração endotraqueal (AE). O objetivo deste estudo foi comparar as repercussões da elevação da FiO2 a 50% acima da basal com a FiO2 de 100% durante a AE em pacientes estáveis ventilados mecanicamente. Métodos: Ensaio cruzado e randomizado em 17 pacientes (55,7±23,9 anos) submetidos a 2 sessões de AE (intervalo de 6hs) com hiperoxigenação prévia por dois valores de FiO2 : 50% acima do valor basal e 100%. A freqüência cardíaca (FC), pressão arterial média (PAM), saturação periférica de oxigênio (SpO2 ) e frequência respiratória (FR) foram registradas na condição basal, 5 minutos após o ajuste da FiO2 (PRÉ), assim como 1º e 5º minutos após o término dos procedimentos. Resultados: Na comparação intragrupos a SpO2 aumentou em todas as fases dos dois protocolos, comparada a condição basal. Houve aumento da FC no 1ºmin após AE no protocolo com elevação da FiO2 a 50%, em relação ao momento PRÉ e basal, assim como a FR no procedimento com FiO2 a 100%. Já a PAM elevou-se apenas no 1º min, comparada a condição basal, no protocolo de aumento da FiO2 a 50%. Na análise intergrupos, a SpO2 foi maior no procedimento com FiO2 a 100% no 1º min após AE, mas sem relevância clínica, assim como a FR. Conclusão: A hiperoxigenação com elevação da FiO2 a 50% acima da basal pode ser utilizada para prevenir a hipoxemia durante a AE em pacientes adultos e estáveis sob ventilação mecânica.
Palavras-chave
Abstract
Introduction and objective: Little is known about the use of fraction of inspired oxygen (FiO2 ) lower than 100% to prevent hypoxemia after endotracheal suctioning (ES). The aim of this study was to compare the repercussions of increasing FiO2 to 50% above the baseline FiO2 with a FiO2 of 100% during ES in mechanically ventilated patients. Methods: A randomized crossover trial with 17 patients (55,7±23,9 years) who underwent 2 sessions of ES (break of 6 hours between them) with prior hyperoxygenation with two different values of FiO2 : 50% above the baseline and 100%. The heart rate (HR), mean arterial pressure (MAP), peripheral oxygen saturation (SpO2 ) and breathing rate (BR) were recorded at baseline, 5 minutes after adjusting the FiO2 , as well as 1 and 5 minutes after the end of the procedures. Results: The intra-group comparison demonstrated that SpO2 increased in all phases of both protocols compared to baseline values. There was an increase in HR at the first min after ES in the protocol with increasing of the FiO2 to 50%, compared to pre-procedure and baseline, as well as the BR in the procedure with FiO2 of 100%. On the other hand, MAP increased only at the firstmin compared to baseline in the protocol with increasing of the FiO2 to 50%. In the intergroup analysis, SpO2 and BR were higher in the procedure with FiO2 of 100% at the first min after the ES, however without clinical relevance. Conclusion: Hyperoxygenation with a FiO2 set at 50% above baseline value can be used to prevent hypoxemia during ES in adult and stable mechanically ventilated patients.
Keywords
Referências
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