c20. ventilação não invasiva (vni) na exacerbação aguda (ea) grave da doença pulmonar obstrutiva crónica (dpoc) numa enfermaria
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ID: 147958
2003
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Abstract
A utilização da VNI tem aumentado na última década em doentes com insuficiência respiratória agudizada. Pretendeu-se avaliar o sucesso da VNI em doentes com acidémia respiratória grave (pH<7,30) no contexto de EA-DPOC, numa enfermaria com experiência em VNI.Procedeu-se a um estudo retrospectivo, nos últimos 30 meses, incluindo 28 doentes (79%homens), com DPOC em estádios III(79%) e IIB(7%), em oxigenoterapia domiciliária 68% e ventilação assistida domiciliária 25%. A média etária foi de 73 anos, 14% não fumadores, maioritariamente internados através de urgência central por infecção respiratória.Após a instituição de VNI, verificou-se sucesso em 82%(grupo1) e insucesso nos restantes (grupo2). Das gasometrias arteriais às 2 e 24 horas, objectivaram-se diferenças no comportamento nos grupos com normalização do pH e melhoria da hipoxémia mais precoce no grupo 1 (p<0,05).Concluímos que o pH inicial não foi factor determinante para o insucesso terapêutico contrariamente à recuperação gasométrica nas primeiras 24 horas. : Use of NIMV has proliferated during the past decade to support patients with acute respiratory failure. The aim of this study was to evaluated the success of NMV in patients with acute respiratory acidemia(pH<7,30) in AE-COPD, in a medical ward with experience in NIMV.We conducted a retrospective analysis of clinical data, in the last 30 months, from 28 patients(79% men), with COPD in stage III(79%) and IIB(7%), in domiciliary oxygen 68% and NMV domiciliary 25%. The mean age was 73 years, 14% non-smokers, in majority admitted from a central emergency ward with respiratory infection. Overall success with NIMV was 82%(group1) and unsucess 28% (group2). From arterial blood gas(ABG) at 2 and 24 hours, there was different behaviour between the groups with pH and hipoxemia improving better and earlier in group1 (p<0,05).We concluded that initial pH was not the determinant factor to unsucess in contrast to improvement of ABG in the first 24 hours. Palavras-chave: VNI, DPOC, acidémia, Key-words: NIMV, COPD, acidosis
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| Reference Key |
oliveira2003revistac20.
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|---|---|
| Authors | ;Ana Sofia Oliveira;Susana Clemente;Fátima Rodrigues;Lurdes Carvalho;Leonor Mota;Cecília Nunes;Suzete Melo;Fernanda Oliveira;Pontes da Mata |
| Journal | the journal of applied psychology |
| Year | 2003 |
| DOI |
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