Abstract
Abstract Introduction Monitoring respiratory mechanics may provide important information for the intensivist, assisting in the early detection of pulmonary function changes of patients hospitalized in ICU. Objective: To compare measurements of respiratory mechanics in VCV and PCV modes, and correlate them with age and oxygenation index. Materials and methods: Cross-sectional study conducted in the adult ICU of the Hospital Nossa Senhora da Conceição, in Tubarão - SC. A hundred and twenty individuals were selected between March and August 2013. The respiratory mechanics measurements were evaluated using compliance and resistance static measures of the respiratory system in PCV and VCV modes between the 1st and 5th day of hospitalization. Simultaneously, the oxygenation index PaO2/FiO2 was collected. Results: The obtained results were: compliance (VCV) = 40.9 ± 12.8 mL/cmH2O, compliance (PCV) = 35.0 ± 10.0 mL/cmH2O, resistance (VCV) = 13.2 ± 4.9 cmH2O/L/s, resistance (PCV) = 27.3 ± 16.2 cmH2O/L/s and PaO2/FiO2 = 236.0 ± 97.6 mmHg. There was statistical difference (p < 0.001) between the compliance and resistance measures in VCV and PCV modes. The correlations between the oxygenation index and compliance in VCV and PCV modes and resistance in VCV and PCV modes were, respectively, r = 0.381 (p < 0.001), r = 0.398 (p < 0.001), r = -0.188 (p = 0.040), r = -0.343 (p < 0.001). Conclusion: Despite the differences between the respiratory mechanics measurements the monitoring using VCV and PCV modes seems to show complementary aspects.
Highlights
Monitoring respiratory mechanics may provide important information for the intensivist, assisting in the early detection of pulmonary function changes of patients hospitalized in ICU
Used since the early twentieth century, it has greatly evolved in recent years, through the acquired knowledge related to the interaction between the cardiopulmonary and respiratory mechanics and computer and electronic revolution [1]
Monitoring of respiratory mechanics performed in volume cycled ventilation (VCV) and pressure controlled ventilation (PCV) modes showed some peculiarities, perhaps indicating the non-linearity of these variables or the complementary aspect of them
Summary
Monitoring respiratory mechanics may provide important information for the intensivist, assisting in the early detection of pulmonary function changes of patients hospitalized in ICU. Used since the early twentieth century, it has greatly evolved in recent years, through the acquired knowledge related to the interaction between the cardiopulmonary and respiratory mechanics and computer and electronic revolution [1] This type of ventilatory support can cause changes in the cardiopulmonary dynamics, due to its non-physiological operation. Changes are described in the cardiovascular system, inflammatory lung injury induced by mechanical ventilation, oxygen toxicity, barotrauma, traumatic complications for the management of artificial airway and lung infection [2]. From this perspective, knowledge of respiratory mechanics can facilitate the detection of changes in the respiratory status and allow a proper set of the ventilation parameters, as well as promote adequate therapeutic intervention to the patient [3]. As it is performed at bedside, it does not involve patient transport and has no financial cost for its implementation
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