Abstract
Criança de 11 meses, sexo feminino, submetida à operação de fechamento de comunicação interventricular, comunicação interatrial e ligadura de canal arterial. Evoluiu no pós-operatório com atelectasia persistente em base pulmonar à direita, não respondendo às manobras fisioterapêuticas convencionais, efetuadas seis vezes ao dia. Após associação, como coadjuvante, da inalação de solução salina hipertônica com NaCl a 6%, imediatamente antes e após o atendimento fisioterápico, observou-se crises de tosse produtiva, com maior indução do escarro e resolução completa da atelectasia, com três dias de tratamento.
Highlights
Atelectasis is described as a state of a determined region of collapsed and non-ventilated pulmonary parenchyma associated to a loss in pulmonary volume and capacity, diagnosed by clinical and complimentary examinations [1]
One coadjuvant option is the inhalation of hypertonic saline solution (HSS) with 6% sodium chloride (NaCl) as it induces productive coughing with a greater quantity of phlegm due to an increase in the mucociliary clearance [4]
Due to the positive effects of HSS, this report aims at demonstrating the effectiveness of the association of respiratory physiotherapy with the inhalation of 6% NaCl HSS in persistent atelectasis following pediatric heart surgery
Summary
Atelectasis is described as a state of a determined region of collapsed and non-ventilated pulmonary parenchyma associated to a loss in pulmonary volume and capacity, diagnosed by clinical and complimentary examinations [1] This corresponds to 80% of pulmonary complications in the postoperative period of cardiovascular surgery [2]. The patient was transferred to the intensive care unit (ICU) under mechanical respiration on the 2nd postoperative day presenting with pulmonary arterial hypertension which became constant implicating a necessity to remain intubated with a prolongation of the mechanical ventilation. During her stay in the ICU there was a significant increase in the amount of pulmonary secretion with extubation only being possible on the 8th postoperative day. Within three days there was total resolution of the atelectasis with a significant improvement of the lung which was clearly attributed to the association of techniques (Figure 2)
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