Patient-ventilator asynchrony in conventional ventilation modes during short-term mechanical ventilation after cardiac surgery: Randomized clinical trial

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Autor(es): dc.contributorUniversidade Federal de Pernambuco (UFPE)-
Autor(es): dc.contributorMassachusetts General Hospital-
Autor(es): dc.contributorUniversidade Estadual Paulista (Unesp)-
Autor(es): dc.contributorHospital Monsenhor Walfredo Gurgel-
Autor(es): dc.creatorLeite, Wagner Souza-
Autor(es): dc.creatorNovaes, Alita-
Autor(es): dc.creatorBandeira, Monique-
Autor(es): dc.creatorRibeiro, Emanuelle Olympia-
Autor(es): dc.creatordos Santos, Alice Miranda-
Autor(es): dc.creatorde Moura, Pedro Henrique-
Autor(es): dc.creatorMorais, Caio César-
Autor(es): dc.creatorRattes, Catarina-
Autor(es): dc.creatorRichtrmoc, Maria Karoline-
Autor(es): dc.creatorSouza, Juliana-
Autor(es): dc.creatorde Lima, Gustavo Henrique Correia-
Autor(es): dc.creatorModolo, Norma Sueli Pinheiro [UNESP]-
Autor(es): dc.creatorGonçalves, Antonio Christian Evangelista [UNESP]-
Autor(es): dc.creatorGonzalez, Carlos Alfredo Ramirez-
Autor(es): dc.creatordo Amparo Andrade, Maria-
Autor(es): dc.creatorde Andrade, Armèle Dornelas-
Autor(es): dc.creatorBrandão, Daniella Cunha-
Autor(es): dc.creatorCampos, Shirley Lima-
Data de aceite: dc.date.accessioned2022-02-22T00:53:42Z-
Data de disponibilização: dc.date.available2022-02-22T00:53:42Z-
Data de envio: dc.date.issued2021-06-25-
Data de envio: dc.date.issued2021-06-25-
Data de envio: dc.date.issued2020-01-27-
Fonte completa do material: dc.identifierhttp://dx.doi.org/10.4081/mrm.2020.650-
Fonte completa do material: dc.identifierhttp://hdl.handle.net/11449/208544-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/11449/208544-
Descrição: dc.descriptionIntroduction and aim: Studies regarding asynchrony in patiients in the cardiac postoperative period are still only a few. The main objective of our study was to compare asynchronies incidence and its index (AI) in 3 different modes of ventilation (volume-controlled ventilation [VCV], pressure-controlled ventilation [PCV] and pressure-support ventilation [PSV]) after ICU admission for postoperative care. Methods: A prospective parallel randomised trialin the setting of a non-profitable hospital in Brazil. The participants were patients scheduled for cardiac surgery. Patients were randomly allocated to VCV or PCV modes of ventilation and later both groups were transitioned to PSV mode. Results: All data were recorded for 5 minutes in each of the three different phases: T1) in assisted breath, T2) initial spontaneous breath and T3) final spontaneous breath, a marking point prior to extubation. Asynchronies were detected and counted by visual inspection method by two independent investigators. Reliability, inter-rater agreement of asynchronies, asynchronies incidence, total and specific asynchrony indexes (AIt and AIspecific) and odds of AI ≥10% weighted by total asynchrony were analysed. A total of 17 patients randomly allocated to the VCV (n= 9) or PCV (n=8) group completed the study. High inter-rated agreement for AIt (ICC 0.978; IC95%, 0,963-0.987) and good reliability (r=0.945; p<0.001) were found. Eighty-two % of patients presented asynchronies, although only 7% of their total breathing cycles were asynchronous. Early cycling and double triggering had the highest rates of asynchrony with no difference between groups. The highest odds of AI ≥10% were observed in VCV regardless the phase: OR 2.79 (1.36-5.73) in T1 vs T2, p=0.005; OR 2.61 (1.27-5.37) in T1 vs T3, p=0.009 and OR 4.99 (2.37-10.37) in T2 vs T3, p<0.001. Conclusions: There was a high incidence of breathing asynchrony in postoperative cardiac patients, especially when initially ventilated in VCV. VCV group had a higher chance of AI ≥10% and this chance remained high in the following PSV phases.-
Descrição: dc.descriptionDepartment of Physical Therapy Universidade Federal de Pernambuco-
Descrição: dc.descriptionDepartment of Anesthesia Critical Care and Pain Medicine Massachusetts General Hospital-
Descrição: dc.descriptionDepartment of Anaesthesiology Institute of Bioscience School of Medicine UNESP-Universidade Estadual Paulista-
Descrição: dc.descriptionHospital Monsenhor Walfredo Gurgel-
Descrição: dc.descriptionDepartment of Anaesthesiology Institute of Bioscience School of Medicine UNESP-Universidade Estadual Paulista-
Idioma: dc.languageen-
Relação: dc.relationMultidisciplinary Respiratory Medicine-
???dc.source???: dc.sourceScopus-
Palavras-chave: dc.subjectBreath triggering-
Palavras-chave: dc.subjectCycle synchrony-
Palavras-chave: dc.subjectThoracic surgery-
Palavras-chave: dc.subjectVentilator weaning-
Título: dc.titlePatient-ventilator asynchrony in conventional ventilation modes during short-term mechanical ventilation after cardiac surgery: Randomized clinical trial-
Tipo de arquivo: dc.typelivro digital-
Aparece nas coleções:Repositório Institucional - Unesp

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