Characterization of parameters and strategies used by physical therapists in difficult mechanical ventilation weaning

Authors

  • Fabíola Maria Sabino Meireles Faculdade Christus
  • Isabel Oliveira Barbosa Faculdade Christus
  • Márcia Cardinalle Correia Viana Faculdade Christus
  • Cymara Pessoa Kuehner Faculdade Christus

DOI:

https://doi.org/10.5020/2618

Keywords:

Diaphragm, Muscle Fatigue, Physical Therapy, Muscle Strength, Intensive Care Units, Respiration, Artificial

Abstract

Objective: To characterize the main strategies and parameters used by physical therapists in difficult mechanical ventilation weaning. Methods: Cross-sectional study including all the physical therapists working in adult Intensive Care Units in three public hospitalsin Fortaleza-CE. A questionnaire with closed questions related to difficult mechanical ventilation weaning was applied, with either one or multiple answers. The data was treated with descriptive and non-parametric analysis. Results: Among the parameters mostly used by the 56 interviewed physical therapists for the difficult weaning, were found: current volume reduction (26 - 46.4%) and desaturation during aspiration (17 - 30.4%). It was observed that 38 (67.9%) alternate T-tube and continuous positive airway pressure (CPAP) as strategies for difficult weaning, and 28 (50%) reported reducing the pressure support. There was no statistical difference between the strategies used in the studied hospitals, neither correlation between strategies and parameters. Conclusion: It was found that physical therapists have been performing similar strategies, which are also shown in the literature, but this is not the case with the parameters. The parameters used are not supported by the literature.

Downloads

Download data is not yet available.

Author Biographies

Fabíola Maria Sabino Meireles, Faculdade Christus

Fisioterapeuta da Faculdade Christus – Fortaleza-CE – Brasil.

Isabel Oliveira Barbosa, Faculdade Christus

Fisioterapeuta da Faculdade Christus – Fortaleza-CE – Brasil.

Márcia Cardinalle Correia Viana, Faculdade Christus

Mestre em Saúde Coletiva pela UECE

Cymara Pessoa Kuehner, Faculdade Christus

Mestrado pela Universidade de Harvard e Institute of Health Profession – MGH IHP – Boston – USA

References

Scarpinella-Bueno MA.Desmame da ventilação mecânica. In: Knobel E. Terapia intensiva: pneumologia e fisioterapia respiratória. São Paulo: Atheneu; 2004.

Boles JM, Bion J, Connors A, Herridge M, Marsh B,Melot C, et al. Weaning from mechanical ventilation.Eur Respir J. 2007;29(5):1033-56.

Blackwood B, Alderice F, Burns KE.; Cardwell CR,Lavery GG, O’Halloran P. Protocolized vs. nonprotocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients:cochrane review protocol. J Adv Nurs. 2009;65(5):957-64.

Blackwood B, Alderdice F, Burns K, Cardwell C,Lavery G, O’Halloran P. Use of weaning protocols for reducing duration of mechanical ventilation in critically ill adult patients: Cochrane systematic review and meta-analysis. Br Med J. 2011;342:7790-214.

Costa AD, Rieder MM, Vieira SRR. Desmame da ventilação mecânica utilizando pressão de suporte ou tubo t. comparação entre pacientes cardiopatas e não cardiopatas. Arq Bras Cardiol. 2005;85(1):65.

Presto B, Presto LDN. Fisioterapia respiratória: uma nova visão. 3ª ed. Rio de Janeiro: BP; 2007.

Goldwasser R, Farias A, Freitas EE, Saddy F, Amado V, Okamoto VN. Desmame e interrupção da ventilação mecânica. Rev Bras Ter Intensiva. 2007;19(3):384-92.

Brasil. Resolução CSN nº 196 de 10 de Outubro de 1996. Aprova diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da União, Brasília, DF, n. 201, 16 out. 1996. Sessão 1, p.21º82

Azeredo CAC. Fisioterapia Respiratória Moderna. 4ªed. Barueri: Manole; 2002.

Polycarpo MR, Souza LC. Desmame em ventilação mecânica. In: Sousa LC. Fisioterapia intensiva. São Paulo: Atheneu; 2007.

Goldwasser RS, David MC. desmame da ventilação mecânica: promova uma estratégia. Rev Bras Ter Intensiva. 2007;19(1):107-12.

Condessa RL. Avaliação do Treinamento Muscular Inspiratório por Threshold IMT no processo de aceleração do desmame da ventilação mecânica[dissertação]. Rio Grande do Sul: Universidade Federal do Rio Grande do Sul; 2008.

Guimaraes FS, Alves FF, Constantino SS, Dias CM,Menezes SLS. Avaliação da pressão inspiratória máxima em pacientes críticos não-cooperativos:comparação entre dois métodos. Rev Bras Fisioter.2007;11(3):233-8.

Eric E, Eric D, Stéphane G, Christophe V, Dominique P, Pierre G, et al. Weaning from mechanical ventilation with pressure support in patients failing a T-tube trial of spontaneous breathing. Intensive Care Med.2006;32(1):165-9.

Published

2013-08-09

How to Cite

Meireles, F. M. S., Barbosa, I. O., Viana, M. C. C., & Kuehner, C. P. (2013). Characterization of parameters and strategies used by physical therapists in difficult mechanical ventilation weaning. Brazilian Journal in Health Promotion, 26(1), 50–54. https://doi.org/10.5020/2618

Issue

Section

Original Articles