Comparação das variáveis pulmonares durante a aspiração endotraqueal com sistema aberto e fechada

Abstract

ABSTRACT

Introduction: Tracheal aspiration is essential for removal of bronchial mucus for patients under mechanical ventilation. And there are two vacuum systems one closed, which does not require circuit disconnection and the open one that needs the disconnection and is the most used. But that has not yet been scientific evidence which would be the most appropriate to aspire critical patients. Objective: To analyze and compare pulmonary variables, tidal volume (CV), dynamic (Cdn) and static (Cest) compliance, inspiratory (Kidney) and expiratory resistance (Rexp) with endotracheal aspiration with the open and closed system. Methodology: The procedures were performed in a single day, with a 3-hour interval between one and the other aspiration system. Data were collected for approximately 15 minutes. Statistical analysis was performed using the SPSS program. A Shapiro-Wilk test was used to evaluate the normality of the data. The comparisons were performed using the Generalized Estimates Equation method for the groups and moments and Bonferroni complementary test to analyze the moments. Statistically significant results were considered for values of p <0.05. Results: No statistical difference was observed in tidal volume, static and dynamic compliance, and inspiratory and expiratory resistance between open and closed systems. There was also no difference between the initial and final moments of aspiration in these variables, except for the expiratory resistance with the open system (p = 0.0238). Conclusion: Aspirations performed with open and closed system demonstrated parity in the Cest and Cdin, Risnp, VC analyzes. However, there was a statistical difference in the procedure in the open system, with the lowest Rexp parameter found after endotracheal aspiration.

Key words: Tracheal aspiration, Systems, respiratory mechanics, physiotherapy.