Análise da Manobra de Recrutamento Alveolar na Síndrome do Desconforto Respiratório Agudo com o auxílio da Tomografia por Impedância Elétrica – uma revisão integrativa

Abstract

Introduction: The acute respiratory distress syndrome (ARDS) is a common clinical problem in critical patients and it is associated to a high mortality. Advances in understanding the ARDS pathophysiology provided the evolution of therapies capable of assisting in the handling of the syndrome, like the alveolar recruitment maneuver. The electrical impedance tomography (EIT) is capable of monitoring mechanical ventilation, continuously and dynamically, making it possible to monitor coexisting events in a recruitment maneuver. Objective: Conduct an integrative literature review in order to analyze the alveolar recruitment maneuver in ARDS with the aid of electrical impedance tomography Method: Through an integrative literature review, were admitted articles published in the databases Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Medical Literature Analysis and Retrieval System Online (MedLine), PubMed, ScienceDirect and Cochrane Library. The articles were obtained by the following keywords: “electrical impedance tomography”, “acute respiratory distress syndrome”, and “PEEP”, “mechanical ventilation. Results: From an initial analysis of 276 potentially relevant articles, only eight met the selection criteria. Five studies were fulfilled in humans and three in animals (hogs). Conclusion: The studies included to this project, in general, demonstrate that the recruitment maneuver, in cases of ARDS, when guided by electrical impedance tomography represent a very safe, viable intervention and with favorable outcome, mainly with regard to reducing the deleterious effects of lung injury induced by mechanical ventilation and the ideal PEEP titration, from monitoring hyperdistention and alveolar collapse.