POSIÇÃO CORPORAL E OXIGENAÇÃO PARTE 2 — PACIENTES COM DISFUNÇÃO PULMONAR BILATERAL

Pimenta, Cibele Andrucioli de Mattos; Koizumi, Maria Sumie

doi:10.1590/0080-6234199002400100067

Resumos

O objetivo deste estudo foi analisar o efeito das posições sentada, supina e laterais sobre os gases do sangue arterial, em portadores de disfunção pulmonar bilateral, no período pós-operatório recente de cirurgia cardíaca. A análise dos gases foi feita após o paciente permanecer 15 minutos em cada posição. Não se constatou diferenças estatisticamente significativas 15 níveis da Pa02 e PaC02, nas quatro posições. No entanto, pelo tratamento descritivo dos dados, detectou-se indicios de melhores níveis na Pa02 na posição supina, e de piores níveis na posição sentada.

Gasometría - Sangue; Posição corporal; Paciente, mudança de posição

The purpose of this study was to analyse the effects of sitting, supine and laterals positions on arterial oxygen tension (Pa02) and arterial carbon dioxide tension (PaC02), in 22 adults patients, carier of some pulmonary bilateral disfunction, in recent post-operative cardiac surgery. The diagnosis of the pulmonary disfunction was done through radiographic torax evaluation. The patients stayed during 15 minutes in each position and after this, the arterial blood gases were measured. Based on Friedman test and Multiple Comparation test (a — 0,05), no significant changes in Pa02 and PaC02 were noted.

Blood gas analysis; Patient position; Patient, posture changes

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REFERÊNCIAS BIBLIOGRÁFICAS

BLAIR, E. & HICKAM, J.B. The effect of change in body position on lung volume and lntrapulmonary gas mixing in normal subjects. J. Clin. Invest., New York, 84(3):383-9, Mar. 1966.
DALRYMPLE, D.G. et alii. Cardiorespiratory effects of the sitting position In neurosurgery. Br. J. Anaesth., London, 51(11):1079-82, Nov. 1979.
DOUGLAS, W.W. et alii. Improved oxygenation in patients with acute respiratory failure: the prone position. Am. Rev. Respir. Dis., New York, 115(4):559-66, Apr. 1977.
GROSMAIRE, E.K. Use of patient positioning to improve Pa02: a review. Heart Lung, Saint Louis, 12(6):650-3, Nov. 1983.
KANEKO, K.J. et alii. Regional distribution of ventilation and perfusion as a function of body position. J. Appl. Physiol., Bethesda, 21(3):767-77, May 1966.
KATZ, L.D. & BARASH, P.G. Positional hypoxaemia following post traumatic pulmonary Insufficiency. Can. Anaesth. Soc. J., Toronto, 24(3):346-52, May 1977.
MARTI, C. & ULMER, W.T. Absence of effect of the body position on arterial blood gases. Respiration, Basel, 43(1):41-4, Jan./Feb. 1982.
PIEHL, M.A. & BROWN, R.S. Use of extreme position changes in acute respiratory failure. Crit. Care Med., New York, 4(1):13-4, Jan./Feb. 1976.
PIMENTA, C.A.M. & KOIZUMI, M.S. Posição corporal e oxigenação. Parte 1 — Pacientes com disfunção pulmonar unilateral. Rev. Esc. Enf. USP, São Paulo, 23(3):—, dez. 1989. (no prelo)
RANKIN, L.S. et alii. Alterations in preload and ejection phase and indices of left ventricular performance. Circulation, Dallas, 51(5):910-5, May 1975.
RUSSEL, W.J. Position of patient and respiratory function in immediate postoperative period. Br. Med. J., London, 283(6299):1079-80, Oct 1981.
SMITH J. et alii. Application of impedance cardiography to study of postural stress. J. Appl. Physiol. Bethesda, 29(1):133-7, July 1970.
WAGNER, P.D. & WEST, J.B. Changes in ventilation-perfusion relationships and gas exchange. In: MACKLEM, P. & PERMUTT, S. The lung in the transition between health and disease. New York, Marcel Dekker, 1973. cap. 9. p.183-226.
WEST, J.B. Fisiología respiratória moderna. São Paulo, Manóle, 1977. p.26-31.
WEST, J.B. & DOLLERY, C.T. Distribution ob blood flow «nd ventilation-perfusion ratio in the lung, measured with radioactive C02. J. Appl. Physiol., Bethesda, 15(3):405-10, 1960.
ZACK, B.M. et alii. The effect of lateral positions on gas exchange in pulmonary disease. Am. Rev. Respir. Dis., New York, 110(4):49-55, Oct. 1974.

Datas de Publicação

Publicação nesta coleção
Abr 1990

Histórico

Recebido
21 Nov 1988

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[1] BLAIR, E. & HICKAM, J.B. The effect of change in body position on lung volume and lntrapulmonary gas mixing in normal subjects. J. Clin. Invest., New York, 84(3):383-9, Mar. 1966.

[2] DALRYMPLE, D.G. et alii. Cardiorespiratory effects of the sitting position In neurosurgery. Br. J. Anaesth., London, 51(11):1079-82, Nov. 1979.

[3] DOUGLAS, W.W. et alii. Improved oxygenation in patients with acute respiratory failure: the prone position. Am. Rev. Respir. Dis., New York, 115(4):559-66, Apr. 1977.

[4] GROSMAIRE, E.K. Use of patient positioning to improve Pa02: a review. Heart Lung, Saint Louis, 12(6):650-3, Nov. 1983.

[5] KANEKO, K.J. et alii. Regional distribution of ventilation and perfusion as a function of body position. J. Appl. Physiol., Bethesda, 21(3):767-77, May 1966.

[6] KATZ, L.D. & BARASH, P.G. Positional hypoxaemia following post traumatic pulmonary Insufficiency. Can. Anaesth. Soc. J., Toronto, 24(3):346-52, May 1977.

[7] MARTI, C. & ULMER, W.T. Absence of effect of the body position on arterial blood gases. Respiration, Basel, 43(1):41-4, Jan./Feb. 1982.

[8] PIEHL, M.A. & BROWN, R.S. Use of extreme position changes in acute respiratory failure. Crit. Care Med., New York, 4(1):13-4, Jan./Feb. 1976.

[9] PIMENTA, C.A.M. & KOIZUMI, M.S. Posição corporal e oxigenação. Parte 1 — Pacientes com disfunção pulmonar unilateral. Rev. Esc. Enf. USP, São Paulo, 23(3):—, dez. 1989. (no prelo)

[10] RANKIN, L.S. et alii. Alterations in preload and ejection phase and indices of left ventricular performance. Circulation, Dallas, 51(5):910-5, May 1975.

[11] RUSSEL, W.J. Position of patient and respiratory function in immediate postoperative period. Br. Med. J., London, 283(6299):1079-80, Oct 1981.

[12] SMITH J. et alii. Application of impedance cardiography to study of postural stress. J. Appl. Physiol. Bethesda, 29(1):133-7, July 1970.

[13] WAGNER, P.D. & WEST, J.B. Changes in ventilation-perfusion relationships and gas exchange. In: MACKLEM, P. & PERMUTT, S. The lung in the transition between health and disease. New York, Marcel Dekker, 1973. cap. 9. p.183-226.

[14] WEST, J.B. Fisiología respiratória moderna. São Paulo, Manóle, 1977. p.26-31.

[15] WEST, J.B. & DOLLERY, C.T. Distribution ob blood flow «nd ventilation-perfusion ratio in the lung, measured with radioactive C02. J. Appl. Physiol., Bethesda, 15(3):405-10, 1960.

[16] ZACK, B.M. et alii. The effect of lateral positions on gas exchange in pulmonary disease. Am. Rev. Respir. Dis., New York, 110(4):49-55, Oct. 1974.

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