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Desmame de ventilação não invasiva: Experiência com períodos de descontinuação
Weaning from non-invasive positive pressure ventilation: Experience with progressive periods of withdraw
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Probst, Demétria Kovelis, Nicoli O. Segretti, Aline M.T. Leoni, Rachel Garrod, Antonio F. Brunetto" "autores" => array:7 [ 0 => array:2 [ "nombre" => "Fábio" "apellidos" => "Pitta" ] 1 => array:2 [ "nombre" => "Vanessa S." "apellidos" => "Probst" ] 2 => array:2 [ "nombre" => "Demétria" "apellidos" => "Kovelis" ] 3 => array:2 [ "nombre" => "Nicoli O." "apellidos" => "Segretti" ] 4 => array:2 [ "nombre" => "Aline M.T." "apellidos" => "Leoni" ] 5 => array:2 [ "nombre" => "Rachel" "apellidos" => "Garrod" ] 6 => array:2 [ "nombre" => "Antonio F." "apellidos" => "Brunetto" ] ] ] ] ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915302178?idApp=UINPBA00004E" "url" => "/08732159/0000001400000001/v1_201509151510/S0873215915302178/v1_201509151510/pt/main.assets" ] "pt" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original/Original Article</span>" "titulo" => "Desmame de ventilação não invasiva: Experiência com períodos de descontinuação" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "49" "paginaFinal" => "53" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "C. Damas, C. Andrade, J.P. Araújo, J. Almeida, P. Bettencourt" "autores" => array:5 [ 0 => array:4 [ "nombre" => "C." "apellidos" => "Damas" "email" => array:1 [ 0 => "cdamas@aeiou.pt" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "af0010" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cr0005" ] ] ] 1 => array:3 [ "nombre" => "C." "apellidos" => "Andrade" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "af0005" ] ] ] 2 => array:3 [ "nombre" => "J.P." "apellidos" => "Araújo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "af0005" ] ] ] 3 => array:3 [ "nombre" => "J." "apellidos" => "Almeida" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "af0005" ] ] ] 4 => array:3 [ "nombre" => "P." "apellidos" => "Bettencourt" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "af0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Serviço de Medicina Interna do Hospital de São João, Porto, Unidade I&D Cardiovascular do Porto, Faculdade de Medicina da Universidade do Porto" "etiqueta" => "1" "identificador" => "af0005" ] 1 => array:3 [ "entidad" => "Serviço de Pneumologia do Hospital de São João, Porto, Unidade I&D Cardiovascular do Porto, Faculdade de Medicina da Universidade do Porto" "etiqueta" => "2" "identificador" => "af0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cr0005" "etiqueta" => "*" "correspondencia" => "Endereço: Carla Damas, Serviço de Pneumologia, Hospital S. João, Alameda Hernâni Monteiro, Porto, Portugal, phone: 0035191888884" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Weaning from non-invasive positive pressure ventilation: Experience with progressive periods of withdraw" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-01-19" "fechaAceptado" => "2007-09-12" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec570319" "palabras" => array:3 [ 0 => "Ventilação não invasiva" 1 => "insuficiência respiratória crónica" 2 => "desmame" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec570318" "palabras" => array:3 [ 0 => "Non-invasive ventilation" 1 => "chronic respiratory failure" 2 => "weaning" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Introdução:</span> Nos últimos anos, a ventilação não invasiva (VNI) tornou-se numa opção terapêutica válida nas exacerbações agudas de doentes com doença pulmonar crónica obstrutiva. No entanto, apesar de muito utilizada, existe muito pouca informação sobre o desmame deste modo ventilatório. <span class="elsevierStyleBold">Objectivos:</span> Descrever um protocolo de desmame baseado em períodos progressivos de descontinuação de VNI. <span class="elsevierStyleBold">Métodos:</span> Durante um ano foram admitidos 78 doentes na nossa unidade para início de VNI devido a exacerbações agudas de doentes com doença pulmonar crónica obstrutiva. O desmame de VNI era considerado em doentes que se apresentavam sem acidose e com frequência respiratória inferior a 25 ciclos por minuto. O desmane era realizado da seguinte forma: Durante as primeiras 24 horas, em cada 3 horas de período diurno o doente estava sem VNI durante uma hora (excepto à noite); no segundo dia, em cada 3 horas o doente estava sem VNI durante 2 horas (excepto à noite), e no terceiro dia a VNI era utilizada apenas em período nocturno. <span class="elsevierStyleBold">Resultados:</span> Sessenta doentes iniciaram o protocolo de desmame. O tempo médio de VNI foi de 120.9 horas (17 a 192 horas). Não houve registo de complicações nos doentes que iniciaram este protocolo. Todos completaram o protocolo sem necessidade de reinstituir VNI ou ventilação invasiva durante o internamento. <span class="elsevierStyleBold">Conclusões:</span> Descrevemos uma taxa excelente de sucesso de desmame de VNI em doentes com exacerbações agudas de doentes com insuficiência respiratória crónica. Apesar de este protocolo implicar uma duração de 72 horas, os resultados sugerem que estratégias baseadas em períodos com e sem VNI são eficazes. No entanto, estratégias menos demoradas merecem investigação.</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2008; XIV (1): 49-53</span></p></span>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Background:</span> In recent years non-invasive ventilation (NIV) as become a valuable therapeutic option in exacerbations of patients with chronic pulmonary obstructive disease. Although widely used there is a paucity of information on weaning from NIV. <span class="elsevierStyleBold">Objectives:</span> We aimed to describe the performance of a weaning protocol based on progressive periods of NIV withdraw. <span class="elsevierStyleBold">Methods:</span> During a one year period we performed NIV in 78 patients with acute exacerbation of chronic respiratory failure. Weaning was considered in patients with 24 hours without acidosis and respiratory rate less than 25 cycles per minute. Weaning was performed as following: during the first 24 hours in each 3 hours, one hour without NIV (except during night period), in the second day in each 3 hours, two hours without NIV (except during night period) and in the third day NIV was used during the night period. <span class="elsevierStyleBold">Results:</span> Sixty five patients began the weaning protocol. Mean NIV time was 120,9<span class="elsevierStyleHsp" style=""></span>hours (17 to 192 hours). No adverse effects were recorded in patients who began the weaning protocol. All patients completed the weaning protocol with no re-institution of NIV or invasive ventilation during hospitalization. <span class="elsevierStyleBold">Conclusions:</span> We report an excellent weaning success rate of NIV in patients with acute severe exacerbation of CRF. Although our weaning protocol required 72 hours, our results suggest that strategies based on periods with and with-out NIV are effective. Weather similar less time consuming weaning strategies are effective, merits investigation.</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2008; XIV (1): 49-53</span></p></span>" ] ] "lecturaRecomendada" => array:1 [ 0 => array:3 [ "vista" => "all" "titulo" => "<span class="elsevierStyleSectionTitle" id="st0025">Bibliography</span>" "seccion" => array:1 [ 0 => array:2 [ "vista" => "all" "bibliografiaReferencia" => array:15 [ 0 => array:3 [ "identificador" => "bb0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Positive pressure respiration and its application to the treatment of acute pulmonary edema" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.L. Barach" 1 => "J. Martin" 2 => "M. 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Elliot" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2000" "volumen" => "355" "paginaInicial" => "1931" "paginaFinal" => "1935" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10859037" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bb0035" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Non-invasive ventilation in acute respiratory failure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "British Thoracic Society" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "2002" "volumen" => "57" "paginaInicial" => "192" "paginaFinal" => "211" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11867822" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bb0040" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute applications of non-invasive positive pressure ventilation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T. Liesching" 1 => "H. Kwok" 2 => "S.N. Hill" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2003" "volumen" => "124" "paginaInicial" => "699" "paginaFinal" => "713" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12907562" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bb0045" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Complications of acute respiratory failure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S.K. Pingleton" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm/137.6.1463" "Revista" => array:6 [ "tituloSerie" => "Am Rev Respir Dis" "fecha" => "1988" "volumen" => "137" "paginaInicial" => "1463" "paginaFinal" => "1493" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3059862" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bb0050" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Noninvasive ventilation for acute respiratory failure: a prospective randomised placebo-controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "F. Thys" 1 => "J. Roeseler" 2 => "M. Reynaert" 3 => "G. Liistro" 4 => "D.O. Rodenstein" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2002" "volumen" => "20" "paginaInicial" => "545" "paginaFinal" => "555" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12358327" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bb0055" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Non invasive mechanical ventilation in acute respiratory failure due to chronic obstructive pulmonary disease: correlates for success" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "N. Ambrosino" 1 => "K. Foglio" 2 => "F. Rubini" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Thorax" "fecha" => "1995" "volumen" => "50" "paginaInicial" => "755" "paginaFinal" => "757" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7570410" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1590865812000229" "estado" => "S300" "issn" => "15908658" ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bb0060" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of a ventilatory support system (BiPAP) for acute respiratory failure in the emergency department" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J.M. Poponick" 1 => "J.P. Renston" 2 => "R.P. Bennett" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1999" "volumen" => "116" "paginaInicial" => "166" "paginaFinal" => "171" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10424521" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bb0065" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A chart of failure risk for non-invasive ventilation inpatients with COPD exacerbation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:5 [ 0 => "M. Confalonieri" 1 => "G. Garuti" 2 => "M.S. Cattaruzza" 3 => "J.F. Osborn" 4 => "M. Antonelli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.05.00085304" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2005" "volumen" => "25" "paginaInicial" => "348" "paginaFinal" => "355" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15684302" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bb0070" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Noninvasive ventilation to treat Hypercapnic coma secondary to respiratory failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:4 [ 0 => "G.G. Diaz" 1 => "A.C. Alcaraz" 2 => "J.C. Talavera" 3 => "P.J. Pérez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.127.3.952" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2005" "volumen" => "127" "paginaInicial" => "952" "paginaFinal" => "960" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15764781" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bb0075" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of non-invasive positive pressure ventilation with standard medical therapy in hypercapnic acute respiratory failure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T. Celikel" 1 => "M. Sungur" 2 => "B. Ceyhan" 3 => "S. Karakurt" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Chest" "fecha" => "1998" "volumen" => "114" "paginaInicial" => "1636" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9872200" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "pt" "url" => "/08732159/0000001400000001/v1_201509151510/S087321591530218X/v1_201509151510/pt/main.assets" "Apartado" => array:4 [ "identificador" => "9575" "tipo" => "SECCION" "pt" => array:2 [ "titulo" => "Artigos originais" "idiomaDefecto" => true ] "idiomaDefecto" => "pt" ] "PDF" => "https://static.elsevier.es/multimedia/08732159/0000001400000001/v1_201509151510/S087321591530218X/v1_201509151510/pt/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087321591530218X?idApp=UINPBA00004E" ]
Article information
ISSN: 08732159Original language: Portuguese
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