Efeitos imediatos da fisioterapia respiratória sobre os parâmetros hemodinâmicos, metabólicos, inflamatórios e de estresse oxidativo em pacientes com choque séptico

• Ano de defesa: 2013
• Autor(a) principal: Santos, Rafael Saldanha dos
• Orientador(a): Oliveira, Jarbas Rodrigues de
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica do Rio Grande do Sul
• Programa de Pós-Graduação: Programa de Pós-Graduação em Medicina e Ciências da Saúde
• Departamento: Faculdade de Medicina
• País: BR
• Palavras-chave em Português: MEDICINA; FISIOTERAPIA; TERAPIA RESPIRATÓRIA; CHOQUE SÉPTICO; ESTRESSE OXIDATIVO
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE::MEDICINA
• Link de acesso: http://tede2.pucrs.br/tede2/handle/tede/1735

Introduction: Septic shock is one of the greatest health problems worldwide, affecting millions of people a year. It presents as a continuum of infectious events and interactions between pathogens caused by the relationship between apoptotic, anti-inflammatory and inflammatory mediators, generating tissue hypoxia, hypovolemia, and increased oxidative stress. Respiratory physiotherapy can help increase oxygenation and improve gas exchanges. The purpose of this study was to evaluate the immediate effect of respiratory physiotherapy on hemodynamic, metabolic, inflammatory and oxidative stress parameters in patients with septic shock. Methods: Before and after quasi-experimental study in thirty patients in septic shock, who underwent respiratory physiotherapy, without associated heart diseases and with vasopressors less than 0.5 mL/Kg/min. Venous and arterial blood gas, clinical and hemodynamic data, inflammatory data, lactate and oxidative stress were evaluated before and 15 minutes after physiotherapy. Results: Thirty patients with a mean age of 61.77±15.91 years and SOFA of 7.9±3.1 were included. Respiratory physiotherapy caused a reduction of pH (p=0.003), PaCO2 (p=0.009), lactate (p=0.0002) and TBARS (p=0.04) and an increase of PaO2 (p=0.026), SaO2 (p=0.018) and PaO2/FiO2 (p=0.04) ratio, 15 minutes after it was applied. Conclusion: The results indicate that respiratory physiotherapy has immediate effects, improving oxygenation, reducing lactate and oxidative damage in patient in septic shock. However, it does not cause alterations in the inflammatory and hemodynamic parameters.