Efeitos hemodinâmicos da pressão positiva contínua nas vias aéreas avaliados pelo ecodopplercardiograma

• Ano de defesa: 2015
• Autor(a) principal: Vinhal, Gabrielle Silva
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Uberlândia; BR; Programa de Pós-graduação em Ciências da Saúde; Ciências da Saúde; UFU
• Palavras-chave em Português: Ventilação não invasiva; Hemodinâmica; Respiração com pressão positiva; Ecocardiograma; Ciências médicas; Ecocardiografia doppler; Noninvasive ventilation; Hemodynamic; Positive-pressure respiration; Echocardiography; CNPQ::CIENCIAS DA SAUDE
• Link de acesso: https://repositorio.ufu.br/handle/123456789/12833; https://doi.org/10.14393/ufu.di.2015.104

Although the use of continuous positive airway pressure (CPAP) has increased considerably, there have been few studies of its hemodynamic effects in patients with healthy cardiopulmonary systems. Objective: To evaluate the hemodynamic effects exerted by different levels of continuous positive airway pressure in healthy individuals using Doppler echocardiography. Methods: This study included 19 healthy volunteers. Three levels of continuous positive airway pressure (5, 10 and 15 cm H2O) were randomly applied for 5 minutes each; 5 minutes of rest were allowed between each application. Echocardiographic variables, vital signs and ventilation were each recorded at baseline and following each pressure application. Results: Continuous positive airway pressures of 10 and 15 cm H2O generated a reduction in the pulmonary velocity-time integral (p=0.01), as well as a reduction in right atrial area (p=0.00). Both cardiac output and heart rate were significantly decreased with each pressure setting (p=0.00 and p=0.00, respectively), whereas stroke volume and blood pressure did not change significantly. Positive correlations were observed between the mitral, pulmonary and aortic velocity-time integrals and both stroke volume and cardiac output. Conclusion: Continuous positive airway pressures of 10 and 15 cm H2O generated reductions in right ventricular preload without changing either left ventricular preload or left ventricular afterload. There was also a decrease in cardiac output due to a reduction in heart rate. A strong correlation was observed between the mitral velocity-time integral and both stroke volume and cardiac output.