Efeito da posição do prematuro no desmame da ventilação mecânica

• Autor(a) principal: Antunes, Letícia C.O. [UNESP]
• Data de Publicação: 2003
• Outros Autores: Rugolo, Lígia M.S.S., Crocci, Adalberto J.
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://dx.doi.org/10.1590/S0021-75572003000300010; http://hdl.handle.net/11449/67280
• topic: Mechanical ventilation; Position; Premature; Weaning; artificial ventilation; body posture; breathing rate; cardiopulmonary hemodynamics; clinical article; female; gestational age; heart rate; human; infant; lung ventilation; male; oxygen saturation; patient positioning; prematurity; respiratory airflow; respiratory distress syndrome; safety; statistical analysis; statistical significance; transcutaneous oxygen monitoring; very low birth weight; Female; Humans; Infant, Newborn; Infant, Premature; Male; Prone Position; Prospective Studies; Ventilator Weaning

Objective: the purpose of this study was to determine the effects of prone positioning on cardiorespiratory stability and weaning outcome of preterm infants during weaning from mechanical ventilation. Methods: from January to December 1999, a sample of 42 preterm infants, with birthweight < 2,000 g, mechanically ventilated in the first week of life, were randomly divided, in the beginning of the weaning process, in two groups according to the position: supine position (n = 21) or prone position (n = 21). Heart rate, respiratory rate, transcutaneous oxygen saturation and ventilatory parameters were recorded every one hour. Length of the weaning process and complications were also assessed. Results: in both groups the mean gestational age was 29 weeks, most of the patients presented very low birthweight and respiratory distress syndrome. The mean length of the weaning process was 2 days. There were no differences between the groups regarding respiratory rate, heart rate and transcutaneous oxygen saturation, however, oxygen desaturation episodes were more frequent in supine position (p = 0.009). Ventilatory parameters decreased faster and reintubation was less frequent in the prone group (4% versus 33%). No adverse effects of prone positioning were observed. Conclusion: these results suggest that prone position is a safe and beneficial procedure during the weaning from mechanical ventilation and may contribute to weaning success in preterm infants.