Efeito do modo ventilatório na cinética do desflurano

Detalhes bibliográficos
Autor(a) principal: Fabri, Daniel Capucci [UNIFESP]
Data de Publicação: 2017
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5060737
https://repositorio.unifesp.br/handle/11600/50779
Resumo: This study analyzed the pharmacokinetics of desflurane inhalatory anesthetic under pressure controlled ventilation (PCV) and volume controlled ventilation (VCV). The aim of this study was to determine if ventilatory modes (PCV and VCV) interfere with the wash in and wash out of desflurane, since PCV could improve gas exchange, optimizing ventilation perfusion ratio. To achieve this purpose, 33 adults ASA I physical status, were randomly assigned to general anesthesia, with induction of propofol, fentanyl and rocuronium as a neuromuscular blocker. The anesthesia was maintained with a continuous infusion pump of propofol and remifentanil. All patients were ventilated with air and oxygen at 60%, with a flow rate of 6 L/min, in a non-rebreathing system. VCV and PCV were performed with VT of 8 mL/kg, peak inspiratory pressure of 30 cmH2O, inspiratory and expiratory time ratio was 1:2, without PEEP. Respiratory rate was adjusted to maintain EtCO2 between 25 and 40 mmHg. After induction, desflurane at 6% concentration was given for 30 minutes. The patients were ventilated with both PCV and VCV, initiating with one of two modes chosen at random. Desflurane kinetics were determined by recording Fi and FA every 10 seconds in the first minute and at times 5, 10, 15, 20, 25 and 30 minutes. After this period, the vaporizer was turned off and the FA values were recorded at this time and also every 30 seconds on the first 5 minutes. The 33 patients had a mean age of 38.4 ± 6.8 years, mean body weight of 63.3 ± 8.4kg and mean height of 1.60 ± 0.1m. During the induction of anesthesia, uptake and elimination of desflurane did not change the heart rate and mean arterial pressure in both VCV and PCV. During the capture and elimination of desflurane, the VM parameters and BIS readings did not present a statistically significant difference between the two groups. At the elimination of desflurane, there was a statistical difference in the EtCO2 values when the vaporizer was turned off. During wash in of desflurane there was no significant difference in the FA/Fi. During the wash out of this anesthetic, there were statistical differences in two moments, at the first and third minutes. In the conditions of this study, desflurane uptake was similar in both ventilatory modes, however its elimination presented a difference in two moments.
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spelling Efeito do modo ventilatório na cinética do desfluranoEffect of the ventilation mode on the kinetics of desfluraneDesfluraneVentilatory modeInhaled anestheticGeneral anesthesiaPressure controlled ventilationControlled volume ventilationDesfluranoModo ventilatórioAnestésico inalatórioAnestesia geralVentilação controlada a pressãoVentilação controlada a volumeThis study analyzed the pharmacokinetics of desflurane inhalatory anesthetic under pressure controlled ventilation (PCV) and volume controlled ventilation (VCV). The aim of this study was to determine if ventilatory modes (PCV and VCV) interfere with the wash in and wash out of desflurane, since PCV could improve gas exchange, optimizing ventilation perfusion ratio. To achieve this purpose, 33 adults ASA I physical status, were randomly assigned to general anesthesia, with induction of propofol, fentanyl and rocuronium as a neuromuscular blocker. The anesthesia was maintained with a continuous infusion pump of propofol and remifentanil. All patients were ventilated with air and oxygen at 60%, with a flow rate of 6 L/min, in a non-rebreathing system. VCV and PCV were performed with VT of 8 mL/kg, peak inspiratory pressure of 30 cmH2O, inspiratory and expiratory time ratio was 1:2, without PEEP. Respiratory rate was adjusted to maintain EtCO2 between 25 and 40 mmHg. After induction, desflurane at 6% concentration was given for 30 minutes. The patients were ventilated with both PCV and VCV, initiating with one of two modes chosen at random. Desflurane kinetics were determined by recording Fi and FA every 10 seconds in the first minute and at times 5, 10, 15, 20, 25 and 30 minutes. After this period, the vaporizer was turned off and the FA values were recorded at this time and also every 30 seconds on the first 5 minutes. The 33 patients had a mean age of 38.4 ± 6.8 years, mean body weight of 63.3 ± 8.4kg and mean height of 1.60 ± 0.1m. During the induction of anesthesia, uptake and elimination of desflurane did not change the heart rate and mean arterial pressure in both VCV and PCV. During the capture and elimination of desflurane, the VM parameters and BIS readings did not present a statistically significant difference between the two groups. At the elimination of desflurane, there was a statistical difference in the EtCO2 values when the vaporizer was turned off. During wash in of desflurane there was no significant difference in the FA/Fi. During the wash out of this anesthetic, there were statistical differences in two moments, at the first and third minutes. In the conditions of this study, desflurane uptake was similar in both ventilatory modes, however its elimination presented a difference in two moments.Este estudo analisou a farmacocinética do anestésico inalatório desflurano nos modos de ventilação controlada a pressão (PCV) e a volume (VCV). O objetivo foi avaliar se os modos ventilatórios (PCV e VCV) interferem na captação e eliminação do desflurano, uma vez que a PCV poderia melhorar as trocas gasosas, otimizando a relação ventilação-perfusão. Para atingir esse propósito, foram randomizados em 33 pacientes, estado físico ASA I, submetidos à anestesia geral, sendo a indução realizada com propofol, fentanil e rocurônio como bloqueador neuromuscular. A anestesia foi mantida com propofol e remifentanil em bomba de infusão continua. Os pacientes foram ventilados com oxigênio a 60%, com fluxo de 6 L/min, em sistema sem reinalação. A VCV e a PCV foram realizadas com VC de 8 mL/kg, pico de pressão inspiratória de 30 cm H2O, a relação tempo inspiratório e expiratório de 1:2, sem PEEP. A frequência respiratória foi ajustada para manter EtCO2 entre 25 e 40 mmHg. Após a indução, foi administrado desflurano com concentração de 6% por 30 minutos. Os pacientes foram ventilados a PCV e VCV, de forma aleatória pelo início do modo ventilatório. A cinética do desflurano foi determinada através do registro da Fi e FA a cada 10 segundos no primeiro minuto e nos tempos 5, 10, 15, 20, 25 e 30 minutos. Após este período, o vaporizador foi desligado e foram registrados os valores de FA neste momento e também a cada 30 segundos nos primeiros 5 minutos. As 33 pacientes possuíam média de idade de 38,4 ± 6,8 anos, peso real corporal médio de 63,3 ± 8,4 Kg e altura média de 1,60 ± 0,1 m. Durante a indução da anestesia, captação e eliminação do desflurano não foram observadas alterações da frequência cardíaca e da pressão arterial média tanto na PCV quanto na VCV. Durante a captação e eliminação do desflurano, os parâmetros volume minuto e valores do BIS não apresentaram diferença estatisticamente significativa entre os dois modos ventilatórios. Na eliminação do desflurano, houve diferença na análise do EtCO2 ao desligar o vaporizador. Durante a administração do desflurano, não houve diferença significativa na relação FA/Fi. Durante a eliminação deste inalatório, houve diferença estatística em dois momentos, no primeiro e no terceiro minutos. Nas condições deste estudo, a captação do desflurano foi semelhante nos dois modos ventilatórios, entretanto durante a eliminação houve diferença em dois momentos.Dados abertos - Sucupira - Teses e dissertações (2017)Universidade Federal de São Paulo (UNIFESP)Oliveira, Itamar Souza de [UNIFESP]Tardelli, Maria Angela [UNIFESP]http://lattes.cnpq.br/9044839480768622http://lattes.cnpq.br/0568989035666759http://lattes.cnpq.br/1102159872135588Universidade Federal de São Paulo (UNIFESP)Fabri, Daniel Capucci [UNIFESP]2019-06-19T14:58:23Z2019-06-19T14:58:23Z2017-09-28info:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/publishedVersion73 f.application/pdfhttps://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5060737https://repositorio.unifesp.br/handle/11600/50779porSão Pauloinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-02T20:01:15Zoai:repositorio.unifesp.br/:11600/50779Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-02T20:01:15Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Efeito do modo ventilatório na cinética do desflurano
Effect of the ventilation mode on the kinetics of desflurane
title Efeito do modo ventilatório na cinética do desflurano
spellingShingle Efeito do modo ventilatório na cinética do desflurano
Fabri, Daniel Capucci [UNIFESP]
Desflurane
Ventilatory mode
Inhaled anesthetic
General anesthesia
Pressure controlled ventilation
Controlled volume ventilation
Desflurano
Modo ventilatório
Anestésico inalatório
Anestesia geral
Ventilação controlada a pressão
Ventilação controlada a volume
title_short Efeito do modo ventilatório na cinética do desflurano
title_full Efeito do modo ventilatório na cinética do desflurano
title_fullStr Efeito do modo ventilatório na cinética do desflurano
title_full_unstemmed Efeito do modo ventilatório na cinética do desflurano
title_sort Efeito do modo ventilatório na cinética do desflurano
author Fabri, Daniel Capucci [UNIFESP]
author_facet Fabri, Daniel Capucci [UNIFESP]
author_role author
dc.contributor.none.fl_str_mv Oliveira, Itamar Souza de [UNIFESP]
Tardelli, Maria Angela [UNIFESP]
http://lattes.cnpq.br/9044839480768622
http://lattes.cnpq.br/0568989035666759
http://lattes.cnpq.br/1102159872135588
Universidade Federal de São Paulo (UNIFESP)
dc.contributor.author.fl_str_mv Fabri, Daniel Capucci [UNIFESP]
dc.subject.por.fl_str_mv Desflurane
Ventilatory mode
Inhaled anesthetic
General anesthesia
Pressure controlled ventilation
Controlled volume ventilation
Desflurano
Modo ventilatório
Anestésico inalatório
Anestesia geral
Ventilação controlada a pressão
Ventilação controlada a volume
topic Desflurane
Ventilatory mode
Inhaled anesthetic
General anesthesia
Pressure controlled ventilation
Controlled volume ventilation
Desflurano
Modo ventilatório
Anestésico inalatório
Anestesia geral
Ventilação controlada a pressão
Ventilação controlada a volume
description This study analyzed the pharmacokinetics of desflurane inhalatory anesthetic under pressure controlled ventilation (PCV) and volume controlled ventilation (VCV). The aim of this study was to determine if ventilatory modes (PCV and VCV) interfere with the wash in and wash out of desflurane, since PCV could improve gas exchange, optimizing ventilation perfusion ratio. To achieve this purpose, 33 adults ASA I physical status, were randomly assigned to general anesthesia, with induction of propofol, fentanyl and rocuronium as a neuromuscular blocker. The anesthesia was maintained with a continuous infusion pump of propofol and remifentanil. All patients were ventilated with air and oxygen at 60%, with a flow rate of 6 L/min, in a non-rebreathing system. VCV and PCV were performed with VT of 8 mL/kg, peak inspiratory pressure of 30 cmH2O, inspiratory and expiratory time ratio was 1:2, without PEEP. Respiratory rate was adjusted to maintain EtCO2 between 25 and 40 mmHg. After induction, desflurane at 6% concentration was given for 30 minutes. The patients were ventilated with both PCV and VCV, initiating with one of two modes chosen at random. Desflurane kinetics were determined by recording Fi and FA every 10 seconds in the first minute and at times 5, 10, 15, 20, 25 and 30 minutes. After this period, the vaporizer was turned off and the FA values were recorded at this time and also every 30 seconds on the first 5 minutes. The 33 patients had a mean age of 38.4 ± 6.8 years, mean body weight of 63.3 ± 8.4kg and mean height of 1.60 ± 0.1m. During the induction of anesthesia, uptake and elimination of desflurane did not change the heart rate and mean arterial pressure in both VCV and PCV. During the capture and elimination of desflurane, the VM parameters and BIS readings did not present a statistically significant difference between the two groups. At the elimination of desflurane, there was a statistical difference in the EtCO2 values when the vaporizer was turned off. During wash in of desflurane there was no significant difference in the FA/Fi. During the wash out of this anesthetic, there were statistical differences in two moments, at the first and third minutes. In the conditions of this study, desflurane uptake was similar in both ventilatory modes, however its elimination presented a difference in two moments.
publishDate 2017
dc.date.none.fl_str_mv 2017-09-28
2019-06-19T14:58:23Z
2019-06-19T14:58:23Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format doctoralThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5060737
https://repositorio.unifesp.br/handle/11600/50779
url https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5060737
https://repositorio.unifesp.br/handle/11600/50779
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 73 f.
application/pdf
dc.coverage.none.fl_str_mv São Paulo
dc.publisher.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
publisher.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
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