Medida da freqüência respiratória e do volume corrente para prever a falha na extubação de recém-nascidos de muito baixo peso em ventilação mecânica

• Autor(a) principal: Davidson, Josy [UNIFESP]
• Data de Publicação: 2008
• Outros Autores: Miyoshi, Milton Harumi [UNIFESP], Dos Santos, Amelia Miyashiro [UNIFESP], Carvalho, Werther Brunow de [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0103-05822008000100006; http://repositorio.unifesp.br/handle/11600/4265
• topic: infant, premature; respiratory function tests; tidal volume; respiration, artificial; ventilator weaning; prematuro; testes de função respiratória; volume de ventilação pulmonar; respiração artificial; desmame do respirador

OBJECTIVE: To verify if respiratory rate (RR), tidal volume (TV) and respiratory rate and tidal volume ratio (RR/TV) could predict extubation failure in very low birth weight infants submitted to mechanical ventilation. METHODS: This prospective observational study enrolled newborn infants with gestational age <37 weeks and birth weight <1,500g, mechanically ventilated from birth during 48 hours to 30 days and thought to be ready for extubation. As soon as the physicians decided for extubation, the neonates received endotracheal continuous positive airway pressure (CPAP) for 10 minutes while spontaneous RR, TV and RR/TV were measured using a fixed-orifice pneumotachograph positioned between the endotracheal tube and the ventilator circuit. Thereafter, the neonates were extubated to nasal CPAP. Extubation failure was defined as the need for reintubation within 48 hours. RESULTS: Of the 35 studied infants, 20 (57%) were successfully extubated and 15 (43%) required reintubation. RR and RR/TV before extubation had a trend to be higher in unsuccessfully extubated infants. TV was similar in both groups. Sensitivity and specificity of these parameters as predictors of extubation failure were 50 and 67% respectively for RR, 40 and 67% for TV and 40 and 73% for RR/TV. CONCLUSIONS: RR, TV and RR/TV showed low sensitivity and specificity to predict extubation failure in mechanically ventilated very low birth weight infants.