Falha de extubação e suas implicações clínicas em unidade de terapia intensiva.

Juliana Harumi Hattori Sauragi Kavaturo, Fernando Osni Machado, Leonardo Jönck Staub, Rosemeri Maurici da Silva

Resumo


Introdução: O uso da ventilação mecânica (VM) aumentou significativamente nas últimas décadas e atualmente é uma importante modalidade terapêutica. Contudo, está associada a complicações que colocam em risco os cuidados do paciente crítico, tornando um grande desafio a identificação do momento correto para extubar um paciente, buscando-se evitar tanto um prolongamento desnecessário da VM como uma extubação prematura, pois ambos estão relacionados ao aumento do risco de complicações. Objetivos: Identificar os fatores associados à falha de extubação, buscando a caracterização de pacientes com risco do seu insucesso e avaliar as implicações clínicas relacionadas com a necessidade de reintubação. Métodos: Foi realizado um estudo de coorte incluindo pacientes internados na unidade de terapia intensiva (UTI) submetidos à VM. Esses foram acompanhados até 48 horas após a extubação, permanecendo aqueles que apresentaram o desfecho considerado neste estudo, como reintubação dentro de 48 horas após a extubação ou a evolução para o óbito durante esse período. Resultados: 83 pacientes foram elegíveis para este estudo. Houve associação significante entre o maior tempo de UTI (p 0,048), maior tempo de VM (p 0,040) e mortalidade na UTI (p 0,022) com falha de extubação. Foram também observados elevação de complicações associadas ao uso do suporte ventilatório, como pneumonia associada à VM (p 0,001) e frequência de traqueostomia (p 0,009). Conclusão: A falha de extubação está associada a aumento da mortalidade na UTI, do tempo de permanência, e duração na ventilação mecânica.


Palavras-chave


Extubação; Desmame do Respirador; Respiração Artificial.

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DOI: https://doi.org/10.32963/bcmufsc.v6i1.3927

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Direitos autorais 2020 Juliana Harumi Hattori Sauragi Kavaturo, Fernando Osni Machado, Leonardo Jönck Staub, Rosemeri Maurici da Silva

URL da licença: https://creativecommons.org/licenses/by/3.0/