Disfunção diafragmática associada à ventilação mecânica invasiva em pacientes adultos críticos
DOI:
https://doi.org/10.31053/1853.0605.v78.n2.28458Palavras-chave:
respiração artificial, unidades de terapia intensiva, mortalidade, diafragma, epidemiologiaResumo
A ventilação mecânica invasiva (VMI) é uma terapia de suporte de vida que não apresenta complicações, como disfunção diafragmática induzida por ventilação mecânica, caracterizada por atrofia e fraqueza do referido músculo. O interesse por essa patologia parece basear-se na associação encontrada com resultados clínicos negativos. A prevalência varia de 29 a 80%, provavelmente devido à variabilidade entre os diferentes métodos de diagnóstico e o tempo de avaliação. O padrão ouro continua sendo a pressão negativa transdiafragmática gerada pela estimulação bilateral dos nervos frênicos, embora, devido à falta de praticidade, o ultra-som diafragmático tenha começado a ser utilizado. Embora tenha várias modalidades, nem todos têm análises de correlação com o padrão-ouro. Outro problema surge ao analisar a associação independente entre patologia e IMV, uma vez que fatores de confusão não são fáceis de isolar.
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