Estratégias de ventilação mecânica invasiva em pacientes adultos com traumatismo cranioencefálico grave
DOI:
https://doi.org/10.34119/bjhrv6n2-017Keywords:
Lesão Cerebral Traumática, respiração artificial, diretrizes clínicas, neuroproteçãoAbstract
Introdução: O cérebro e pulmões estão fortemente ligados, interagindo de forma complexa, sendo um grande desafio utilizar estratégias ventilatórias adequadas a fim de obter equilíbrio cérebro-pulmões. E estudos demonstram que estratégias ventilatórias têm impacto na lesão cerebral, sendo um fator de risco de morbimortalidade em pacientes com traumatismo cranioencefálico grave. Objetivo: Descrever as principais estratégias de ventilação mecânica invasiva em pacientes adultos com traumatismo cranioencefálico grave. Metodologia: Trata-se de uma revisão sistemática de literatura, na qual utilizou dos DESCs combinados para busca nas bases de dados eletrônicos, incluindo publicações dos últimos 10 anos. Resultados e Discussão: Após revisões, pôde se apurar que, a prevenção de lesões secundárias nesse grupo de pacientes através de estratégias ventilatórias é útil, visto que alterações na ventilação mecânica causam impactos ao cérebro, podendo afetar o fluxo sanguíneo cerebral e consequentemente a oxigenação cerebral. Considerações Finais: O manejo do ventilador, utilizando estratégia de ventilação protetora além parâmetros modificáveis incluindo, frequência respiratória e volume minuto adequado afim de manter uma normocapnia esta associados a resultados benéficos e são indicada pela maioria das diretrizes, pois otimiza a proteção neurologia em pacientes com traumatismo cranioencefálico grave, e ao mesmo tempo previne a lesão pulmonar induzida pela ventilação conhecida como VILI, diminuindo o risco de afetar o prognóstico de morbimortalidade, e declínio na qualidade de vida desses pacientes.
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