RESUMO
Undergraduate biomedical students often have difficulties in understanding basic concepts of respiratory physiology, particularly respiratory mechanics. In this study, we report the use of electrical impedance tomography (EIT) to improve and consolidate the knowledge about physiological aspects of normal regional distribution of ventilation in humans. Initially, we assessed the previous knowledge of a group of medical students ( n = 39) about regional differences in lung ventilation. Thereafter, we recorded the regional distribution of ventilation through surface electrodes on a healthy volunteer adopting four different decubitus positions: supine, prone, and right and left lateral. The recordings clearly showed greater pulmonary ventilation in the dependent lung, mainly in the lateral decubitus. Considering the differences in pulmonary ventilation between right and left lateral decubitus, only 33% of students were able to notice it correctly beforehand. This percentage increased to 84 and 100%, respectively ( P < 0.01), after the results of the ventilation measurements obtained with EIT were examined and discussed. A self-assessment questionnaire showed that students considered the practical activity as an important tool to assist in the understanding of the basic concepts of respiratory mechanics. Experimental demonstration of the physiological variations of regional lung ventilation in volunteers by using EIT is feasible, effective, and stimulating for undergraduate medical students. Therefore, this practical activity may help faculty and students to overcome the challenges in the field of respiratory physiology learning.
Assuntos
Educação Médica/métodos , Impedância Elétrica , Fisiologia/educação , Ventilação Pulmonar/fisiologia , Estudantes de Medicina , Tomografia/métodos , Compreensão/fisiologia , Feminino , Humanos , Masculino , Adulto JovemRESUMO
O índice de desmame ventilatório Ferrari-Tadini éum método utilizado como parâmetro de desmame em pacientescom o quadro de insufi ciência respiratória. O objetivo deste estudofoi analisar a efi cácia deste índice em uma unidade de terapia intensivade um hospital da rede pública de Fortaleza/CE. Material e métodos:Realizou-se acompanhamento de 13 pacientes que estavam emprocesso de desmame após permanência na ventilação mecânica porperíodo igual ou superior a 48 horas conforme protocolo da UTI,na qual se aplica o teste de ventilação espontânea através da peça T.Imediatamente antes da extubação calculou-se o Índice de DesmameVentilatório Ferrari Tadini. De acordo com o índice, o procedimentode extubação foi classifi cado como: I (indicado), II (favorável), III(desfavorável) e IV (contraindicado). Resultados: 38,46% (n = 5)receberam pontuação entre 27 e 30, correspondendo à classifi caçãoI, sendo efi caz em 100% das extubações; 53,85% (n = 7) obtiverampontuação entre 23 e 26, que corresponde à classifi cação II, efi cazem 90,91, enquanto que 7,69 (n = 1) obteve pontuação entre20 e 22, que corresponde à classifi cação III e nenhum paciente foiclassifi cado como classe IV. O paciente classifi cado como desfavorável(classe III) foi reintubado. Conclusão: O índice de desmameventilatório Ferrari-Tadini, na amostra estudada, demonstrou serefi caz para avaliar o momento da extubação e efi ciente em prevero sucesso para a extubação, que aconteceu em 84,62% dos casos...
Introduction: Ferrari-Tadini Index is a predictor of the outcomeof weaning fr om mechanical ventilation. Th e purposeof this study was to evaluate the accuracy of this index in anintensive care unit of a public hospital in Fortaleza/CE. Methods:Thirteen patients requiring mechanical ventilation for more than48 hours were assigned to usual weaning protocol with T peace.Ferrari-Tadini Index classifi cation were performed just before theextubation: I (indicated), II (favorable), III (unfavorable) and IV(not indicated) Results: Five patients (38.46%) had a weaning scoreof between 27 and 30 - class I; seven patients (53.85%) had scorebetween 23 and 26, which corresponded to class II; one patient(7.69%) had score between 20 and 22, corresponding to class III. Nopatient was categorized under class IV. Reintubation was requiredfor one patient, who was classifi ed as III class. Conclusion: FerrariTadini weaning index could accurately predict the ability to besuccessfully weaned from mechanical ventilator support, and itwas observed in 84.62% cases...
