ABSTRACT
INTRODUCTION: Currently, transesophageal echodopplercardiography (TEE) is frequently performed under sedation on an outpatient basis. Sedation is related with increase in incidents on airways. Bearing in mind this scenario, we developed a new double lumen oropharyngeal cannula aimed at keeping airway patency, in addition to reducing risks to patients during endoscopy procedures performed under sedation. The main objective of our study was to assess the incidence of oxygen desaturation in a series of cases of adult patients submitted to outpatient TEE exam, under sedation and using the oropharyngeal cannula. METHOD: Thirty patients under sedation with intravenous midazolam and propofol were assessed. After loss of consciousness, the cannula was placed and patients were maintained on spontaneous breathing. Oxygen saturation, capnometry, heart rate and non-invasive arterial blood pressure, in addition to subjective data: airway patency, handling of cannula insertion, and comfort of examiner were analyzed. RESULTS: The incidence of mild desaturation was 23.3%, and there was no severe desaturation in any of the cases. The insertion of the oropharyngeal cannula was considered easy for 29 patients (96.6%), and TEE probe handling was appropriate in 93.33% of exams performed. CONCLUSIONS: TEE exams under sedation aided by the double-lumen oropharyngeal cannula presented a low incidence of desaturation in patients assessed, and allowed analysis of expired CO2 during the exams.
Subject(s)
Cannula , Deep Sedation , Echocardiography, Transesophageal/instrumentation , Echocardiography, Transesophageal/methods , Oxygen/metabolism , Adult , Aged , Equipment Design , Female , Humans , Hypnotics and Sedatives/administration & dosage , Male , Midazolam/administration & dosage , Middle Aged , Propofol/administration & dosageABSTRACT
Abstract Introduction: Currently, transesophageal echodopplercardiography is frequently performed under sedation on an outpatient basis. Sedation is related with increase in incidents on airways. Bearing in mind this scenario, we developed a new double lumen oropharyngeal cannula aimed at keeping airway patency, in addition to reducing risks to patients during endoscopy procedures performed under sedation. The main objective of our study was to assess the incidence of oxygen desaturation in a series of cases of adult patients submitted to outpatient transesophageal echo exam, under sedation and using the oropharyngeal cannula. Method: 30 patients under sedation with intravenous midazolam and propofol were assessed. After loss of consciousness, the cannula was placed and patients were maintained on spontaneous breathing. Oxygen saturation, capnometry, heart rate and non-invasive arterial blood pressure, in addition to subjective data: airway patency, handling of cannula insertion and, comfort of examiner were analyzed. Results: The incidence of mild desaturation was 23.3%, and there was no severe desaturation in any of the cases. The insertion of the oropharyngeal cannula was considered easy for 29 patients (96.6%), and transesophageal echo probe handling was appropriate in 93.33% of exams performed. Conclusions: Transesophageal echo exams under sedation aided by the double-lumen oropharyngeal cannula presented a low incidence of desaturation in patients assessed, and allowed analysis of expired CO2 during the exams.
Resumo Introdução: Nos dias atuais, exames de ecocardiografia transesofágica (ETE) são realizados de forma frequente sob sedação em regime ambulatorial. A sedação está relacionada com aumento de intercorrências nas vias aéreas. Dentro desse contexto, desenvolvemos uma cânula orofaríngea de duplo-lúmen com finalidade de manutenção da via aérea pérvia, reduzindo riscos aos pacientes durante procedimentos endoscópicos sob sedação. O principal objetivo do nosso estudo foi avaliar a incidência de dessaturação em uma série de casos de pacientes adultos submetidos a ETE ambulatorial sob sedação com o uso da cânula orofaríngea. Métodos: Foram avaliados 30 pacientes sedados com midazolam e propofol intravenoso. A cânula foi inserida após perda da consciência e os pacientes foram mantidos com ventilação espontânea. Analisados saturação de oxigênio, capnometria, frequência cardíaca e pressão arterial não invasiva, além de dados subjetivos: patência das vias aéreas, manuseio e inserção da cânula e conforto ao examinador. Resultados: A incidência de dessaturação leve foi de 23.3% e não houve dessaturação grave em nenhum caso. A inserção da cânula orotraqueal foi considerada fácil em 29 pacientes (96,6%) e o manuseio da sonda de ETE foi adequada em 93,33% dos exames realizados. Conclusões: A realização dos exames de ETE sob sedação com auxílio da cânula orofaríngea de duplo lúmen apresentou baixa incidência de dessaturação nos pacientes avaliados, além de permitir análise do CO2 expirado durante a realização dos exames.
Subject(s)
Echocardiography , Cannula , Anesthesia and Analgesia , Conscious SedationABSTRACT
OBJETIVO: conhecer e analisar o perfil demográfico e epidemiológico da clientelaatendida no HPSM-MP. MÉTODO: a pesquisa foi realizada através da coleta de 1000prontuários hospitalares entre os meses de janeiro à agosto de 2011. RESULTADOS: emrelação à demanda por faixa etária,duas faixas, juntas (20-39 e 40-59), concentram mais dametade dos atendimentos; em relação à demanda por sexo, observou-se o predomínio dosexo masculino (quase 60% dos atendimentos avaliados); dentre os atendimentos porespecialidades os setores de Clínica Médica, Pequena Cirurgia e Traumatologia são asprincipais especialidades procuradas; cerca de 80% dos pacientes atendidos eramprocedentes da própria capital; os bairros da Pedreira, Telégrafo e Sacramenta foram osque mais procuraram atendimento no local; a faixa de horário mais prevalente concentrou-seentre os horários de 6 às 18 horas (61,8% do total). CONCLUSÃO: Os dados coletadoslevam a inferir que o HPSM-MP atende prioritariamente a população da capital, desde aatenção básica até os procedimentos mais complexos. Assim o perfil da demanda doserviço de urgência e emergência do HPSM-MP caracteriza-se por: faixa etária de 20 a 59anos, sexo masculino, procedente de Belém, no horário entre 06-18 horas, no setor de ClínicaMédica.
AIM: to analyze the demographic and epidemiological profile of the patients in HPSM-MP.METHODS: the survey was conducted by collecting a thousand hospital records, between themonths of January to August 2011. RESULTS: compared to the demand by age, two groups(20-39 and 40-59), concentrated more than 50% of treatment; there was a predominance ofmales (almost 60% of the cases evaluated); in relation of appointments, the sectors ofClinical Medicine, Surgery and Traumatology are the main specialties; about 80% ofpatients had come from the capital itself; the neighborhoods of Pedreira, Telégrafo andSacramenta were the main that searched for hospital care; the time were more prevalentbetween the hours of 6 to 18 hours (61.8% of total). CONCLUSIONS: the data collected led toinfer that the HPSM-MP primarily serves the population of the capital, from primary care to themost complex procedures. So the demand profile of the HPSM-MP?s emergency service ischaracterized by: age 20 to 59 years, male, from Belém, between the time of 06-18hours, attended in the Intern Clinic.
