Complicações pós-operatórias relacionadas à ventilação mecânica

Abstract

Mechanical ventilation is the support necessary to fully or partially maintain the gas exchange function of the lungs by means of a set of specific equipment and circuits. It is indicated in cases of respiratory failure, general anesthesia, in post-operativepatients who need to be sedated for some time or due to clinical or surgical respiratory complications. Its prolonged use increases the possibility of pulmonary complications due to decreased lung capacity, atelectasis, the development of pathologies such as ventilator-associated pneumonia, ventilator-induced diaphragmatic dysfunction, hospital-acquired infections, lung damage and polyneuropathy, and thus consequently increases the mortality rate. OBJECTIVES: To analyze the main postoperative complications related to mechanical ventilation in patients undergoing general anesthesia and admitted to the Intensive Care Unit. METHODS: This is a prospective, exploratory-descriptive, quantitative study carried out in the ICU of a public teaching hospital in the city of Teresina, in the state of Piauí. The population consisted of medical records of patients discharged from the intensive care unit who had undergone surgical procedures under general anesthesia, required mechanical ventilation and developed complications related to mechanical ventilation during their stay. RESULTS: 48 medical records were analyzed, 52% were male, 62.5% were over 60 years of age, 75% had hypertension and 45.8% had DM, among the patients who developed complications during the postoperative period related to the use of mechanical ventilation. The main surgical procedure performed was myocardial revascularization, 21% of which required mechanical ventilation in the postoperative period. The duration of use of mechanical ventilation was 3 days in most cases. The main indication for use was associated with 56.2% unstable respiratory drive, followed by 41.6% acute respiratory failure. Among the complications observed, 85.4% were muscle fatigue, followed by 79.2% hypoventilation and 35.4% bronchoaspiration. With regard to deaths, 46.6% suffered septic shock and pneumonia, predominantly in patients undergoing neurosurgery and heart surgery. CONCLUSION: In relation to the complications developed during the use of mechanical ventilation, it was possible to observe that the patient's clinical condition directly interferes with the development of more serious complications. Mechanical ventilation is an essential and life-saving support for lung function. However, due to its complexity, there is a series of multi-professional precautions to be taken with patients in order to manage ventilatory support accurately and efficiently, with the aim of minimizing the risk of complications for the patient. In this context, nurses play a fundamental role in identifying problems and intervening in a timely manner together with the intensive care team.