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Revista Brasileira de Anestesiologia
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Revista Brasileira de Anestesiologia
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Revista Brasileira de Anestesiologia
Article . 2017
License: CC BY NC ND
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O jejum influencia a responsividade à pré‐carga em voluntários ASA I e II?

Authors: Alves, Daniel Rodrigues; Ribeiras, Regina;

O jejum influencia a responsividade à pré‐carga em voluntários ASA I e II?

Abstract

Resumo Introducao O jejum no pre‐operatorio e ha muito tempo considerado uma importante causa de deplecao de liquidos, leva a instabilidade hemodinâmica durante a cirurgia, caso a reposicao nao seja prontamente instituida. Recentemente, esse ponto de vista tradicional tem sido progressivamente desafiado e um numero crescente de autores agora propoe uma abordagem mais restritiva para o controle de liquidos, embora permanecam duvidas quanto a verdadeira influencia hemodinâmica do jejum no pre‐operatorio. Metodos Estudo observacional, analitico, prospectivo e longitudinal, no qual 31 voluntarios ASA I e II foram submetidos a exame ecocardiografico antes e apos um periodo de jejum de no minimo seis horas. Os dados dos indices de pre‐carga tanto estaticos quanto dinâmicos foram obtidos em ambos os periodos e subsequentemente comparados. Resultados Os indices estaticos de pre‐carga mostraram um comportamento acentuadamente variavel com o jejum. Os indices dinâmicos, entretanto, foram bem mais consistentes entre si, todos apontam na mesma direcao; isto e, nao evidenciam alteracao estatisticamente significativa com o periodo de jejum. Analisamos tambem a confiabilidade dos indices dinâmicos para responder a alteracoes pre‐carga intencionais conhecidas. A variacao da integral de velocidade-temo (VTI) aortica com a manobra de elevacao passiva dos membros inferiores foi a unica variavel que mostrou sensibilidade suficiente para sinalizar de forma consistente a presenca de variacao na pre‐carga. Conclusao O jejum nao pareceu causar uma alteracao na pre‐carga de voluntarios conscientes nem alterou substancialmente a sua posicao na curva de Frank‐Starling, mesmo com tempos de jejum mais prolongados do que o normalmente recomendado. A variacao do VTI transaortico com a manobra de elevacao passiva dos membros inferiores foi o indice dinâmico mais consistente (dos estudados) para avaliar a capacidade de resposta a variacoes da pre‐carga em pacientes que respiram espontaneamente.

Keywords

Anesthesiology and Pain Medicine

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
6
Top 10%
Average
Average
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