Thoracic Surgery Clinical Trial
Official title:
Effects of Mechanical Ventilation on Controlled Volume, Controlled Pressure and Pressure Support in the Immediate Postoperative Period of Cardiac Surgery on Pulmonary Electrical Impedance and Patient-ventilator Asynchrony: a Parallel Clinical Trial
This study evaluates the effects of VCV, PCV and PSV ventilatory modes during the immediate postoperative period on the variables resulting from regional and global pulmonary electrical impedance and diaphragmatic mobility, as well as perform ventilator synchrony analysis in PSV mode by mechanical ventilator. Half of the participants will receive VCV followed by PSV for weaning, while the other half will receive PCV followed by PSV for weaning.
In the immediate postoperative period of cardiac surgery, patients are found under mechanical
ventilatory support. Commonly, they are ventilated in controlled and assisted-controlled
volume (VCV) or pressure (PCV) modes, with weaning at pressure support (PSV).
Systematic reviews indicate that there is no difference between the VCV and PCV ventilatory
modes for some clinical outcomes or that the existing evidence is insufficient. The
distribution of regional ventilation and diaphragmatic mobility can be measured from the use
of electrical impedance tomography (EIT) and diaphragmatic ultrasonography (US) to clarify
the physiological changes and / or mechanisms of adaptation of the organism submitted to
controlled modes cycled at volume or at pressure and spontaneously flow cycled mode.
Besides EIT and US measures, gasometric, hemodynamic and respiratory data will also be
recorded. The statistical analysis will be considered α≤0.05 for a statistically significant
difference.
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