Quais as estratégias de ventilação pulmonar na síndrome do desconforto respiratório agudo causada pela COVID-19? Um estudo de revisão

Autores

DOI:

https://doi.org/10.33448/rsd-v10i1.12037

Palavras-chave:

COVID-19; Betacoronavirus; Respiração artificial; Síndrome do desconforto respiratório do adulto.

Resumo

No final de 2019, emergiu um grupo de casos de pneumonia associados a um novo coronavírus de RNA envelopado, espalhando-se rapidamente pelos continentes e sendo rotulado como pandemia global por COVID-19. Uma proporção considerável da população doente não necessitará de hospitalização, entretanto, alguns pacientes podem desenvolver a forma grave da doença e apresentar complicações como a síndrome do desconforto respiratório agudo (SDRA), requerendo ventilação mecânica invasiva (VMI). Pacientes com SDRA por COVID-19 podem apresentar algumas características específicas em comparação com as formas típicas da síndrome, desenvolvendo fenótipos distintos que ainda tem sido estudados. As pesquisas têm, então, se concentrado em esclarecer estratégias ventilatórias protetoras do pulmão (EPP) para estes pacientes. Esta revisão narrativa teve como objetivo investigar a experiência mundial atual em relação à EPP como manejo da SDRA associada à COVID-19 e destacar considerações para as práticas de VMI durante a pandemia. Após um processo de rastreamento de estudos nas bases de dados PubMed e BVS, foram selecionados 20 estudos a serem analisados. Na maior parte dos estudos o manejo ventilatório dos pacientes se assemelhou ao da SDRA “clássica” e, portanto, a EPP destacou-se como importante aliada na regressão da SDRA nos pacientes COVID-19. No entanto, deve ser levado em consideração a heterogeneidade fenotípica dos pacientes, principalmente quanto à mecânica pulmonar e capacidade de recrutamento. Este estudo possibilitou aprofundamento cientifico sobre as semelhanças e diferenças da SDRA por COVID-19 e por outras causas, além de permitir a formação de orientações quanto aos ajustes ventilatórios iniciais em pacientes com SDRA/COVID-19.

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28/01/2021

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OLIVEIRA, M. I. da S. .; BRANDÃO, C. B. F. .; COSTA, K. V. da .; SILVA, J. P. dos S. .; FERNANDES, V. M. de S. .; BRITO, G. E. G. de .; ELIHIMAS JÚNIOR, U. F. .; FRANÇA, E. E. T. de . Quais as estratégias de ventilação pulmonar na síndrome do desconforto respiratório agudo causada pela COVID-19? Um estudo de revisão. Research, Society and Development, [S. l.], v. 10, n. 1, p. e51110112037, 2021. DOI: 10.33448/rsd-v10i1.12037. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/12037. Acesso em: 17 jul. 2024.

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