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J. bras. pneumol. vol.30 número6

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(1)

596

Traqueostomia percutânea no doente crítico: a experiência

de uma unidade de terapia intensiva clínica

Ag ra d e ce m o s a o s Drs Te d d e e J a t e n e p e la

a t e n ç ã o d i s p e n s a d a n a l e i t u r a d e n o s s a

ca su íst ica , e p rin cip a lm e n t e p e la p re o cu p a çã o

e c r í t ic a c o m r e la ç ã o a in t e r p r e t a ç ã o d o s

n o sso s d a d o s.

(1 )

Em re la çã o a o s cu id a d o s co m a ve n t ila çã o

m e c â n i c a e h e m o d i n â m i c a d u r a n t e o

p ro ce d im e n t o , n o ssa a t e n çã o f o i n o se n t id o

d e e vit a r p e río d o s d e h ip o ve n t ila çã o e a u t o

P E E P e x t r e m o c o m s u a s r e s p e c t i v a s

co n se q ü ê n cia s.

(2 ,3 )

O e sp a ço e n t re o se g u n d o

e o t e r c e ir o a n é is e r a p u n c io n a d o p a r a a

in s e r ç ã o d a c â n u la d e t r a q u e o s t o m ia , c o m

d isse cçã o d ig it a l p ré via p a ra a f a st a m e n t o d o

ist m o d a t ire o id e .

(4 )

Qu a n t o a f a ct ib ilid a d e e

b o n s r e s u lt a d o s a c u r t o e m é d io p r a z o d a

t é cn ica , sã o ca ra ct e ríst ica s d a n o ssa ca su íst ica

e t a m b é m p re se n t e s n a lit e ra t u ra ,

(5 ,6 )

in clu sive

e m s it u a ç õ e s e s p e c ia is o n d e a t r a q u é ia s e

e n c o n t r a e m p la n o s m a is p r o f u n d o s .

(7 )

Os

re su lt a d o s e m p ra z o s m a io re s q u e 1 a n o a in d a

n ã o sã o b e m d e f in id o s, m a s é in t e re ssa n t e

sa b e r q u e e m b re ve t e re m o s m a is re sp o st a s

s o b r e o s r e s u lt a d o s t a r d io s d a t é c n ic a d a

t ra q u e o st o m ia p e rcu t â n e a .

MARCELO PARK, LUCIANO C. P. AZEVEDO

Médicos Assist en t es - UTI Clín ica - HCFMUSP

REFERÊNCIAS

1 . Park M, Brau er L, San g a RR, Am aral ACKB, Lad eira J P, Az e ve d o LCP, Ta n ig u c h i LU, a n d Cr u z Ne t o LM . Tr a q u e o s t o m i a p e r c u t â n e a n o d o e n t e c r i t i c o : a exp eriên cia d e u m a u n id a d e d e t era p ia in t en siva clín ica . J BP 3 0 , 2 3 7 - 2 4 2 . 2 0 0 4 .

2 . Lapin sky SE, Leu n g RS. Au t o- PEEP an d elect romechan ical dissociat ion . N. En gl. J. Med. 1996; 335: 674. 3 . Re illy P M, An d e rso n HL, III, Sin g RF, Sc h w a b CW,

Ba r t le t t RH. Oc c u lt h yp e r c a r b ia . An u n r e c o g n iz e d p h e n o m e n o n d u r i n g p e r c u t a n e o u s e n d o s c o p i c t ra ch e o st o m y. Ch e st 1 9 9 5 ; 10 7 : 1 7 6 0 - 3 .

4 . Do lln er R, Verch M, Sch weig er P, Gra f B, Wa lln er F. Lo n g - t e r m o u t c o m e a f t e r Gr ig g s t ra c h e o s t o m y. J . Ot o la ryn g o l. 2 0 0 2 ; 31 : 3 8 6 - 9 .

5 . Wa lz MK, Peit g en K, Th u ra u f N, Tro st HA, Wo lfh a rd U, Sa n d e r A, Ah m a d i C, Eig le r FW. Pe rc u t a n e o u s d ila t a t io n a l t ra ch eo st o m y—ea rly resu lt s a n d lo n g - t erm o u t co m e o f 3 2 6 crit ica lly ill p a t ien t s. In t en sive Ca re Med . 1 9 9 8 ; 2 4 : 6 8 5 - 9 0 .

6 . Ga m b a le G, Ca n c e llie r i F, Ba ld in i U, Va c c h i SM , B a r o n c i n i S , F e r r a r i F, P e t r i n i F. C i a g l i a p e r c u t a n e o u s d ila t io n a l t ra c h e o s t o m y. Ea r ly a n d l a t e c o m p l i c a t i o n s a n d f o l l o w - u p . M i n e r v a An e s t e s io l. 2 0 0 3 ; 6 9 : 8 2 5 - 3 0 .

Referências

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