Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942004000100004
Brazilian Journal of Anesthesiology
Scientific Article

Umidificação e aquecimento do gás inalado durante ventilação artificial com baixo fluxo e fluxo mínimo de gases frescos

Inhaled gases humidification and heating during artificial ventilation with low flow and minimal fresh gases flow

Susane Bruder Silveira Gorayb; José Reinaldo Cerqueira Braz; Regina Helena Garcia Martins; Norma Sueli Pinheiro Módolo; Giane Nakamura

http://dx.doi.org/10.1590/S0034-70942004000100004 Braz J Anesthesiol, vol.54, n1, p.20-36, 2004
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Resumo

JUSTIFICATIVA E OBJETIVOS: Em pacientes sob intubação traqueal ou traqueostomia, a umidificação e o aquecimento do gás inalado são necessários para a prevenção de lesões no sistema respiratório, conseqüentes ao contato do gás frio e seco com as vias aéreas. O objetivo da pesquisa foi avaliar o efeito do sistema respiratório circular com absorvedor de dióxido de carbono do aparelho de anestesia Cícero da Dräger, quanto à capacidade de aquecimento e umidificação dos gases inalados, utilizando-se fluxo baixo (1 L.min-1) ou mínimo (0,5 L.min-1) de gases frescos. MÉTODO: O estudo aleatório foi realizado em 24 pacientes, estado físico ASA I, com idades entre 18 e 65 anos, submetidos à anestesia geral, utilizando-se a Estação de Trabalho Cícero da Dräger (Alemanha), para realização de cirurgias abdominais, os quais foram distribuídos aleatoriamente em dois grupos: grupo de Baixo Fluxo (BF), no qual foi administrado 0,5 L.min-1 de oxigênio e 0,5 L.min-1 de óxido nitroso e fluxo mínimo (FM), administrando-se somente oxigênio a 0,5 L.min-1. Os atributos estudados foram temperatura, umidade relativa e absoluta da sala de operação e do gás no sistema inspiratório. RESULTADOS: Os valores da temperatura, umidade relativa e umidade absoluta no sistema inspiratório na saída do aparelho de anestesia e junto ao tubo traqueal não apresentaram diferença significante entre os grupos, mas aumentaram ao longo do tempo nos dois grupos (BF e FM), havendo influência da temperatura da sala de operação sobre a temperatura do gás inalado, nos dois grupos estudados. Níveis de umidade e temperatura próximos dos ideais foram alcançados, nos dois grupos, a partir de 90 minutos. CONCLUSÕES: Não há diferença significante da umidade e temperatura do gás inalado utilizando-se baixo fluxo e fluxo mínimo de gases frescos.

Palavras-chave

EQUIPAMENTOS, EQUIPAMENTOS, TÉCNICAS ANESTÉSICAS, Geral, TÉCNICAS ANESTÉSICAS, Geral

Abstract

BACKGROUND AND OBJECTIVES: Inhaled gas humidification and heating are necessary in patients under tracheal intubation or tracheostomy to prevent damage to respiratory system resulting from the contact of cold and dry gas with the airways. This study aimed at evaluating the effect of respiratory circle systems with carbon dioxide absorbers from Dräger's Cicero anesthesia machine (Germany) as to inhaled gases heating and humidification ability using low fresh gases flow (1 L.min-1) or minimum flow (0.5 L.min-1).
METHODS: Participated in this study, 24 patients, physical status ASA I, aged 18-65 years, submitted to general anesthesia using Dräger's Cicero workstation (Germany) for abdominal surgery, who were randomly distributed in two groups: low flow group (LF) received 0.5 L.min-1 oxygen and 0.5 L.min-1 nitrous oxide, and minimum flow group (MF) received 0.5 L.min-1 oxygen only. Evaluated attributes were temperature, relative and absolute humidity of the operating room and of respiratory circuit gas.
RESULTS: There were no significant differences in inhaled gas temperature, relative and absolute humidity between groups, but they have increased along time in both groups, with influence of operating room temperature on inhaled gas temperature for both groups. Near optimal levels of humidity and temperature were reached as from 90 minutes in both groups.
CONCLUSIONS: There have been no significant differences in inhaled gas humidity and temperature with fresh gases low flow or minimum flow.

Keywords

ANESTHETIC TECHNIQUES, General: inhalational, low flow; EQUIPMENTS: anesthesia machine, CO2 absorber

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