Ventilação mecânica em pacientes com síndrome respiratória aguda grave durante a pandemia influenza A (H1N1)

Abstract

During Influenza A (H1N1) pandemic, patients who had severe acute respiratory syndrome (SARS) needed intensive care. The objective of this study was to evaluate mechanical ventilation (MV) application in patients with SARS in a intensive unit care (ICU) of Belo Horizonte. It was also evaluated the profile of disease, accessibility and integration between levels of care of these patients. Nine men and six women received non invasive mechanical ventilation (NIMV), of which 60% had a positive result to Influenza A (H1N1) diagnoses? and were discharged of hospital. Clinic-demographic, laboratorial, gasometric and ventilatory variables were analyzed. There was statistically significant relationship between death and high scores of APACHE II (p=0.04). From patients who received only NIMV, all were discharged of hospital. There was no statistically correlation between laboratorial variables and clinical outcome. There was pH increase (p= 0.001) and CO2 pressure decrease (p= 0.002) after NIMV application. When compared to invasive mechanical ventilation (IMV), NIMV had smaller ICU stay (p=0,024) and hospital stay (p=0,039). Patients who received IMV were interviewed about symptoms of hospital entry, comprehensive care and daily activities realization. It was observed fever (100%), productive cough (59%) and dyspnoea (66%) in all patients. The first place of care was emergency units (59%) and basic health units (29,4%). 68% of patients consult only in single health system (SHS) and 6% had accompaniment of service family system program after discharge of hospital. Two years after discharge of hospital, 17,6% of patients were not able to do their daily activities. It was concluded that NIMV had satisfactory gasometric values and clinical outcome and the post care of integrated network is still a critical point.