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Previous issue date: 2013-03-25 / Introduction: Septic shock is one of the greatest health problems worldwide, affecting millions of people a year. It presents as a continuum of infectious events and interactions between pathogens caused by the relationship between apoptotic, anti-inflammatory and inflammatory mediators, generating tissue hypoxia, hypovolemia, and increased oxidative stress. Respiratory physiotherapy can help increase oxygenation and improve gas exchanges. The purpose of this study was to evaluate the immediate effect of respiratory physiotherapy on hemodynamic, metabolic, inflammatory and oxidative stress parameters in patients with septic shock. Methods: Before and after quasi-experimental study in thirty patients in septic shock, who underwent respiratory physiotherapy, without associated heart diseases and with vasopressors less than 0.5 mL/Kg/min. Venous and arterial blood gas, clinical and hemodynamic data, inflammatory data, lactate and oxidative stress were evaluated before and 15 minutes after physiotherapy. Results: Thirty patients with a mean age of 61.77?15.91 years and SOFA of 7.9?3.1 were included. Respiratory physiotherapy caused a reduction of pH (p=0.003), PaCO2 (p=0.009), lactate (p=0.0002) and TBARS (p=0.04) and an increase of PaO2 (p=0.026), SaO2 (p=0.018) and PaO2/FiO2 (p=0.04) ratio, 15 minutes after it was applied. Conclusion: The results indicate that respiratory physiotherapy has immediate effects, improving oxygenation, reducing lactate and oxidative damage in patient in septic shock. However, it does not cause alterations in the inflammatory and hemodynamic parameters. / Introdu??o: O choque s?ptico ? um dos maiores problemas de sa?de no mundo, afetando milh?es de pessoas a cada ano. Ele se apresenta como uma continuidade de eventos infecciosos e intera??es entre pat?genos causadas pela rela??o entre mediadores apopt?ticos, anti-inflamat?rios e inflamat?rios, gerando hip?xia tecidual, hipovolemia e aumento do estresse oxidativo. A fisioterapia respirat?ria pode promover aumento da oxigena??o e melhora das trocas gasosas, oferecendo uma demanda de oxig?nio ? via aer?bica. Objetivos: Avaliar o efeito imediato da fisioterapia respirat?ria sobre os par?metros hemodin?micos, metab?licos, inflamat?rios e de estresse oxidativo em pacientes com choque s?ptico. M?todos: Estudo quasi-experimental, do tipo antes e depois. Foram inclu?dos pacientes com choque s?ptico e que realizaram fisioterapia respirat?ria, sem cardiopatias associadas e com vasopressores inferiores a 0,5 mL/Kg/min. Foram avaliados gasometria venosa e arterial, dados cl?nicos e hemodin?micos, inflamat?rios, lactato e estresse oxidativo antes e 15 minutos ap?s a fisioterapia. Resultados: Participaram do estudo 30 pacientes com m?dia de idade de 61,77?15,91 anos e SOFA de 7,9?3,1. A fisioterapia respirat?ria provocou uma diminui??o na pH (p=0,003), PaCO2 (p=0,009), lactato (p=0,0002) e TBARS (p=0,04) e aumento na PaO2 (p=0,026), SaO2 (p=0,018) e rela??o PaO2/FiO2 (p=0,04) 15 minutos ap?s a sua aplica??o. Conclus?o: Os resultados indicam que a fisioterapia respirat?ria provoca efeitos imediatos, melhorando a oxigena??o, diminuindo o lactato e o dano oxidativo em pacientes com choque s?ptico, por?m sem provocar altera??es nos par?metros inflamat?rios e hemodin?micos
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/1735 |
| Date | 25 March 2013 |
| Creators | Santos, Rafael Saldanha dos |
| Contributors | Oliveira, Jarbas Rodrigues de |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de, PUCRS, BR, Faculdade de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 7620745074616285884, 500, 600, -8624664729441623247 |
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