Efeitos da higienização brônquica nas variáveis cardiorrespiratórias de pacientes em ventilação mecânica

INTRODUCTION: During mechanical ventilation (MV), the airways may accumulate secretions. Patients are submitted to Respiratory Therapy (RT) and tracheal aspiration when in MV, alone or associated, to eliminate these secretions. OBJECTIVE: The objective was to compare the effects of different protocols of bronchial hygiene in blood pressure, heart rate, oxygen saturation and respiratory rate of patients undergoing MV. MATERIALS AND METHODS: We conducted a prospective, randomized, controlled crossover, with intentional non-probabilistic sample in the Medical School Hospital of Marília. We included patients in invasive MV who were submitted to three different bronchial hygiene protocols: PP - physiotherapy protocol (manual chest compression and manual hyperinflation); AP - aspiration protocol; and PP + AP. Respiratory rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen saturation and heart rate were evaluated in three moments: before (M1), immediately after (M2) and 30 minutes after (M3) for each protocol. The differences among protocols and times were assessed using ANOVA and post hoc Student Newman-Keus (p < 0.05). RESULTS: We studied eighteen 71.2 ± 13.9 year-old patients with 15.1 ± 17.7 days of MV. There were no differences among protocols. There was a significant decreasing in SBP (p = 0.0261) and DBP (p = 0.0119) from M2 to M3 in the aspiration protocol. CONCLUSION: There was a decrease of blood pressure on MV patients after 30 minutes of aspiration and no change in the other variables, and there was no difference among protocols.

Effect of different methods of cutting fluid application on turning of a difficult-to-machine steel (SAE EV-8)

In this study, different methods of cutting fluid application are used in turning of a difficult-to-machine steel (SAE EV-8). Initially, a semisynthetic cutting fluid was applied using a conventional method (i.e. overhead flood cooling), minimum quantity of cutting fluid, and pulverization. A lubricant of vegetable oil (minimum quantity of lubricant) was also applied using the minimum quantity method. Thereafter, a cutting fluid jet under high pressure (3.0 MPa) was singly applied in the following regions: chip-tool interface, top surface of the chip (between workpiece and chip) and tool-workpiece contact. Moreover, two other methods were used: an interflow between conventional application and chip-tool interface jet (combined method) and, finally, three jets simultaneously applied. In order to carry out these tests, it was necessary to set up a high-pressure system using a piston pump for generating a cutting fluid jet, a venturi for fluid application (minimum quantity of cutting fluid and minimum quantity of lubricant) and a nozzle for cutting fluid pulverization. The output variables analyzed included tool life, surface roughness, cutting tool temperature, cutting force, chip form, chip compression rate and machined specimen microstructure. Among the results, it can be observed that the tool life increases and the cutting force decreases with the application of cutting fluid jet, mainly when it is directed to the chip-tool interface. Excluding the methods involving jet fluid, the conventional method seems to be more efficient than other methods of low pressure, such as minimum quantity of volume and pulverization, when considering just the cutting tool wear. © 2013 IMechE.

Different methods of cutting fluid application on turning of a difficult-to-machine steel

Different methods of cutting fluid application are used on turning of a difficult-tomachine steel (SAE EV-8). A semi-synthetic cutting fluid was applied using a conventional method, minimum quantity of cutting fluid (MQCF), and pulverization. By the minimum quantity method was also applied a lubricant of vegetable oil (MQL). Thereafter, a cutting fluid jet under high pressure (3.0 MPa) was singly applied in the following regions: chip-tool interface; top surface of the chip; and tool-workpiece contact. Two other methods were used: an interflow between conventional application and chip-tool interface jet and, finally, three jets simultaneously applied. In order to carry out these tests, it was necessary to set up a high pressure system using a piston pump for generating a cutting fluid jet, a Venturi for fluid application (MQCF and MQL), and a nozzle for cutting fluid pulverization. The output variables analyzed included tool life, surface roughness, cutting tool temperature, cutting force, chip form, chip compression rate and machined specimen microstructure. It can be observed that the tool life increases and the cutting force decreases with the application of cutting fluid jet, mainly when it is directed to the chip-tool interface. Excluding the methods involving jet fluid, the conventional method seems to be more efficient than other methods of low pressure. © (2013) Trans Tech Publications, Switzerland.

Avaliação dos efeitos de diferentes manobras de fisioterapia respitatória no desfecho de pacientes ventilados mecanicamente

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Fisioterapia respiratória, pressão intra-abdominal e função renal de pacientes de terapia intensiva

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Chest associated to motor physiotherapy acutely improves oxygen saturation, heart rate and respiratory rate in premature newborns with periventricular-intraventricular hemorrhage

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)