Avaliação da repercussão hemodinâmica da ventilação não invasiva como terapia de expansão pulmonar em recém-nascidos pré-termos

Abstract

Introduction: Premature infants present cardiopulmonary instability predisposing to the need for non-invasive ventilatory support (NIV), which may influence cardiovascular homeostasis. Objective: To evaluate the hemodynamic repercussion of NIV as pulmonary expansion therapy in preterm newborns. Methods: The pilot study included neonates of gestational age from 26 to 37 weeks, birth weight <2,500 g, under hood oxygen therapy or in ambient air. The participants were submitted to NIV as respiratory therapy while hemodynamic variables were evaluated by echocardiography and transcranial ultrasonography before, at 5 minutes during and 30 minutes after the therapy. Results: Eight participants from the preterm newborns group participated in the study, six with diagnosis of respiratory distress syndrome, presented respiratory pattern variations and cardiovascular variables during NIV at clinically acceptable values. During therapy, the lowest values observed on the right ventricle and left and the resistance index (RI) of the pericalosa cerebral artery were 113 ml/kg/min, 90 ml/kg/min and 0.66, respectively. Conclusion: There was a trend of reduction in ventricular debit and a little variation of cerebral blood flow during NIV, with no clinical relevance in this sample.