Sitting obese patient on the bedside during spontaneous breathing trial as physiological instruments for improvement of gas exchange and orotracheal extubation
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2025.215101Keywords:
Case report, Sitting position, Extubation, Ventilator weaning, Intensive Care UnitAbstract
Background: One of the factors that can increase the risk of weaning failure is the presence of atelectasis that reduces oxygenation and leads to increased respiratory muscle work, which can be treated by lung expansion strategies, when reversible. Objective: To describe the evolution of ventilatory weaning of a patient in the postoperative period of neurological surgery with bad gas exchanges due to probable alveolar hypoventilation, which was benefited by the strategies of verticalization and spontaneous breathing for pulmonary expansion instead of alveolar recruitment . Case description: An obese 57-year-old man who was in the ventilatory process after neurological surgery. He had bad gas exchanges due to alveolar hypoventilation which was benefited by the strategies of verticalization(training of sit on the bedside and orthostasis) and spontaneous breathing for pulmonary expansion instead of alveolar recruitment. Outcomes: After carrying out the mobilization strategies carried out and spontaneous breathing, there was improvement of the exchanges and the maintenance of the other criteria of aptitude for satisfactory weaning(partial oxygen pressure-PaO2/inspired oxygen fraction-FiO2 > 150). This way, the team chose to evolve with orotracheal extubation in sitting position, which was performed without complications. Conclusion: These interventions promoted improvement of gas exchange and facilitated the process of orotracheal extubation of a patient in the postoperative period of neurological surgery, without the need for more harmful interventions such as alveolar recruitment and unnecessary exposure to high positive pressures.
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Copyright (c) 2025 Manuella Franco Cerqueira da Silva, Jônatas Santos da Conceição, Fabiano Gomes Miranda Pereira, Helder Brito Duarte, Mansueto Gomes Neto, Bruno Prata Martinez
This work is licensed under a Creative Commons Attribution 4.0 International License.
