Evaluation of transoperatory ventilation modalities by a questionnaire

2010 
Summary Background and objectives Anesthesia devices have been making it possible to reduce the physiological repercussions and problems caused by mechanical ventilation. The objective of this study was to evaluate, retrospectively, ventilatory methods and support resources used by a group of anesthesiologists in patients without prior lung damage in the intraoperative period. Methods A non-identifiable questionnaire composed of 27 questions was applied to a group of anesthesiologists and anesthesiology residents who work at different private hospitals in the city of Sao Paulo. The questionnaires were applied over a 15-day period. Ventilation patterns, positive end-expiratory pressure (PEEP), alveolar recruitment maneuvers, and the calculation of the tidal volume used with tracheal intubation were observed. Results Participants were predominantly males, 40.5% bearing the Anesthesiology Superior Title (TSA), and the majority concluded their residency less than 10 years ago. Most anesthesiologists used PEEP, between 5 and 10 cmH 2 O, routinely. Fresh gas flow above 1,000 mL.min -1 is still used by most anesthesiologists. Alveolar recruitment maneuvers were performed by 80% of those interviewed, shortly after intubation and before removing the ET tube with the most common strategy insufflation with 40 cmH 2 O for 15 seconds. As for strategies to protect ventilation, only 30% used a tidal volume with less than 7 mL.kg -1 with inspired oxygen fraction between 40% and 60%. Conclusions This descriptive study allows us to state that in the hospitals evaluated the majority of anesthesiologists uses resources to minimize eventual repercussions of controlled mechanical ventilation. This data can orient the development of continuing medical education programs in mechanical ventilation associated with anesthesia aiming to safety and improvement of patient care.
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