Banca de QUALIFICAÇÃO: EDER RODRIGUES ARAÚJO

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : EDER RODRIGUES ARAÚJO
DATE: 22/12/2024
TIME: 09:00
LOCAL: remoto
TITLE:

EFFECTS OF NON-INVASIVE VENTILATION WITH DIFFERENT MODALITIES IN PATIENTS UNDERGOING HEART SURGERY: A RANDOMIZED CONTROLLED CLINICAL TRIAL.

KEY WORDS:

Non-invasive ventilation. Cardiac surgery. lung function.

PAGES: 38
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Introduction: The cardiac surgical procedure leads to a reduction in respiratory muscle strength. To restore it, certain strategies must be employed. Physiotherapy uses resources and techniques such as deep breathing stimulation, tone stimulation, use of incentive spirometers, mobilization and ambulation. However, sometimes these resources and techniques may prove to be insufficient, and additional measures are used, such as Non-Invasive Ventilation (NIV). Non-invasive positive pressure ventilation (NIPPV) has been used to accelerate the recovery of lung function, as well as to prevent and treat postoperative pulmonary complications. NIV decreases the risk of ventilator-associated complications due to its non-invasive nature. Consequently, NIV was adopted to avoid post-extubation complications in patients after cardiac surgery. Objective: To conduct a planned clinical trial and evaluate the effectiveness of NIV compared to conventional physiotherapy in terms of pulmonary complication rates among patients undergoing cardiac surgery in a selected hospital in Campina Grande, Paraíba, Brazil. Methods: This is a randomized controlled, double-blind clinical trial (patient, analyst) that proposes the intervention using the BIPAP group of NIV BIPAP modality in a group with usual physiotherapy care and in the CPAP group of NIV CPAP modality in a group with usual physiotherapy care and the control group with only usual physiotherapy care. The outcomes observed will be: assessment between NIV modalities, spirometry, lung capacity and vital signs. Secondary outcomes included are degree of satisfaction using the global perception of change scale, and MIF – measure of functional independence and blood gas parameters. The normality of the variables will be assessed using the Shapiro-Wilk test. Student's t-test for paired samples will be used to compare data before and after the intervention. The effect of NIV (CPAP or BIPAP) plus usual physiotherapy treatment over time will be compared between groups via two-way analysis of variance (ANOVA). In addition, we will use analysis of covariance (ANCOVA), as a supporting analysis, to compare differences between groups after the intervention, adjusting for values of the respective results at baseline. The effect size will be calculated using Cohen's d. Continuous variables will be reported as a mean ± standard deviation (SD) and 95% confidence interval (95% CI), and categorical variables will be presented in absolute frequencies and percentages. The significance level will be set at 5% for all analyzes (p ≤ 0.05). The work was registered at clinicaltrials: NCT05966337 and at the research ethics committee: CAAE: 65600722.1.0000.5187. Expected results: It is expected that the results of this research can contribute to the verification of NIV in surgical cardiac patients in clinical practice, pointing out the best trend of modality for use. The research is already in the initial collection phase (pilot study), with initial data already available, but without definition with data still insufficient for a more precise analysis. 

COMMITTEE MEMBERS:
Externo ao Programa - 2419223 - GERSON FONSECA DE SOUZA - nullPresidente - 1632408 - PATRICIA ANGELICA DE MIRANDA SILVA NOGUEIRA
Externa à Instituição - ZÊNIA TRINDADE DE SOUTO ARAÚJO