Proposta de Definição e Classificação de Insuficiência Respiratória

Autores

DOI:

https://doi.org/10.24950/rspmi.1359

Palavras-chave:

Insuficiência Respiratória/classificação, Síndrome do Desconforto Respiratório/classificação

Resumo

A insuficiência respiratória (IR) não é reconhecida como uma síndrome clínica, com sintomas e sinais característicos, com diferentes estádios de evolução e níveis de gravidade, e com alterações fisiopatológicas dependentes da etiologia, mas apenas como algumas alterações laboratoriais que só se tornam evidentes depois de realizada a gasometria do sangue arterial (GSA). Isto dificulta o seu diagnóstico clínico, sobretudo em fases precoces, impede o seu estudo e compreensão, e não permite que o tratamento adequado seja efetuado no tempo certo, numa elevada percentagem de situações. Além disso dificulta a investigação clínica em diferentes grupos homogéneos de doentes com IR, para melhor compreensão da síndrome e do seu tratamento. A prática clínica demonstra- -nos que temos um conhecimento incompleto sobre IR, sobre a sua abordagem diagnóstica e sobre a sua gestão e tratamento. A IR tem influência direta na qualidade de vida e no prognóstico dos doentes e deve ser considerada uma entidade nosológica, com características clínicas e fisiopatológicas evolutivas próprias, que exigem investigação dedicada visando a sua melhor compreensão e tratamento com o objetivo de alterar o seu curso e melhorar os resultados clínicos.

Downloads

Não há dados estatísticos.

Referências

Roussos C, Koutsoukou A. Respiratory failure. Eur Respir J. 2003; 22:3s14s.

Eui-Sik S, Hart N. Respiratory failure. Medicine. 2012;40: 293-7.

Scala R, Heunks L. Highlights in acute respiratory failure. Eur Respir Rev. 2018;27:180008. doi: 10.1183/16000617.0008-2018.

Luhr OR, Antonsen K, Karlsson M, Aardal S, Thorsteinsson A, Frostell CG, et al. Incidence and mortality after acute respiratory failure and acute respiratory distress syndrome in Sweden, Denmark, and Iceland: The ARF Study Group. Am J Respir Crit Care Med. 1999; 159: 1849-61. doi: 10.1164/ajrccm.159.6.9808136.

Vincent JL, Akça S, De Mendonça A, Haji-Michael P, Sprung C, Moreno R, et al. The epidemiology of acute respiratory failure in critically ill patients(*). Chest. 2002;121:1602-9. doi: 10.1378/chest.121.5.1602.

Pham T, Pesenti A, Bellani G, et al. Outcome of acute hypoxaemic respiratory failure: insights from the LUNG SAFE Study. Eur Respir J. 2021; 57: 2003317 doi: 10.1183/13993003.03317-2020].

Ferrer M, Esquinas A, Leon M, Gonzalez G, Alarcon A, Torres A. Noninvasive ventilation in severe hypoxemic respiratory failure: a randomized clinical trial. Am J Respir Crit Care Med. 2003;168:1438-44. doi: 10.1164/ rccm.200301-072OC.

Lemiale V, Mokart D, Resche-Rigon M, Pène F, Mayaux J, Faucher E, et al. Effect of Noninvasive Ventilation vs Oxygen Therapy on Mortality Among Immunocompromised Patients With Acute Respiratory Failure: A Randomized Clinical Trial. JAMA. 2015;314:1711-9. doi: 10.1001/ jama.2015.12402.

Ranieri VM, Tonetti T, Navalesi P, Nava S, Antonelli M, Pesenti A, et al. High-Flow Nasal Oxygen for Severe Hypoxemia: Oxygenation Response and Outcome in Patients with COVID-19. Am J Respir Crit Care Med. 2022;205:431-9. doi: 10.1164/rccm.202109-2163OC.

Villar J, Schultz MJ, Kacmarek RM. The LUNG SAFE: a biased presentation of the prevalence of ARDS! Crit Care. 2016;20:108. doi: 10.1186/s13054- 016-1273-x.

Bellani G, Laffey JG, Pham T, Fan E, Brochard L, Esteban A, et al. Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries. JAMA. 2016;315:788-800. doi: 10.1001/jama.2016.0291. Erratum in: JAMA. 2016;316:350. Erratum in: JAMA. 2016;316:350.

Laffey JG, Madotto F, Bellani G, Pham T, Fan E, Brochard L, et al. Geo-economic variations in epidemiology, patterns of care, and outcomes in patients with acute respiratory distress syndrome: insights from the LUNG SAFE prospective cohort study. Lancet Respir Med. 2017;5:627-38. doi: 10.1016/S2213-2600(17)30213-8.

Elshof J, Duiverman ML, Wijkstra PJ. The NIVO score: can it help to improve noninvasive ventilation in daily clinical practice? Eur Respir J. 2021;58:2100336. doi: 10.1183/13993003.00336-2021.

Javaheri S, Sicilian L. Lung function, breathing pattern, and gas exchange in interstitial lung disease. Thorax. 1992;47:93-7. doi: 10.1136/thx.47.2.93.

Bag R, Suleman N, Guntupalli KK. Respiratory failure in interstitial lung disease. Curr Opin Pulm Med. 2004;10:412-8. doi: 10.1097/01. mcp.0000136404.09581.41.

Hook JL, Arcasoy SM, Zemmel D, Bartels MN, Kawut SM, Lederer DJ. Titrated oxygen requirement and prognostication in idiopathic pulmonary fibrosis. Eur Respir J. 2012 ;39:359-65. doi: 10.1183/09031936.00108111.

Gläser S, Noga O, Koch B, Opitz CF, Schmidt B, Temmesfeld B, et al. Impact of pulmonary hypertension on gas exchange and exercise capacity in patients with pulmonary fibrosis. Respir Med. 2009;103:317-24. do 10.1016/j.rmed.2008.08.005.

Decramer M. Treatment of chronic respiratory failure: lung volume reduction surgery versus rehabilitation. Eur Respir J Suppl. 2003;47:47s-56s. doi: 10.1183/09031936.03.00009903.

Budweiser S, Jörres RA, Pfeifer M. Treatment of respiratory failure in COPD. Int J Chron Obstruct Pulmon Dis. 2008;3:605-18. doi: 10.2147/copd. s3814.

Boutou AK, Tanner RJ, Lord VM, Hogg L, Nolan J, Jefford H, et al. An evaluation of factors associated with completion and benefit from pulmonary rehabilitation in COPD. BMJ Open Respir Res. 2014;1:e000051. doi: 10.1136/bmjresp-2014-000051.

ATS/ERS Task Force on Pulmonary Rehabilitation. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188:e13-64. doi: 10.1164/rccm.201309-1634ST. Erratum in: Am J Respir Crit Care Med. 2014;189:1570.

Swenson KE, Ruoss SJ, Swenson ER. The Pathophysiology and Dangers of Silent Hypoxemia in COVID-19 Lung Injury. Ann Am Thorac Soc. 2021;18:1098-105. doi: 10.1513/AnnalsATS.202011-1376CME.

Kallet R, Branson RD, Lipnick MS; Respiratory drive, dyspnea and silent hypoxemia: a physiological review in the context of Coronavirus Disease 19. Respir Care 2022; 10.4187/respcare. 10075 doi:10.4187/respcare.10075.

Parshall MB, Schwartzstein RM, Adams L, Banzett RB, Manning HL, Bourbeau J, et al. An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med. 2012;185:435-52. doi: 10.1164/rccm.201111-2042ST.

Gravelyn TR, Weg JG. Respiratory rate as an indicator of acute respiratory dysfunction. JAMA. 1980;244:1123-5.

Centre for Clinical Practice at NICE (UK). Acutely ill patients in hospital: recognition of and response to acute illness in adults in hospital. London: National Institute for Health and Clinical Excellence (UK); 2007.

Hall JE. Guyton and Hall’s textbook of medical physiology. 13th ed. Amsterdam: Elsevier Inc.; 2016.

Royal College of Physicians. National Early Warning Score (NEWS) 2. Standardising the Assessment of Acute-illness Severity in the NHS. [accessed June 2022] Available at: https://www.rcplondon.ac.uk/file/8636/ download?token=lOf4KLST.

Neff TA. Routine oximetry. A fifth vital sign? Chest. 1988;94:227. doi: 10.1378/chest.94.2.227a.

Chan ED, Chan MM, Chan MM. Pulse oximetry: understanding its basic principles facilitates appreciation of its limitations. Respir Med. 2013;107:789-99. doi: 10.1016/j.rmed.2013.02.004.

Jubran A. Pulse oximetry. Crit Care. 2015;19:272. doi: 10.1186/s13054- 015-0984-8.

Sjoding MW, Dickson RP, Iwashyna TJ, Gay SE, Valley TS. Racial Bias in Pulse Oximetry Measurement [published correction appears in N Engl J Med. 2021;385: 2496]. N Engl J Med 2020; 383: 2477-8.

Sowho M, Amatoury J, Kirkness JP, Patil SP. Sleep and respiratory physiology in adults. Clin Chest Med. 2014;35:469-81. doi: 10.1016/j. ccm.2014.06.002.

Faverio P, De Giacomi F, Bonaiti G, Stainer A, Sardella L, Pellegrino G, et al. Management of Chronic Respiratory Failure in Interstitial Lung Diseases: Overview and Clinical Insights. Int J Med Sci. 2019;16:967-80. doi: 10.7150/ijms.32752.

Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014;44:1428-46. doi: 10.1183/09031936.00150314.

Singh SJ, Puhan MA, Andrianopoulos V, Hernandes NA, Mitchell KE, Hill CJ, et al. An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease. Eur Respir J. 2014;44:1447-78. doi: 10.1183/09031936.00150414.

Gupta R, Ruppel GL, Espiritu JR. Exercise-Induced Oxygen Desaturation during the 6-Minute Walk Test. Med Sci. 2020;8:8. doi: 10.3390/medsci8010008.

Berry RB, Quan SF, Abreu AR, ; for the American Academy of Sleep Medicine. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, Version 2.6. Darien: American Academy of Sleep Medicine; 2020.

Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications. Chest. 2014;146:1387-94. doi: 10.1378/chest.14- 0970.

Böing S, Randerath WJ. Chronic hypoventilation syndromes and sleep-related hypoventilation. J Thorac Dis. 2015;7:1273-85. doi: 10.3978/j. issn.2072-1439.2015.06.10.

Simonds AK. Chronic hypoventilation and its management. Eur Respir Rev. 2013;22:325-32. doi: 10.1183/09059180.00003113.

ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, et al. Acute respiratory distress syndrome: the Berlin definition. JAMA. 2012; 307: doi:10.1001/jama.2012.5669.

Rochwerg B, Brochard L, Elliott MW, Hess D, Hill NS, Nava S, et al. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J. 2017; 50: 1602426. doi: 10.1183/13993003.02426-2016.

Downloads

Publicado

19-12-2022

Como Citar

1.
Martins A, Fernandes M, Maia JM, Cortesão N, Ferrão C, Neves J, Leuschner P. Proposta de Definição e Classificação de Insuficiência Respiratória. RPMI [Internet]. 19 de Dezembro de 2022 [citado 19 de Abril de 2024];29(4):248-55. Disponível em: https://revista.spmi.pt/index.php/rpmi/article/view/1359

Edição

Secção

Artigo de Opinião

Artigos mais lidos do(s) mesmo(s) autor(es)