Desenvolvimento de modelo para simulação de sistema de aspiração endotraqueal em modo contínuo ou intermitente

Abstract

Endotracheal Suctioning is a clinical resource commonly used for the bronchial hygiene of patients under artificial ventilation that can lead to several complications and even death. Seeking to minimize damage to the simulated patient during this process, this work proposes a new procedure, where intermittent suctioning is used. When intermittent suctioning is used, it is expected that a smaller volume of air will be removed from the simulated patient, resulting in a lower pressure drop. Considering the importance of assessing the impact of the Mechanical Ventilation-Suctioning interaction on the respiratory system, one of the objectives of this work is the validation of a computational model of a closed tracheal suctioning system. For that, the pressures obtained by the computational model were compared to those resulting from suctioning in a physical lung model, using combinations of different sizes of catheters, orotracheal tubes and ventilatory and suctioning pressures. The difference between the alveolar pressures obtained with the computational and physical models was not higher than 0.3 cmH2O; with a correlation between the signals greater than 0.999. Therefore, the computational model was considered adequate for the alveolar mechanical representation in the proposed condition. With the validated digital model, a suctioning with parameters of 4 type of simulated patients was implemented (one healthy, one with restrictive disease, one with obstructive disease and one critical with both diseases) and the simulation with continuous suctioning was compared with intermittent suctioning. When comparing continuous and intermittent suctioning, there was an improvement in simulated patients with respiratory diseases where a higher mean alveolar pressure and a lower maximum pressure drop during suctioning in these patients were obtained.