Valor da vibro compressão como método fisioterápico de desobstrução prévia da árvore traqueobrônquica para a coleta de amostra de aspirado traqueal para o diagnóstico etiológico de pneumonia

Abstract

Communitary-acquired pneumonia is the main infectious disease around the world, which is responsible for the main cause of hospitalization and death in elderly Brazilians, and the second cause of death in less than 5-year-old children. Hospital-acquired pneumonia is the main cause of death among hospital infections, and pneumonia associated to mechanical ventilation represents an independent factor of mortality to patients in intense care units. The microbiological diagnosis of pneumonia, performed by the culture of pulmonary secretions, has the objective of knowing its etiology and allowing the adequate use of antibiotics. The inadequate antibiotic therapy may interfere on patients prognostics, increasing their mortality rate. The tracheal aspirate, because its practicability and low cost, besides a good co-relation with other ways of collection, is widely used. The vibrocompression is a largely used technique in physiotherapy with the purpose of mobilizing pulmonary secretion. In this paper it was performed a comparison in 50 patients, either intubated or tracheostomized, who were undergone to two collections of their lower airway secretions by means of aspiration. The first collection was without vibrocompression, and the second one after vibrocompression. There was not a significant alteration for the vital data, with or without vibrocompression. There was an increase in the representativeness of the sample collected after vibrocompression. From the samples without vibrocompression, 40% were representative and 60% werent, while from the samples with vibrocompression 58% were representative and 42% werent, with significant level (p<0.05). The sensibility (sufficient secretion to perform laboratory analysis) from the collection of the secretion without vibrocompression observed 46% sufficient and 54% not sufficient. After vibrocompression, 66% were, and 34% were not sufficient, respectively (p<0,05). The significant level of the vibrocompression was observed before the collection of the secretion from the tracheal aspirate in intubated and tracheostomized patients.