DPOC Exacerbada Flashcards

1
Q

Definiçao

A

Piora aguda dos sintomas respiratorios que necessita aumento do tto habitual

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2
Q

Causa mais comum de exacerbação

A

Infecçao

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3
Q

Clinica

A
  • aumento do vol de expectoraçao
  • Escarro amarelo ou verde
  • Piora da dispneia
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4
Q

Etiologias

A
  1. Infecçao Viral
  2. Infecçao Bac
  3. Nao infecciosas: Alergenos, RGE, x TTO
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5
Q

FR

A
  • Exacerbaçao previa
  • DRGE
  • Maior idade
  • Diminuiçao da F. Pulmonar
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6
Q

Indicaçao de Internaçao

A
  • IRA
  • Piora dispneia
  • Cor pulmonale
  • x rta tto
  • comorbidades
  • x suporte social
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7
Q

UCI

A
  • Dispneia intensa
  • Alt. mental
  • Hipoxemia/acidose cm tto
  • VM
  • Instabilidade HD
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8
Q

TTO- Oxigeno

A
  • Meta Sat 88-92%
  • Vol Max 3L/min
  • Evitar carbonarcose
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9
Q

TTO- VNI

A
  • Acidose respiratoria
  • Dispneia c/ s/s de esforço respiratorio
  • Hipoxemia persistente
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10
Q

TTO- VM

A
  • Falha VNI
  • Alt. HD
  • Dim. COnsciencia
  • Vomito ou broncoaspiraçao
  • Secreçao abundante
  • Arritmia
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11
Q

Parametros da VM no D.E.

A
  • FR: 8-12
  • Fi 02: 65-80
  • Vol. Corr: 6ml/Kg ideal
  • Fluxo inspiratorio Alto
  • I:E- 1:3
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12
Q

TTO fcologico

A
  • SABA+SAMA + TTO BASE(long action)
  • CTC sistemico
  • ATB de acordo a +-F.R.
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13
Q

ATB s/ FR c/ VEF1>50

A

-Cefuroxima
-Azitromicina
-Claritromicina
VO

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14
Q

ATB c/ FR OU VEF1 <50

A
  • Quinolonas

- Amoxi-Clavu

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15
Q

ATB- pcte internado

A

Cefalosporina 3/4G + Macrolideo OU

Quinolona

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16
Q

ATB- Suspeita Pseudomona

A

Piper-Tazo

17
Q

Cuando solicitar cultura de escarro?

A
  • Exacerbaçoes frequentes
  • vm/vni
  • Aumento da limitaçao
18
Q

Mecanismo da carbonarcose

A

Aumento da oferta de oxigenio suprime o centro respiratorio que diminui a FR e aumenta concentraçao de CO2

19
Q

FR. para uso de ATB

A
  • > 65a
  • DN
  • Disp. Grave
  • DM
  • IR/ IH
  • > 4 exa. ultimo ano
  • Uso recente de atb
  • Hospitalizaçao ano anterior
  • CTC 3 meses