Learning tool for mechanical ventilation during spontaneous breathing test on patients intoxicated with pesticides

Abstract

Organophosphorus compounds (OC) are widely used as pesticides and produce neuromuscular compromise after acute exposure causing paralysis in rib cage muscles. Given the acute respiratory failure in these patients, it is necessary to provide assistance for breathing with mechanical ventilation. According to the World Health Organization, about 20% of poisonings in the world involves organophosphate pesticides [1]. The management of this kind of patient is difficult due to the lack of information concerning the evolution of poisoning and the long time under mechanical ventilatory support. The flaw in determining the ideal moment for patient disconnection of ventilator, not only increases the time attendance but also the probability of death [2]. Therefore, the development of tools to facilitate the dissemination of knowledge about the effect on ventilatory mechanics of poisoning with these compounds contributes significantly to patient treatment. This article describes a learning tool on effect of intoxication over the mechanical ventilation, through of the interaction with different clinical cases of poisoned patients under mechanical ventilation. This tool allows knowing different variables (heart rate, respiratory rate, arterial blood pressure, rapid shallow breathing index, Richmond agitation sedation scale index, PaO2, PaCO2, QT interval, corrected QT interval) that are important in decisions-making during the spontaneous breathing tests.