Conforto e nível de satisfação da máscara de mergulho adaptada em relação à máscara orofacial convencional em pacientes no pós-operatório de cirurgia cardíaca.

Abstract

Background: Cardiovascular diseases are among the conditions with the highest mortality in the world, and cardiac surgeries (CC) have increased the survival rate of this population. Non-invasive ventilation (NIV) is widely used in the postoperative period (PO), however, with the Covid-19 pandemic, it was necessary to implement safer interfaces that avoid greater aerosolization. The study aimed to evaluate the comfort and satisfaction level of the adapted diving mask (Owner Mask) in relation to the conventional orofacial mask as an alternative for the institution of NIV in patients in the PO of SC. Methods: Randomized clinical trial that evaluated PO patients admitted to the intensive care unit (ICU). The sample was allocated to the Orofacial Group (GOF) and the Owner Group (GOW) and analyzed for clinical, sociodemographic and anthropometric data. Pain was assessed using the Visual Analog Pain Scale (VAS) and the perception of dyspnea using the Modified Borg Scale. NIV was instituted in BiPAP mode for 30 minutes. The adverse effects of the use of masks were evaluated using a specific questionnaire and satisfaction with their use, using the Global Perception of Change Scale, before discharge from the ICU. Data normality assessed using the Kolmogorov Smirnov test and the comparison of outcomes between groups using the Student t test. The Chi-Square test compared the proportions of the categorical variables studied and the Mann-Whitney Utest evaluated the distributions of continuous variables (p<0.05). Results: Sample composed of 47 patients (GOF: n= 25 and GOW: n= 22) (male sex: n= 29) with a mean age of 62±10 years. There was no difference between vital signs, pain perception and dyspnea between the moments before and after NIV. There was no difference in the occurrence of pain in the forehead (p=0.871), in the nose (p=0.871), in the cheek (p=0.364), leakage in the eyes (p=0.069) and in the mouth (p=0.079), dryness nasal (p=0.793), mouth and throat (p=0.781), pressure (p=0.767), skin irritation (p=0.364) and claustrophobia (p=0.325) among the groups analyzed, and, in in both groups no patient reported pain in the chin. There was no difference between the groups regarding the level of satisfaction (p=0.454) and comfort of the mask (p=0.297), with a strong and positive correlation being observed regarding the level of satisfaction and the comfort of the mask in the GOF ( r=0712; p<0.001). Conclusion: The adapted diving mask proved to be a viable and effective alternative for the application of NIV in the PO of CC, having presented similar levels of comfort and satisfaction level in relation to the orofacial mask, in addition to not having evidenced severe levels of discomfort or adverse effects that make its use unfeasible.