Novo dispositivo EPAP subaquático no pós-operatório de cirurgia de revasculariza？？o do miocárdio

introduction: the prevalence of cardiac surgery is high and results in high costs due to secondary complications. the main complications are pulmonary changes. respiratory therapy plays a relevant role in surgical interventions, working in the removal of pulmonary secretions and lung reexpansion, by treating with positive end expiratory pressure (peep). objectives: to describe a new underwater peep device, in order to revert atelectasis and post-surgery complications in patients submitted to myocardium revascularization surgery (mr). materials and methods: the device was tested on a small sample set, non-probabilistic and deliberated, composed by 17 patients, hospitalized in the coronary unit of the cardiology institute of santa catarina, in s？o josé, brazil, aged between 55-65 years old, post wean of post-surgery mechanical ventilation, conscious, orientated and in contact, with cognitive system preserved and without oral-facial physical deformities. the following parameters were measured: oxygen saturation (spo2) and heart rate, forced expiratory volume in the first second (evf1), forced vital capacity (fvc), maximal expiratory flow (mef) or peak flow (pef), diastolic and systolic blood pressure. also, it was performed pulmonary auscultation and measured respiratory frequency. it was also assessed thoracic radiographic images, main complain and volume of expectoration. results: spirometric data did not show statistical significance but the vital signs remained normal. conclusion: underwater peep improves oxygen saturation and removal of secretions through collateral ventilation and expectoration; optimizes pulmonary auscultation; reduces the main complaint, "pain", increasing progressively thoracic mobility. besides, it reverts atelectasis, becoming essential in the treatment of respiratory post-operative mr alterations.