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Colegio de Medicos y Cirujanos República de Costa Rica

2020, Número 629

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Rev Med Cos Cen 2020; 86 (629)


Soporte ventilatorio no invasivo y posición prono despierto en paciente con COVID-19

Fernández CR, Catarinella GC, Chacón PL

Idioma: Español
Referencias bibliográficas: 31
Paginas: 67-72
Archivo PDF: 121.87 Kb.


RESUMEN

En pacientes con COVID-19 deben considerarse o agotarse opciones de soporte ventilatorio no invasivo previo a colocación de tubo endotraqueal. La ventilación mecánica no invasiva es una forma de provisión de soporte ventilatorio sin intubación endotraqueal que consiste en la entrega de presión positiva mediante una interface externa. Está demostrado que este método de ventilación está asociada a menor riesgo de infecciones nosocomiales, menor uso de antibióticos y menor tiempo de estancia hospitalaria en comparación con ventilación mecánica invasiva. Otra opción, es la cánula nasal de alto flujo, un sistema mediante el cual se le administra al paciente con ventilación espontanea, aire y oxígeno a altos flujos. La implementación temprana de sesiones prolongadas de pronación se asocia con una disminución de la mortalidad en pacientes con síndrome de distrés respiratorio del adulto mediante diversos mecanismos fisiológicos. La combinación de la pronación con soportes respiratorios no invasivos en el SDRA puede dar lugar a mejores efectos fisiológicos sobre el desequilibrio en la relación ventilación / perfusión, un mejor drenaje de secreciones purulentas en el SDRA de causa infecciosa y una mayor homogeneidad en la mecánica del SDRA mientras el paciente recibe soporte con presión positiva.


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