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2007, Número 2

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Gac Med Mex 2007; 143 (2)


Factores predictores de falla en la extubación en recién nacidos de pretérmino

Tapia-Rombo CA, Galindo-Alvarado AM, Saucedo-Zavala VJ, Cuevas-Urióstegui ML

Idioma: Español
Referencias bibliográficas: 28
Paginas: 101-108
Archivo PDF: 73.72 Kb.


RESUMEN

Objetivo: Determinar los factores que originan la falla en la extubación en recién nacidos de pretérmino (RNPT).
Material y métodos: Se consideró falla en la extubación cuando hubo necesidad de reintubar al paciente en las primeras 72 horas. Se estudiaron en forma prospectiva a los RNPT críticamente enfermos que habían estado con asistencia mecánica ventilatoria durante por lo menos 24 horas. Se integraron 2 grupos: un grupo A (casos) con RNPT que tuvieron fallas en la primera extubación y un grupo B (control) con RNPT que no tuvieron fallas en la extubación. Se consideró zona de significancia con p menor a 0.05. Resultados: La edad gestacional y el peso al nacer mostraron diferencias significativas a favor del grupo B (control). Los factores que mostraron significancia en el análisis multivariado, fueron la edad gestacional (‹ 32 semanas), el aporte calórico (≤ 100 cal/Kg/ día) y la presión media de vías aéreas (PMVA) (≥ 4.5 cm H2O).
Conclusiones: De acuerdo con lo encontrado en este estudio, antes de realizar la extubación habrá que considerar si el RNPT tiene menos de 32 semanas de edad gestacional, por lo menos un aporte calórico superior a 100 cal/Kg/día y una PMVA en el ventilador menor a 4.5 cm H2O.


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