Morayta MGUC, Molinar RF, Vázquez HMI, Baltazar TJA, Hernández EG, Cano OA

Idioma: Español
Referencias bibliográficas: 27
Paginas: 12-18
Archivo PDF: 117.77 Kb.

RESUMEN

Objetivo. Comparar los efectos de fentanil con midazolam en la sedación de pacientes asistidos con ventilación mecánica (VMA).
Diseño. Estudio abierto prospectivo.
Sitio. Una UCI de 14 camas de un hospital de tercer nivel de atención de la Ciudad de México.
Pacientes. Un total de 40 pacientes consecutivos con VMA.
Intervenciones. Cuarenta pacientes fueron asignados para recibir durante 24 horas fentanil (grupo A [una dosis inicial de 3 µg/kg, seguido de una infusión de 1-3 µg/kg/h]) o midazolam (grupo B [un bolo inicial de 0.5-0.3 mg/kg, seguido de una infusión de 0.05-0.13 mg/kg/h).
Mediciones y resultados principales. Se registró el nivel de sedación (escala de Ramsay) presión arterial media, presión venosa central (PVC) y frecuencia cardiaca a los 15, 30, 60, 240, 480, 720 y 1,440 minutos. El nivel de sedación a los 30' fue de 4 ± 0.78 (grupo A) vs. 3.3 +± 0.9 (grupo B), p = 0.012. Se observó un aumento significativo en el grupo A, de la frecuencia cardiaca a los 480 y 1,440 minutos y de la PVC a las 24 horas A (p ‹ 0.05).
Conclusión. El fentanil es útil en la sedación de los pacientes críticos asistidos con ventilación mecánica.

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