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2009, Número 1

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Med Sur 2009; 16 (1)


Óxido nítrico inhalado para el manejo de hipoxemia refractaria en pacientes con síndrome de insuficiencia respiratoria aguda

Carrillo ER, Carrillo CJR, Carrillo CLD

Idioma: Español
Referencias bibliográficas: 36
Paginas: 4-9
Archivo PDF: 135.04 Kb.


RESUMEN

Antecedentes: El síndrome de insuficiencia respiratoria aguda (SIRA) se caracteriza por hipertensión pulmonar, incremento del cortocircuito de derecha a izquierda e hipoxemia. Objetivo: Evaluar la eficacia del óxido nítrico inhalado (ON) en enfermos con SIRA e hipoxemia refractaria que se manejaron en la Unidad de Terapia Intensiva de la Fundación Clínica Médica Sur. Pacientes y métodos: Se incluyeron a 10 pacientes con SIRA e hipoxemia refractaria. Se manejaron con ON inhalado en dosis progresivas hasta llegar a 25 ppm. Se monitorizaron durante el estudio variables hemodinámicas y de intercambio gaseoso. Resultados: El ON inhalado a concentración de 25 ppm redujo la presión pulmonar media (Ppm) de 45 ± 5 a 30 ± 3 mmHg (p ‹ 0.01), el cortocircuito intrapulmonar (Qs/Qt) de 40 ± 10 a 30 ± 5% (p ‹ 0.01). La relación PaO2/FiO2 también denominado índice de oxigenación que avalúa la oxigenación de la sangre arterial aumentó de 150 ± 20 a 250 ± 20 mmHg (p ‹ 0.01). Conclusión: El ON inhalado en enfermos con SIRA e hipoxemia refractaria reduce la presión de la arteria pulmonar, el cortocircuito e incrementa la oxigenación arterial.


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