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2001, Número 4

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Rev Mex Anest 2001; 24 (4)


Extubación temprana en pacientes sometidos a revascularización coronaria

Rojas JRA, Uriarte MF, Munguía FY, Vergara LM

Idioma: Español
Referencias bibliográficas: 38
Paginas:
Archivo PDF: 48.66 Kb.


RESUMEN

La extubación temprana permite disminuir la morbimortalidad cardiorrespiratoria, así como acortar la estancia en la unidad de cuidados intensivos (UCI) y hospitalaria. Esta técnica se basa en la combinación de narcótico, benzodiazepinas, agentes inhalatorios a concentraciones variables con buena respuesta hemodinámica, permitiendo la extubación entre 4 y 8 h posteriores a la llegada a la UCI. Se estudiaron 40 pacientes de ambos sexos, elegidos al azar. Programados para revascularización coronaria, divididos en dos grupos: Grupo I, recibió midazolam, fentanilo, sevofluorano. Grupo II, recibió diazepam, fentanilo, isoflurano. Los criterios de inclusión fueron: Pacientes con fracción de expulsión de ventrículo izquierdo (FEVI) mayor a 50%; tiempo de circulación extracorpórea (CEC) entre 50 a 80 minutos, estabilidad hemodinámica, cirugía electiva, sin apoyo de inotrópicos. Tiempo quirúrgico menor de 6 h, ritmo sinusal, gasto urinario 0.5-l ml/kg/h. No se presentaron variaciones significativas en los grupos de edad, sexo, talla, peso. Las constantes hemodinámicas, frecuencia cardiaca, presión arterial y presión venosa central mostraron pequeñas diferencias, significativas. Los pacientes se progresaron reuniendo condiciones necesarias para extubación dentro de las primeras 6 h a su llegada a la UCI. La técnica anestésica actualmente es segura y disminuye costos intrahospitalarios.


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