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2003, Número 3

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Trauma 2003; 6 (3)


Síndrome de insuficiencia respiratoria aguda y trauma. Una visión práctica

Hernández BA

Idioma: Español
Referencias bibliográficas: 49
Paginas: 95-102
Archivo PDF: 92.96 Kb.


RESUMEN

La aparición de insuficiencia respiratoria, acompañada de hipoxemia severa y persistente, a pesar de la administración de concentraciones altas de oxígeno, asociada con infiltrados alveolares difusos asimétricos en ambos hemitórax debe hacer pensar invariablemente en el síndrome de insuficiencia respiratoria aguda (SIRA). El consenso Americano-Europeo de SIRA describe las definiciones clínicas: lesión pulmonar aguda y SIRA. En la actualidad múltiples estudios de SIRA continúan reportando una mortalidad del 40 al 60% a pesar de los avances en el diagnóstico y tratamiento. Las medidas de inmunomodulación junto con el manejo del reclutamiento alveolar y el apoyo ventilatorio forman parte del tratamiento de esta alteración, el decúbito prono se considera una medida de rescate en los casos de fracaso del reclutamiento, sin embargo aún persiste la mortalidad alta. Se presenta una descripción de la fisiopatología del SIRA y sus implicaciones clínicas y terapéuticas, para facilitar su detección y manejo conjunto en el paciente con trauma.


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