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2013, Número 2

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AMC 2013; 17 (2)


Impacto del uso de la ventilación con presión positiva continua nasal en la evolución del recién nacido de muy bajo peso

Barreras AJ, Agüero DA, Avilés CE, Murray HJ, Gómez VY

Idioma: Español
Referencias bibliográficas: 45
Paginas: 139-149
Archivo PDF: 206.53 Kb.


RESUMEN

Fundamento: con el uso de la presión positiva continua nasal se disminuyen las complicaciones de los recién nacidos de muy bajo peso.
Objetivo: determinar el impacto del uso de la ventilación con presión positiva continua nasal en la evolución del recién nacido de muy bajo peso.
Método: se realizó una investigación de evaluación con un diseño observacional analítico en forma retrospectiva. El universo de estudio estuvo constituido por los 163 niños de muy bajo peso al nacer, atendidos en el Servicio de Neonatología del Hospital Universitario Gineco-Obstétrico Ana Betancourt de Mora y que requirieron algún tipo de ventilación en el período comprendido del 1ro de enero de 2007 al 31 de diciembre de 2010. La muestra estuvo compuesta por un grupo estudio de 95 niños y un grupo control de 68 niños.
Resultados: existió gran similitud en el peso y edad gestacional de ambos grupos. La duración de la ventilación fue considerablemente menor en el grupo estudio (97.87 contra 127 días). Hubo una disminución significativa del bloqueo aéreo y la neumonía pos-ventilación en el grupo estudio. No hubo diferencia significativa en la incidencia de hemorragia intraventricular. Fallecieron menos niños en el grupo estudio (0.08 % contra 0.15 %).
Conclusiones: el impacto del uso de la Ventilación con Presión Positiva Continua Nasal en la evolución del recién nacido de muy bajo peso atendido en el Servicio de Neonatología del Hospital Universitario Ginecobstétrico Ana Betancourt de Mora ha sido satisfactorio.


REFERENCIAS (EN ESTE ARTÍCULO)

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  2. Richardson CP, Jung AL. Effects of continuous positive airway pressure on pulmonary function and blood gases of infants with respiratory distress syndrome. Pediatr Res. 1978 Jul;12(7):771–4.

  3. Liptsen E, Aghai ZH, Pyon KH, Saslow JG, Nakhla T, Long J, et al. Work of breathing during nasal continuous positive airway pressure in preterm infants: a comparison of bubble vs variable-flow devices. J Perinatol. 2005;25:453–8.

  4. Miller MJ, Carlo WA, Martin RJ. Continuous positive airway pressure selectively reduces obstructive apnoea in preterm infants. J Pediatr. 1985;106(1):91–4.

  5. Miller MJ, DiFiore JM, Strohl KP, Martin RJ. Effects of nasal CPAP on supraglottic and total pulmonary resistance in preterm infants. J Appl Physiol. 1990;68:141-6.

  6. Jaile JC, Levin T, Wung JT, Abramson SJ, Ruzal-Shapiro C, Berdon WE. Benign gaseous distension of the bowel in premature infants treated with nasal continuous airway pressure: a study of contributing factors. AJR Am J Roentgen. 1992;158:125–7.

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  29. Jaile JC, Levin T, Wung JT, Abramson SJ, Ruzal-Shapiro C, Berdon WE. Benign gaseous distension of the bowel in premature infants treated with nasal continuous airway pressure: a study of contributing factors. AJR Am J Roentgen. 1992;158:125–7.

  30. Yong SC, Chen SJ, Boo NY. Incidence of nasal trauma associated with nasal prong versus nasal mask during continuous positive airway pressure treatment in very low birth weight infants: a randomised control study. Arch Dis Child Fetal Neonatal. 2005;90:F480–F3.

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  35. Miksch RM, Armbrust S, Pahnke J, Fusch C. Outcome of very low birth weight infants after introducing a new standard regime with the early use of nasal CPAP. Eur J Pediatr. 2008 Aug;167(8):909-16.

  36. Davis PG, Henderson-Smart DJ. Nasal continuous positive airways pressure immediately after extubation for preventing morbidity in preterm infants [Internet]. Oxford: La Biblioteca Cochrane Plus; 2011 [updated 2011 Nov 20; cited 2012 Feb 12]. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000143/pdf

  37. Morley CJ, Davis PG, Doyle LW, Brion LP, Hascoet JM, Carlin JB. Nasal CPAP or intubation at birth for very preterm infants. N Engl J Med. 2008;58(7):700–8.

  38. Finer NN, Carlo WA, Walsh MC, Rich W, Gantz MG, Laptook AR, et al. Early CPAP versus surfactant in extremely preterm infants. N Engl J Med. 2010;362:1970–9.

  39. Sekar KC, Corff KE. To tube or not to tube babies with respiratory distress syndrome. J Perinatol. 2009 May;29 Suppl 2:S68-72.

  40. Jay D, Iams MD. The epidemiology of preterm birth. Clin Perinatol. 2003;30:651-64.

  41. Tucker J, McGuire W. ABC of preterm birth. Epidemiology of preterm birth. BMJ. 2004;329:675-8.

  42. Kamath BD, Macguire ER, McClure EM, Goldenberg RL, Jobe AH. Neonatal mortality from respiratory distress syndrome: lessons for low-resource countries. Pediatrics. 2011 Jun;127(6):1139-46.

  43. Sweet DG, Carnielli V, Greisen G, Hallman M, Ozek E, Plavka R, et al. European Association of Perinatal Medicine. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants - 2010 . Neonatology. 2010 Jun;97(4):402-17.

  44. Diblasi RM. Nasal continuous positive airway pressure (CPAP) for the respiratory care of the newborn infant. Respir Care. 2009 Sep;54(9):1209-35.

  45. Bohlin K, Jonsson B, Gustafsson AS, Blennow M. Continuous positive airway pressure and surfactant. Neonatology. 2008;93(4):309-15.




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