2013, Número 3
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Med Crit 2013; 27 (3)
Neumonía asociada a la ventilación mecánica: cómo prevenirla y situación en México
Chaires GR, Palacios CA, Monares ZE, Poblano MM, Aguirre SJ, Franco GJ
Idioma: Español
Referencias bibliográficas: 41
Paginas: 138-145
Archivo PDF: 186.60 Kb.
RESUMEN
Una de las complicaciones más frecuentes y temidas en los pacientes críticamente enfermos es la neumonía asociada a la ventilación mecánica. A pesar de ello, la aplicación de medidas preventivas no parece corresponder a esta frecuencia y temor, principalmente debido a la evidencia conflictiva respecto a la efectividad de dichas medidas. En nuestro país, la información respecto a esta patología es escasa. En este artículo analizamos la utilidad de distintas medidas preventivas en forma individual y como grupo de medidas, además de ofrecer un panorama de la situación actual de esta enfermedad en México.
REFERENCIAS (EN ESTE ARTÍCULO)
Klompas M, Platt R. Ventilator-associated pneumonia: the wrong quality measure for benchmarking. Ann Intern Med. 2007;147:803-805.
Lisboa T, Diaz E, Sa-Borges M, et al. The ventilator-associated pneumonia PIRO score: a tool for predicting ICU mortality and health-care resources use in ventilator-associated pneumonia. Chest. 2008;134:1208-16.
Timsit JF, Zahar JR, Chevret S. Attributable mortality of ventilator-associated pneumonia. Curr Opin Crit Care. 2011;17:464-471.
Klompas M. Ventilator-associated pneumonia: Is zero possible? Clin Infect Dis. 2010;51:1123-1126.
Niederman MS, Craven DE, Bonten MJ, et al. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005;171(4):388-416.
Garibaldi RA, Britt MR, Coleman ML, et al. Risk factors for postoperative pneumonia. Am J Med. 1981;70:677-680.
Cook DJ, Walter SD, Cook RJ, et al. Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients. Ann Intern Med. 1998;129:433-440.
Leal-Noval SR, Márquez-Vacaro JA, García-Curiel A, et al. Nosocomial pneumonia in patients undergoing heart surgery. Crit Care Med. 2000;28:935-940.
Drakulovic MB, Torres A, Bauer TT, et al. Supine body position as a risk factor for nosocomial pneumonia in mechanically ventilated patients: a randomized trial. Lancet. 1999;354:1851-1858.
Tejada A, Bello S, Chacon E, et al. Risk factors for nosocomial pneumonia in critically ill trauma patients. Crit Care Med. 2001;29:304-309.
Han J, Liu Y. Effect of ventilator circuit changes on ventilator-associated pneumonia: a systematic review and meta-analysis. Respiratory Care. 2010;55:245-252.
Holzapfel L, Chevret S, Madinier G, et al. Influence of long-term oro- or nasotracheal intubation on nosocomial maxillary sinusitis and pneumonia: results of a prospective, randomized, clinical trial. Crit Care Med. 1993;21:1132-1138.
Rouby JJ, Laurent P, Gosnach M, et al. Risk factors and clinical relevance of nosocomial maxillary sinusitis in the critically ill. Am J Respir Crit Care Med. 1994;150:776-783.
Kollef MH, Von Harz B, Prentice D, et al. Patient transport from intensive care increases the risk of developing ventilator-associated pneumonia. Chest. 1997;112:765-773.
Chastre J, Fagon JY. Ventilator-associated pneumonia. Am J Respir Crit Care Med. 2002;165:867-903.
Maselli J, Restrepo M. Strategies in the prevention of ventilator-associated pneumonia. Ther Adv Resp Dis. 2011;5(2):131-141.
Wood G, MacLeod B, Moffatt S. Weaning from mechanical ventilation: physician-directed vs a respiratory-therapist-directed protocol. Respir Care. 2007;40:219-224.
Nseir S, Makris D, Mathieu D, et al. Intensive Care Unit-acquired infection as a side effect of sedation. Crit Care. 2010;14:30-46.
Orozco-Levi M, Torres A, Ferrer M, et al. Semirecumbent position protects from pulmonary aspiration but not completely from gastroesophageal reflux in mechanically ventilated patients. Am J Respir Crit Care Med. 1995;152:1387-1390.
Ibáñez J, Peñafiel A, Raurich, et al. Gastroesophageal reflux in intubated patients receiving enteral nutrition: effect of supine and semirecumbent positions. J Parenter Enteral Nutr. 1992;16:419-422.
Drakulovic MB, Torres A, Bauer, et al. Supine body position as a risk factor for nosocomial pneumonia in mechanically ventilated patients: a randomized trial. Lancet. 1999;354:1851-1858.
Cook DJ, Kollef MH. Risk factors for ICU-acquired pneumonia. JAMA. 1998;279:1605-1066.
Han J, Liu Y. Effect of ventilator circuit changes on ventilator-associated pneumonia: a systematic review and meta-analysis. Respir Care. 2010;55:467-474.
Valencia M, Ferrer M, Farre R, et al. Automatic control of tracheal tube cuff pressure in ventilated patients in semirecumbent position: a randomized trial. Crit Care Med. 2007;35:1543-1549.
Bouza E, Perez MJ, Muñoz P, et al. Continuous aspiration of subglottic secretions in the prevention of ventilator-associated pneumonia in the postoperative period of major heart surgery. Chest. 2008;134:938-946.
Dezfulian C, Shojania K, Collard HR, et al. Subglottic secretion drainage for preventing ventilator-associated pneumonia: a meta-analysis. Am J Med. 2005;118:11-18.
Kollef MH, Shapiro SD, Silver P, et al. A randomized, controlled trial of protocol-directed versus physician-directed weaning from mechanical ventilation. Crit Care Med. 1997;25:567-574.
Liberati A, D’Amico R, Pifferi S, et al. Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care. Cochrane Database Syst Rev. 2009;7:CD000022.
Afessa B, Shorr AF, Anzueto A, et al. Association between a silver-coated endotracheal tube and reduced mortality in patients with ventilator-associated pneumonia. Chest. 2010;137:1015-1021.
Rello J, Kollef M, Diaz E, et al. Reduced burden of bacterial airway colonization with a novel silver-coated endotracheal tube in a randomized multiple-center feasibility study. Crit Care Med. 2006;34:2766-2772.
Zilberberg MD, Shorr AF, Kollef MH. Implementing quality improvements in the intensive care unit: ventilator bundle as an example. Crit Care Med. 2009;37:305-309.
Berenholtz SM, Pham JC, Thompson DA, et al. Collaborative cohort study of an intervention to reduce ventilator-associated pneumonia in the intensive care unit. Infect Control Hosp Epidemiol. 2011;32(4):305-314.
The Institute for Healthcare Improvement. 100K Lives Campaign. Disponible en: http://www.ihi.org/IHI/Programs/Campaign/
Halpern NA, Hale KE, Sepkowitz KA, et al. A world without ventilator-associated pneumonia: time to abandon surveillance and deconstruct the bundle. Crit Care Med. 2012;40 (1):267-270.
Bouadma L, Deslandes E, Lolom I, et al. Long-term impact of a multifaceted prevention program on ventilator-associated pneumonia in a medical intensive care unit. Clin Infect Dis. 2010;51(10):1115-1122.
Bouadma L, Mourvillier B, Deiler V, et al. A multifaced program to prevent ventilator-associated pneumonia: impact on compliance with prevenyve measures. Crit Care Med. 2010;38(3):789-796.
Rello J, Lode H, Cornaglia G, et al. A European care bundle for prevention of ventilator-associated pneumonia. Intensive Care Med. 2010;36(5):773-780.
Molinar F, Vázquez MI, Baltazar JA, et al. Incidencia de neumonía asociada a la ventilación mecánica en pacientes críticos. Rev Asoc Mex Med Crit y Ter Int. 2001;15 (1):18-21.
Martínez M, Lazo S, Eraña JA. Neumonía asociada a ventilación mecánica: incidencia, etiología y factores de riesgo en una Unidad de Cuidados Intensivos General. Rev Asoc Mex Med Crit y Ter Int. 2005;19 (5-6):163-168.
Chaires R, Palacios A, Monares E, et al. Impacto de la aplicación de medidas de prevención basadas en la evidencia sobre la tasa de neumonía asociada a la ventilación mecánica. Rev Asoc Mex Med Crit y Ter Int. 2012;26:226-229.
Dudeck MA, Horan TC, Peterson KD, et al. National Healthcare Safety Network (NHSN) Report. Data summary for 2010. Device-associated module. Am J Infect Control. 2011;39:798-816