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Archivos de Medicina de Urgencia de México

2013, Número 2

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Arch Med Urg Mex 2013; 5 (2)


Neumonía asociada a la ventilación mecánica

Ballesteros-Flores CG, Martínez-Martínez J, Reyes-Pérez MM, Alarcón-Sánchez LL, Cervantes-Puma LE

Idioma: Español
Referencias bibliográficas: 50
Paginas: 78-84
Archivo PDF: 196.13 Kb.


RESUMEN

La neumonía asociada a la ventilación mecánica ocurre en pacientes sometidos a este tipo de ventilación por periodos mayores de 48 horas. La incidencia de neumonía asociada a la ventilación mecánica reportada en literatura médica comprende de 10 a 20% de los pacientes. La neumonía asociada a la ventilación mecánica de inicio temprano es definida como aquella diagnosticada entre el tercero y el séptimo día. La de inicio tardío es la diagnosticada después del séptimo día. Muchos factores de riesgo contribuyen al desarrollo de neumonía asociada a la ventilación mecánica. La etiología asociada más frecuente incluye bacilos Gram negativos: Pseudomonas aeuriginosa, Acinetobacter baumannii, y Stenotrophomonas maltophilia (40%), Enterobacter sp (29%), y cocos Gram positivos: Staphylococcus aureus (21%). Establecer un diagnóstico adecuado de neumonía asociada a la ventilación mecánica es uno de los requisitos más importantes y difíciles en el cuidado de pacientes en estado crítico. Existen estrategias para la prevención de neumonía asociada a la ventilación mecánica; sin embargo, sólo algunas han demostrado ser efectivas. La mortalidad atribuible aún es tema de debate, y se ha asociado con rangos de 20 a 70%.


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