Carrillo ER, Hernández RA

Idioma: Español
Referencias bibliográficas: 32
Paginas: 6-11
Archivo PDF: 151.25 Kb.

RESUMEN

Objetivo: Valorar el efecto de la posición de decúbito prono en la oxigenación de enfermos con síndrome de insuficiencia respiratoria aguda (SIRA).
Metodología: Estudio clínico, experimental, abierto. Lugar. Terapia intensiva de un Hospital de tercer nivel.
Pacientes y método: Se estudiaron 5 pacientes con SIRA secundario a infección (4) y pancreatitis (1). Todos presentaban índice de Kirby ‹ 200 e índice de Murray > 2.5 y fracción inspirada de oxígeno › 80%, antes de la posición de decúbito prono. Los enfermos fueron colocados en posición de decúbito prono sin modificación del patrón ventilatorio inicial, evaluándose gasometrías e índice de Kirby. Se les practicaron radiografía y tomografía axial computada de tórax antes del procedimiento y a las 24 y 48 h, para valorar extensión y evolución de los infiltrados y condensación alveolar.
Resultados: Los 5 enfermos respondieron al decúbito prono con incremento estadísticamente significativo del índice de oxigenación, que se asoció a disminución y redistribución de los infiltrados y condensación alveolar. La mejoría en el índice de oxigenación fue rápida y sostenida, manteniéndose al volver al decúbito supino. Todos los enfermos sobrevivieron.
Conclusiones: La posición de decúbito prono mejora la oxigenación, limita el daño pulmonar y además de redistribuir y limitar la condensación alveolar en pacientes con SIRA cuando se utiliza de manera temprana.

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