Pérez-Calatayud ÁA, Carrillo-Esper R, Arch-Tirado E

Idioma: Español
Referencias bibliográficas: 36
Paginas: 304-312
Archivo PDF: 216.59 Kb.

RESUMEN

Introducción: La ventilación mecánica (VM) es una modalidad de soporte vital que se utiliza en una proporción significativa de los enfermos de terapia intensiva. Determinar el tiempo adecuado para descontinuar la VM exitosa, aún en la actualidad, continúa siendo un reto. Es por eso que se sigue con la investigación de nuevos protocolos para el retiro de la ventilación. La evaluación ecocardiográfica de la función diastólica, el diafragma y el pulmón son herramientas de gran utilidad para el retiro de la ventilación mecánica invasiva (VMI) en especial en pacientes con retiro difícil o prolongado. Aún se necesita validar en estudios controlados la eficacia de un protocolo integrado para el retiro de la VMI. Métodos: Basado en la literatura actual se desarrolló un puntaje explicado en modelo matemático basado en inecuaciones. Cuando χ ⇒ 5 el riesgo de fracaso en el retiro aumenta, por lo que no se debe continuar con el proceso; cuando χ ⇒ 1 el riesgo de fracaso disminuye, por lo que se debe retirar la VMI. Conclusiones: El uso de modelos matemáticos para la toma de decisiones es de vital importancia, ya que establece un parámetro de objetividad con respecto a las evaluaciones existentes. En este trabajo se propone el uso de las inecuaciones con la finalidad de establecer intervalos de solución en los tres grandes rubros que se toman en cuenta en la toma de decisión en el retiro de la VMI; de esta manera, las inecuaciones propuestas generan un área de certidumbre con respecto a los valores propuestos y los intervalos de solución del presente trabajo.

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