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ISSN 2448-8909 (Impreso)

2020, Número 5

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Med Crit 2020; 34 (5)


Impacto de las asincronías en el pronóstico del paciente bajo ventilación mecánica invasiva

Nicolás MEL, Mercado VP, Vidal MJJ, Rivero SE, Domínguez CG

Idioma: Español
Referencias bibliográficas: 30
Paginas: 273-278
Archivo PDF: 211.02 Kb.


RESUMEN

La ventilación mecánica es común en pacientes críticos. La asincronía paciente-ventilador existe cuando las fases de la respiración administradas por el ventilador no coinciden con las del paciente. Las asincronías son frecuentes e infradiagnosticadas, éstas se han asociado con desenlaces desfavorables como son: mayor duración de ventilación mecánica, estancia en la unidad de terapia intensiva, mortalidad, incomodidad del paciente, alteraciones del sueño y disfunción diafragmática. Esta revisión describe los desenlaces adversos reportados que se han asociado a la presencia de asincronías en pacientes adultos bajo ventilación mecánica invasiva. La evidencia actual sugiere que el mejor enfoque para manejar las asincronías es ajustar la configuración del ventilador y mejorar su detección. Si bien la mayoría de la evidencia proviene de estudios observacionales y ensayos clínicos aleatorizados realizados en poblaciones heterogéneas y con un número limitado de pacientes, los resultados sugieren desenlaces desfavorables clínicamente significativos en los pacientes que experimentan un índice de asincronía elevado. Por lo anterior, es necesario generar mayor evidencia en este tópico.


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