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Antes Revista del Instituto Nacional de Enfermedades Respiratorias

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2020, Número 3

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Neumol Cir Torax 2020; 79 (3)


¿Aceptar a priori que la ventilación mecánica en posición prona en COVID-19 es la mejor?

García-Rodríguez DF, Martínez-Reséndiz JA, González-Juárez F

Idioma: Español
Referencias bibliográficas: 35
Paginas: 141-144
Archivo PDF: 189.58 Kb.


FRAGMENTO

Se sabe que aproximadamente 170,000 casos de síndrome de distrés respiratorio del adulto (SDRA) ocurren anualmente en los Estados Unidos con tasas de mortalidad de 25-40%. Hoy día el SDRA secundario a coronavirus 2019 (COVID-19) se ha puesto en boga debido a la actual pandemia que lo está causando. A pesar de que ocasiona daño pulmonar similar al SDRA clásico, la dificultad respiratoria parece asociarse con daño vascular importante que no necesariamente requiere el manejo ventilatorio que por lo regular utilizamos para SDRA.
Recientemente se han descrito dos tipos de comportamiento de la enfermedad, se clasifican como «tipo L (Low)», baja elastancia pulmonar (alto compliancia), peso pulmonar más bajo y baja respuesta al PEEP o «tipo H (High)», consolidaciones por tomografía extensas, alta elastancia (bajo compliancia), mayor peso pulmonar y alta respuesta de PEEP; sin embargo, se puede manifestar como formas intermedias consecuentemente con características superpuestas.


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