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2000, Número 3

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Med Crit 2000; 14 (3)


Índice de daño pulmonar en cáncer

Fonseca LJA, Herrera GA

Idioma: Español
Referencias bibliográficas: 40
Paginas: 82-89
Archivo PDF: 156.50 Kb.


RESUMEN

Objetivo: Evaluar la eficacia de un nuevo índice para establecer el pronóstico y la severidad de la falla respiratoria (IRA) en pacientes con cáncer.
Diseño: Estudio clínico prospectivo.
Lugar: UCI Médico/Quirúrgica de un hospital oncológico de la Ciudad de México.
Pacientes: Estudiamos durante un año 260 pacientes oncológicos tratados con ventilación mecánica, divididos en tres grupos:
I) pacientes ingresados a la UCI después de cirugía; II) pacientes con IRA de cualquier etiología; III) pacientes con síndrome de insuficiencia respiratoria aguda (SIRA)
Intervenciones: Ninguna.
Mediciones y resultados principales: Comparamos una nueva fórmula: Índice de Daño Pulmonar en Cáncer, IDPC [paw x D (A-a) O2/1000 + Rx] con la escala de APACHE II y la escala de Murray. En el análisis de regresión logística la capacidad predictiva fue mejor con el IDPC (área bajo ROC = 0.764 que la escala de APACHE II = 0.6986 (p ‹ 0.05) y la escala de Murray = 0.6077 (p ‹ 0.05). IDPC fue 1.72 ± 1.03, 5.73 ± 2.74 y 14.08 ± 4.07 para los grupos I, II y III, respectivamente (p ‹, 0.05).
Conclusión: El IDPC puede cuantificar la severidad de la IRA y su valor predictivo supera las escalas de APACHE II y Murray.


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