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Colegio de Medicina Interna de México.

2022, Number 4

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Med Int Mex 2022; 38 (4)

Clinic-ventilatory differences between patients with orotracheal intubation due to COVID-19 with criteria for tracheotomy compared with those without criteria

Jiménez-Rodríguez MJ, Lugo-Machado JA, Charles-LozanoAE, Barragán-Márquez FV, Quintero-Bauman A, Sepúlveda-Martínez MA, Luna-Valenzuela JP, Jacobo-PinelliR, Rodríguez-Quintana OS, Guerrero-Paz JA, Canché-Martín EM, Reina-Loaiza JR, Sainz-Fuentes N

Language: Spanish
References: 36
Page: 791-803
PDF size: 223.81 Kb.


ABSTRACT

Objective: To describe some characteristics among patients with orotracheal intubation due to coronavirus disease SARS-CoV-2 (COVID-19) hospitalized in the intensive care unit, who were candidates for tracheotomy, comparing against those who were not candidates for this procedure and that finally died.
Materials and Methods: A retrospective, descriptive, cross-sectional study of a series of two groups was carried out from April 2020 to March 2021 at Hospital de Especialidades no. 2 Lic. Luis Donaldo Colosio Murrieta, IMSS, Ciudad Obregon, Sonora, Mexico. Variables such as age, sex, comorbidities, time of orotracheal intubation, ventilatory parameters, blood gases and the Kirby index were included.
Results: There were included 41 cases, from which 29 were males; mean age was of 56 years; 92.6% had at least one comorbidity. Group of tracheotomy included 21 patients. Previous ventilatory parameters were: PEEP: 7.61, FiO2: 41.42, blood gas with pH: 7.42, pO2: 95.04, pCO2: 41.47, HCO3: 29.14, O2 saturation: 94.7%, Kirby index: 235. In the not-operated group due to death it was found: PEEP: 9.5, FiO2: 82.3%, blood gas pH: 7.33, pO2: 62.45, pCO2: 58.5, HCO3: 30.9, O2 saturation: 86.5%, Kirby index: 81.8.
Conclusions: We believe that PaO2/FiO2 (Kirby index) ≤ 81.8 could be related to high morbidity due to the disease, considering patients not candidates for the tracheostomy procedure.


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