Sifuentes HCJ, Trujillo RN, Marín RMC

Language: Spanish
References: 30
Page: 72-77
PDF size: 233.48 Kb.

ABSTRACT

Introduction: prone ventilation is ventilation that is administered with the patient lying prone, it can be used for the treatment of ARDS mainly as a strategy to improve oxygenation when more traditional modes of ventilation fail. Objective: to know if there is an association between the initial tomographic category and the response to ventilation in the prone position. Material and methods: observational, analytical, longitudinal and retrospective study of all the clinical records of patients hospitalized in the Intensive Care Unit from June 2020 to June 2021 with invasive mechanical ventilation in the prone position, who underwent chest tomography at hospital admission in the period. Results: 66 clinical records were included, of which 48 were male and 18 female. The mean age was 51 years. In the initial tomography, the majority corresponded to a tomographic category C with up to 48.5% and in a lower percentage to tomographic category A and B with a frequency of 27.3 and 24.2% respectively. Tomographic category B had the highest percentage of responders in the prone position up to 87%, category A and C had a percentage of responders of 66.7 and 44.7% respectively, without statistical significance, perhaps due to the limited number of patients. Conclusions: patients with category B were the ones that best responded to this strategy. There is a relationship between the category and the response to mechanical ventilation in the prone position.

REFERENCES

1. Nakos G, Tsangaris I, Kostanti E, Nathanail C, Lachana A, Koulouras V, et al. Effect of the prone position on patients with hydrostatic pulmonary edema compared with patients with acute respiratory distress syndrome and pulmonary fibrosis. Am J Respir Crit Care Med. 2000;161(2 Pt 1):360-368.

2. Bloomfield R, Noble DW, Sudlow A. Prone position for acute respiratory failure in adults. Cochrane Database Syst Rev. 2015;2015(11):CD008095.

3. Baccaro RH, Ribeiro MF, Valiatti JL, Gomes AJL. Effects of prone position on the oxygenation of patients with acute respiratory distress syndrome. 2006;124(1):15-20.

4. Hernández-López GD, Mondragón-Labelle T, Torres-López L, Magdaleno-Lara G. Posición prono, más que una estrategia en el manejo de pacientes con síndrome de insuficiencia respiratoria aguda. Rev Hosp Jua Mex. 2012;79(4):263-270.

5. Setten M, Plotnikow GA, Accoce M. Prone position in patients with acute respiratory distress syndrome. Rev Bras Ter Intensiva. 2016;28(4):452-462.

6. Mora-Arteaga JA, Bernal-Ramírez OJ, Rodríguez SJ. Efecto de la ventilación mecánica en posición prona en pacientes con síndrome de dificultad respiratoria aguda. Una revisión sistemática y metaanálisis. Med Intensiva. 2015;39(6):352-365.

7. Peniche Moguel KG, Sánchez Díaz JS, Castañeda Valladares E, Calyeca Sánchez MV, Díaz Gutiérrez SP, Pin Gutiérrez E. Ventilación mecánica en decúbito prono: estrategia ventilatoria temprana y prolongada en SIRA severo por influenza. Med Crit. 2017;31(4):198-204.

8. Pelosi P, Brazzi L, Gattinoni L. Prone position in acute respiratory distress syndrome. Eur Respir J. 2002;20(4):1017-1028.

9. Mentzelopoulos SD, Roussos C, Zakynthinos SG. Prone position reduces lung stress and strain in severe acute respiratory distress syndrome. Eur Respir J. 2005;25(3):534-544.

10. Rodríguez-Buenahora RD, Ordoñez-Sánchez SA, Gómez-Olaya JL, Camargo-Lozada ME. Decúbito prono en el Síndrome de Dificultad Respiratoria Aguda, de la fisiología a la práctica clínica. Medicas UIS. 2016;29(2):81-101.

11. Cornejo RA, Díaz JC, Tobar EA, Bruhn AR, Ramos CA, González RA, et al. Effects of prone positioning on lung protection in patients with acute respiratory distress syndrome. Am J Respir Crit Care Med. 2013;188(4):440-448.

12. Pelosi P, Tubiolo D, Mascheroni D, Vicardi P, Crotti S, Valenza F, et al. Effects of the prone position on respiratory mechanics and gas exchange during acute lung injury. Am J Respir Crit Care Med. 1998;157(2):387-393.

13. Mora Arteaga JA, Rodríguez SJ, Bernal OJ. Ventilación mecánica en posición prona en el síndrome de dificultad respiratoria aguda. Rev Cub Med Int Emerg. 2009;8(2):1561-1568.

14. Amelines Acevedo IC, González Sánchez MV, Ciro JD. Ventilación mecánica en posición prono en pacientes con lesión cerebral aguda. Acta Colomb Cuid Intensivo. 2015;15(1):67-70.

15. Beuret P, Carton MJ, Nourdine K, Kaaki M, Tramoni G, Ducreux JC. Prone position as prevention of lung injury in comatose patients: A prospective, randomized, controlled study. Intensive Care Med. 2002;28(5):564-569.

16. Alsaghir AH, Martin CM. Effect of prone positioning in patients with acute respiratory distress syndrome: a meta-analysis. Crit Care Med. 2008;36(2):603-609.

17. Lamm WJE, Graham MM, Albert RK. Mechanism by which the prone position improves oxygenation in acute lung injury. Am J Respir Crit Care Med. 1994;150(1):184-193.

18. Kopterides P, Siempos II, Armaganidis A. Prone positioning in hypoxemic respiratory failure: Meta-analysis of randomized controlled trials. J Crit Care. 2009;24(1):89-100.

19. Douglas WW, Rehder K, Beynen FM, Sessler AD, Marsh HM. Improved oxygenation in patients with acute respiratory failure: the prone position. Am Rev Respir Dis. 1977;115(4):559-566.

20. Drahnak DM, Custer N. Prone positioning of patients with acute respiratory distress syndrome. Crit Care Med. 2015;35(6):29-37.

21. Juárez-Hernández F, García-Benítez MP, Hurtado-Duarte AM, Rojas-Varela R, Farías-Contreras JP, Pensado PLE, et al. Hallazgos tomográficos en afectación pulmonar por COVID-19, experiencia inicial en el Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México. Neumol Cir Torax. 2020;79(2):71-77.

22. García García J, Piqueras Diaz J, Ortiz Navarro MC, Martínez Márquez MC, Carrillero López C, Torralba Melero M, et al. Protocolo maniobra de decúbito prono en el servicio de medicina intensiva [Internet]. Gerencia de atención integrada de Albacete Servicio de Salud de Castilla La Mancha. 2018. 24 p. Disponible en: https://www.chospab.es/publicaciones/protocolosEnfermeria/documentos/1fa4f12fc6244e81de4663b061ec9a5e.pdf

23. De la Torre Martín MM, González Priego T, Caballero López T, López Reusch S. Decúbito prono: estudio hemodinámico, respiratorio y complicaciones. Enferm Intensiva. 2000;11(3):127-135.

24. Benítez Canosa MC, Brea Fernández A, Camino Castiñeiras M, Fernández Barral R, Fragua Mariño M, Roca Vázquez J, et al. protocolo y plan de cuidados críticos. Nursing (Lond). 2005;23(6):56-66.

25. Verónica P, Albornoz R, Olvera Guzmán C, Zárate CR, Alexandra G, Blanco G, et al. Posición prona en el síndrome de distrés respiratorio agudo grave. Rev Asoc Mex Med Crit Ter Int. 2016;30(4):235-241.

26. Girard R, Baboi L, Ayzac L, Richard JC, Guérin C. The impact of patient positioning on pressure ulcers in patients with severe ARDS: Results from a multicentre randomised controlled trial on prone positioning. Intensive Care Med. 2014;40(3):397-403.

27. Unión C de D del HC de la Constitución Política de los Estados Unidos Mexicanos. En: Diario Oficial de la Federación; 2016. p. 1-194.

28. Cámara de Diputados del H. Congreso de la Unión. Ley federal de protección de datos personales en posesión de los particulares [Internet]. 2010. p. 1-18. Disponible en: http://www.diputados.gob.mx/LeyesBiblio/pdf/LFPDPPP.pdf

29. Cámara de Diputados del H. Congreso de la Unión. Reglamento de la Ley General de Salud en Materia de Investigaciones para la Salud [Internet]. Vol. DOF 02-04-, Ley General de Salud. 1987. p. 1-31.

30. Guérin C, Reignier J, Richard JC, Beuret P, Gacouin A, Boulain T, et al. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med. 2013;368(23):2159-2168.