Hernández AJ, Pacheco AD, Reyes DDJ, Anzaldo CMC

Language: Spanish
References: 26
Page: 154-161
PDF size: 365.15 Kb.

ABSTRACT

Introduction: mechanical ventilation is a therapeutic intervention that is encountered with some frequency in patients who are treated in the emergency department. The programming of the different parameters of mechanical ventilation has the function of oxygenating, ventilating and favouring the recovery or repair of the dysfunctional organ for which it was indicated: brain, heart or lung. Objective: to establish the morbidity and mortality associated with the use of alveolar protective measures in patients with invasive mechanical ventilation in the Emergency Service of the Regional General Hospital No. 20. Material and methods: with prior authorization from the Local Committee for Research and Ethics in Health Research and Director of the Hospital, an observational, descriptive, longitudinal, retrospective study was carried out during the period from January 1, 2017 to November 30, 2018. Those older than 18 years who entered the emergency department who required invasive mechanical ventilation were included; the ventilatory parameters were assessed at the beginning and 24 hours; the frequency of use of alveolar protective measures in this unit was determined, and the morbidity and mortality associated with the use of alveolar protective measures were also assessed. Results: in patients in whom quality alveolar protective measures were used (≥ 3 measures) there were fewer deaths (18.6% deaths), compared to those in whom less than two measures were used (81.3% deaths) and in whom no measures were used (100% deaths). The most frequent causes of death were acute respiratory distress syndrome (ARDS) (37%), pneumonia (35.8%) and septic shock (9.8%). The most frequent complications were pneumonia and ARDS, there was no statistical significance relating them to the use of protective alveolar measures. Conclusions: morbidity did not show a decrease with the use of alveolar protective measures, but it did reduce mortality with the use of protective measures.

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