2011, Number 2
<< Back Next >>
Mediciego 2011; 17 (2)
Bronchoscopy for the management of respiratory secretions in ventilated patients.
Pérez GEA, Ruiz VY
Language: Spanish
References: 26
Page:
PDF size: 60.76 Kb.
ABSTRACT
Artificial mechanical ventilation is a support for the critically ill patient in intensive care unit. One of
the biggest problems in patients with acute respiratory failure in ventilatory support is the presence
of respiratory secretions. They cause obstruction of the artificial airway, trachea and bronchus,
altering the gas flow to and from the alveoli also they become a predisposing factor in the genesis of
atelectasis and pneumonia associated to artificial mechanical ventilation. Conventional therapies
such as hydration, antibiotics, steroids, mucolytic agents, respiratory physiotherapy,
bronchodilators, and blind endotracheal aspirations are not entirely effective.A controlled
experimental study was carried out where they were demonstrated the benefits of the procedure to
be less moderate and abundant respiratory secretions after the fourth day of ventilation.
REFERENCES
Davis JE, Stembach GL, Varon J, Froman RE. Paracelsus and mechanical ventilation. Resuscitation. 2000; 47(1):3-5.
Vesalius A. Pulmonis motuum de humani corporis fabrica libri septem. Basel Oporinus. 1543; p. 658. http://www.bireme.br/cgi-bin/wxislind.exe/iah/online/?
Hooke R. An account of on experiment made by M. Hooke, of preserving animals alive by blowing trhough theirs lungs with bellows. Phil Trans R Soc London. 1667; (2):539-540.
Lassen HC. Preliminary report in the 1952 epidemic of poliomyelitis in Copenhagen. Lancet. 1953; 1:37-41.
Esteban A, Anzueto A, Alua I. How is mechanical ventilation employed in the Intensive Care Units? An international utilization review. Am J Respir Crit Care Med. 2000; 161: 1450-8.
Tomicic V. Characteristics and factors associated with mortality in patients receiving mechanical ventilation. Rev Med Chile. 2008; 136(8): 29-36.
Nunn JF, Milledge JS, Singaraya J. Survival of patients ventilated in an intensive therapy unit. Br Med J. 1979; 1:1525-7.
Knaus WA. Prognosis with mechanical ventilation: the influence of disease, severity of disease, age, and chronic health status on survival from an acute illness. Am Rev Respir Dis. 1989; 140: S8-S13.
Santiago de Cuba. Hospital Provincial Docente “Saturnino Lora”. Departamento Registros Médicos. Movimiento hospitalario 2009. [Documento no publicado].
Villa Clara. Hospital Provincial Docente “Arnaldo Milián Castro”. Departamento de Registros Médicos. Movimiento hospitalario 2009. [Documento no publicado].
Santi Spiritus. Hospital Provincial Docente Camilo Cienfuegos. Departamento de registros médicos. Movimiento hospitalario 2009. [Documento no Publicado]
Holguin. Hospital Provincial “Vladimir Ilich Lenin”. Departamento de Registros Médicos. Movimiento hospitalario 2009. [Documento no publicado].
Ciudad de la Habana. Centro de Investigaciones Médicoquirúrgicas. Departamento de Registros Médicos. Movimiento hospitalario 2009. [Documento no publicado].
Amato MB, Barbas CS, Medeiros DM, Magaldi RB, Schettino G, Lorenzi- Filho G, et al. Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med [Internet]. 1998 [citado 10 Ago 2010]; 338: 347-54. Disponible en: http://www.bireme.br/cgi-bin/wxislind.exe/iah/online/?
Smith D, Tolfmand A. The acute respiratory distress syndrome network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med [Internet]. 2000 [citado 10 Ago 2010]; 342:1301-8. Disponibe em: http://www.bireme.br/cgi-bin/wxislind.exe/iah/online/?
Ciego de Ávila. Departamento de Registros Médicos. Movimiento hospitalario 2009. [Documento no publicado].
Iglesias Almanza NR, Barreras Ramírez R, Guirola de la Parra J. Complicaciones de la ventilación mecánica en las unidades de cuidados intensivos. MediCiego [Internet]. 2002 [citado 10 Ago 2010]; 8(1): [aprox. 8 p.]. Disponible en: http://bvs.sld.cu/revistas/mciego/vol8_01_02/articulos/a9_v8_0102.htm
Rodríguez Hidalgo LA, Bonilla C, Guerreros A, Gutarra K, Herrera JM, Iberico C. Utilidad de broncofibroscopia flexible en el diagnóstico de las causas de hemoptisis. Enferm Tórax (Lima). 2006; 50(1):38-41.
Pontoppidan H, Geffin B, Lowenstein E. Acute respiratory failure in the adults 3. N Engl J Med. 1972; 287:799-806.
Snyder J, Lindholm CE, Ollman B. Flexible fiberoptic bronchoscopy in critical care medicine: diagnosis, therapy, and complications. Crit Care Med. 1974; 2:250–261.
Stevens RP, Lillington GA, Parsons G. Fiberoptic bronchoscopy in the intensive care unit. Heart Lung. 1981; 10:1037–1045.
Maciques Rodríguez R, Castro Pacheco B. Neumonía asociada a la ventilación mecánica. Rev Cubana Pediatr. 2002; 74(3):222-232.
Johnson N, Marini JJ, Pierson DJ. Acute lobar atelectasis: effect of chest percussion and postural drainage (CPPD) on resolution. Am Rev Respir Dis. 1987; 135:A433.
Chang AB, Faoagali J, Cox NC, Marchant JM, Dean B, Petsky HL, Masters IB. A bronchoscopic scoring system for airway secretions-airway cellularity and microbiological validation. Pediatr Pulmonol. 2006; 41(9):887-92.
Raoof S, Chowdhrey N. Effect of combinedkinetic therapy and percussion therapy of the resolution of atelectasis in critically ill patients. Chest. 1999; 115:1658–1666.
Raoof S, Mehrishi S, Prakash UB. Role of bronchoscopy in modern medical intensive care unit. Clin Chest Med. 2001; 22(2):123-130.