Puga TMS, Parellada BJ, Hernández PW, Pérez PF, Quiñones ZA, Oscar RL

Language: Spanish
References: 20
Page: 2485-2489
PDF size: 175.96 Kb.

ABSTRACT

Introduction: The introduction of the science advances in clinical practice in mechanically ventilated patients plays a key role in a number of variables.
Objectives: To determine the impact that represented applying scientific advances of the last decade on mechanical ventilation in the ICU.
Methods: A cohort prospective observational study including a group of 225 patients ventilated in the intensive care unit of “Dr. Luis Diaz Soto” Hospital, from January 2011 to June 2012 was performed and compared with a similar one conducted from January 2001 to June 2002.
Results: We observed a higher frequency of chronic obstructive pulmonary disease (0,9 % vs 8,0 %) and less acute respiratory distress syndrome (ARDS) (5,3 % vs 1,8 %) as initial main cause of mechanical ventilation, increased use of low tidal volumes (20 % vs 80 %) and ventilatory strategy for limiting pressure in ARDS (14 % vs 60 %), reduced use of T-tube (52,3 % vs 6,1 %) and increased use of pressure support (34,5 % vs 83,8 %) as the selected method used to test spontaneous ventilation. Furthermore, the use of noninvasive ventilation was five times higher (1,4 % vs. 7,5 %) and ventilator associated pneumonia significantly decreased (36 % vs. 16 % in 2011-2012) due to the introduction of a decontaminant (Iodopovidona 10 % on aqueous solution).
Conclusions: The introduction of scientific, international recommendations and modern ventilation equipment in this decade had a significant positive impact on the care of our patients. Despite these positive changes in clinical practice, no significant impact on the ICU length of stay or a significant reduction in mortality was obtained.

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