Bacardí ZPA, Paéz CY, Jones RO, Rodríguez CA, Gondres LKM

Language: Spanish
References: 18
Page: 24-30
PDF size: 686.06 Kb.

ABSTRACT

Objetive: To describe the use of noninvasive mechanical artificial ventilation in a vulnerable population according to the socioepidemiological, ventilating, clinical variables and those of concern.
Method: An observational descriptive study, of series of cases, was performed from October 2013 to May 2014, in the Service of Intermediate Cares of the Provincial Clinical Surgical Teaching Hospital “Saturnino Lora Torres” of Santiago de Cuba City. The sample selected included 38 patients who had the parameters required, to which a clinical and gasometric follow-up was performed during 24 hours.
Results: The average age was 60 years old, male sex prevailed (60, 52%). Chronic obstructive pulmonary disease was the most significant category (44, 73%) and the ventilator modality CPAP/SP (73,68%) was used with highest frequency. Diminishment of the respiratory frequency, cardiac and mean blood pressure were accentuated; with an increase in the Glasgow of 14,7 ± 1,2, as well as the pH, PaO2, SaO2 and the relationship PaO2/FiO2 (278,3 ± 87,5). Hospitalization stay was reduced in 26 patients and 29 of them were discharged alive.
Conclusions: Evidence of the predominance of middle-aged patients and elders associated with the male sex is provided. Diseases of the respiratory system show the best response, with a significant modification in the physiological and hemogasometric parameters in 24 hours, an important decrease of the hospitalization stay and improvement of survival. The benefits achieved with the application of the noninvasive mechanical ventilation, establish it as an alternative therapy of interest in the critical patient´s care units.

REFERENCES

1. Beneditt JO. Novel uses of noninvasive ventilation. Respir Care. 2009; 54(2):212-9.

2. Cruz M, Zamora V. Ventilação mecânica não invasiva. Revista Hospital Universitário Pedro Ernesto, Local de publicação (editar no plugin de tradução o arquivo da citação ABNT), 12, set. 2013. Disponível em: . Acesso em: 12 marzo. 2014.

3. Zarbock A, Mueller E, Netzer S, Gabriel A, Feindt P, Kindgen Milles D. Prophylactic nasal continuous positive airway pressure following cardiac surgery protects from postoperative pulmonary complications; a prospective, randomized, controlled trial in 500 patients. Chest. 2009; 135(5):1252-9.

4. Gallardo Romero JM, Gómez García T, Sancho Chust JN, González Martínez M. Ventilación no invasiva. Arch Bronconeumol. 2010; 46(Supl 6):15-16.

5. Archambault PM, St-Onge M. Invasive and noninvasive ventilation in the emergency department. Emerg Med Clin North Am.2012; 30(2):421-49.

6. Pires FM, Caruso P, Ribeiro CR, Carvalho J. Avaliação do desempenho de diferentes interfaces para ventilação não invasiva em modelo mecânico simulando paciente com EPOC. Revista de Medicina, Brasil, v. 91, n. 2, p. 60-68, jun. 2012. ISSN 1679-9836. Disponible en: . Revisado: 12/3/2014

7. Orozco S, Guerra NT, Pérez C. Eosinopenia en pacientes con síndrome de respuesta inflamatoria sistémica, características operativas y asociación con su calidad pronóstica. Disponible en: http://intellectum.unisabana.edu.co: 8080/jspui/ bitstream/10818/1300/1/ Silvana %20Orozco %20 Araujo.pdf. Revisado: 10/11/2013.

8. Rose L, Gray S, Burns K, Atzema C, Kiss A, Worster A, Scales DC, Rubenfeld G, Lee J. Emergency department length of stay for patients requiring mechanical ventilation: a prospective observational study. Scand J Trauma Resusc Emerg Med. 2012;20:30.

9. Burns KE, Adhikari NK, Keenan SP, Meade M. Use of non-invasive ventilation to wean critically ill adults off invasive ventilation: meta-analysis and systematic review. BMJ. 2009; 338:1574.

10. Scala R, Naldi M. La ventilación no invasiva con presión positiva en la insuficiencia respiratoria aguda hipercápnica: diez años de experiencia clínica de una unidad de terapia semiintensiva respiratoria. Rev Cienc Salud Bogotá Colombia 2007; 5(3): 7-23.

11. Obrador L, Navarro Z, Del Pozo C, Rodríguez A, Pozo T. Ventilación mecánica no invasiva en el síndrome de distress respiratorio agudo en pacientes quirúrgicos. Revista Cubana de Medicina Intensiva y Emergencias [Articulo en línea]. 2009 [citado 16 nov 2013]; 8 (4). Disponible en: http://bvs.sld.cu/revistas/mie/vol8 409/mie10409.htm.

12. Navarro Z, Matos K, Cobas O, Pozo T, Obrador L. Ventilación mecánica no invasiva en insuficiencia respiratoria postoperatoria de la cirugía torácica de urgencia. Revista Cubana de Medicina Intensiva y Emergencia [Articulo en línea]. 2009 [citado 16 nov 2013]; 8 (2). Disponible en: http://bvs.sld.cu/revistas/mie/vol8 209/mie 072 09.htm.

13. Silverthorn, Dee Unglaub. Fisiología humana: Un enfoque integrado. Ed. Médica Panamericana, 2008.

14. Teasdale G, Jennet B. Assesment of coma impaired consciouness. A practical escale. The Lancet. 1974;2:81-3.

15. Fernández-Vivas M, Gonzalez-Diaz G, Caturla-Such J, Delgado-Vilchez FJ, Serrano-Simon JM, Carrillo-Alcaraz A, et al. Utilización de la ventilación no invasiva en la insuficiencia respiratoria aguda. Estudio multicéntrico en unidades de cuidados intensivos. Med Intensiva. 2009;33(4):153-60.

16. Echave-Sustaeta J, Comeche-Casanova L, Garcia-Lujan R, Sayas-Catalan J, Gomez de la Camara A, Lopez-Encuentra A. Pronóstico tras una agudización grave de la EPOC tratada con ventilación mecánica no invasiva. Arch Bronconeumol. 2010; 46:405-10.

17. Col D Bhattacharyya, Col R Ramprasad. Early predictors of success of non-invasive positive pressure ventilation in hypercapnic respiratory failure. MJAFI 2011;67:315–319.

18. Lightowler JVJ, Elliott MW. Predicting the outcome from NIV for acute exacerbations of COPD. Thorax 2013; 55:815-816.