Sánchez DJS, Flores HR, Martínez REA, Peniche MG, Huanca PJM, Calyeca SV

Language: Spanish
References: 12
Page: 347-350
PDF size: 225.79 Kb.

ABSTRACT

Mechanical ventilation (MV) long increases the risk of complications, moreover early retirement of it exposes the patient to the risks presented before starting. Cerebral vascular event (CVE) can be complicated, requiring intubation and mechanical ventilation for respiratory support. We report the case of a male 76 years of age with acute ischemia cerebellar that failed extubation despite having objective parameters correct and proper tolerance test «T-piece». The parameters that evaluate the success or failure of extubation in neurological patient is an unresolved problem until today the Glasgow coma scale (GCS) is the variable associated with good or bad results.

REFERENCES

1. Guerrero LF, Fernández ME. Extubación de pacientes neurocríticos con bajo nivel de conciencia. Un problema por resolver. Med Intensiva. 2000;24:304-306.

2. Grotta J, Pasteur W, Khwaja W, Hamel T, Fisher M, Ramirez A. Elective intubation for neurologic deterioration after stroke. Neurology. 1995;45(4):640-644.

3. MacIntyre NR, Cook DJ, Ely EW, Epstein SK, Fink JB, Heffner JE, et al. Evidence-based guidelines for weaning and discontinuing ventilatory support: a collective task force facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine. Chest. 2001;120:375-395.

4. Esteban A, Anzueto A, Frutos F, Alía I, Brochard L, Stewart TE, et al. Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA. 2002;287:345-355.

5. Pelosi P, Ferguson ND, Frutos-Vivar F, Anzueto A, Putensen C, Raymondos K, et al. Management and outcome of mechanically ventilated neurologic patients. Crit Care Med. 2011;39:1482-1492.

6. Souter MJ, Manno EM. Ventilatory management and extubation criteria of the neurological/neurosurgical patient. Neurohospitalist. 2013;3(1):39-45.

7. Coplin WM, Pierson DJ, Cooley KD, Newell DW, Rubenfeld GD. Implications of extubation delay in brain injured patients meeting standard weaning criteria. Am J Respir Crit Care Med. 2000;161(5):1530-1536.

8. Namen AM, Ely EW, Tatter SB, Case LD, Lucia MA, Smith A et al. Predictors of successful extubation in neurosurgical patients. Am J Respir Crit Care Med. 2001;163(3 pt 1):658-664.

9. Wendell LC, Raser J, Kasner S, Park S. Predictors of extubation success in patients with middle cerebral artery acute ischemic stroke. Stroke Res Treat. 2011;2011:248789.

10. Wang S, Zhang L, Huang K, Lin Z, Qiao W, Pan S. Predictors of extubation failure in neurocritical patients identified by a systematic review and meta-analysis. PLoS One. 2014;9(12):e112198.

11. Magaña MC, Salinas MC, Santiago TJ, Olvera GC, Aguirre SJ, Franco GJ. Evaluación del espacio muerto ajustado al volumen corriente en pacientes con ventilación mecánica. Rev Asoc Mex Med Crit y Ter Int. 2011;25(3):131-141.

12. Blanch L, Villagra A, Sales B, Montanya J, Lucangelo U, Luján M et al. Asynchronies during mechanical ventilation are associated with mortality. Intensive Care Med. 2015;41:633-641.