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2020, Number 5

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Med Crit 2020; 34 (5)

Index of oxygenation in neurosurgical patients using two ventilatory strategies on the perioperatory

González EEA, Sánchez DJS, Hernández LIM, Peniche MKG, Villegas DJE, Calyeca SMV

Language: Spanish
References: 39
Page: 265-272
PDF size: 243.67 Kb.


ABSTRACT

Introduction: Postoperative pulmonary comorbidity will depend on factors related to the patient, modifiable and non-modifiable, but intraoperative ventilatory parameters definitely play a fundamental role. There are oxygenation indices (OI) that may be useful in assessing the degree of lung injury.
Material and methods: Prospective, descriptive, analytical, case-control study. Patients who required neurosurgical intervention (urgent or elective) and invasive mechanical ventilation for the procedure. During the period from January 1, 2018 to December 31, 2018. Patients who met the inclusion criteria were assigned 1 to 1 to belong to the Intermediate Tidal Volumen group (ItV) (› 8 to ‹ 10 mL/kg predicted weight) or to the Low Tidal Volumen group (LtV) (6-8 mL/kg predicted weight). PEEP was determined for the doctor’s consideration (anesthesiologist).
Results: In the period considered, 60 patients were included who met the inclusion criteria. Of the total, 30 patients were included in the ItV group and 30 patients in the LtV group. The most commonly used ventilatory modality was asysto-control-volume (ACV) with 96.7% for ItV and 100% for LtV with p = 0.3. The predicted weight tV in the ItV group had an average of 8.9 mL/kg and in the LtV group an average of 7.1 mL/kg with a p = 0.001 The Glasgow coma scale (GCE) after extubation was of 14.3 points and 14.4 points for ItV and LtV without statistically significant difference.
Conclusion: Using intermediate tidal volume (› 8 to ‹ 10 mL/kg predicted weight) in neurosurgical patients, causes alteration of oxygenation rates: PaO2/FiO2 and PaO2/PAO2. The level of PEEP during the perioperative period of neurosurgical patients does not cause a significant difference in the Glasgow coma scale.


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