Análisis de las complicaciones que presentan los pacientes sometidos a un programa de ventilación mecánica invasiva

  1. Gómez de Oña, Julia
  2. De la Hoz García, Celia
  3. Utrilla Cid, Nuria
  4. Cárdenas Cruz, Antonio
Revista:
Actualidad médica

ISSN: 0365-7965

Ano de publicación: 2020

Tomo: 105

Número: 811

Páxinas: 153-159

Tipo: Artigo

DOI: 10.15568/AM.2020.811.OR01 DIALNET GOOGLE SCHOLAR lock_openAcceso aberto editor

Outras publicacións en: Actualidad médica

Obxectivos de Desenvolvemento Sustentable

Resumo

Objective: To analyze, from a qualitative and quantitative point of view, the different complications directly related to critically ill patients under invasive mechanical ventilation (IMV) as well as the main associated risk factors. Material and methods: It is a descriptive longitudinal study, which has as study population all patients under IMV program in the Intensive Medicine Unit (UMI) of Poniente Hospital in Almería throughout 2019, regardless of the cause that conditioned the use of this therapeutic resource. Results: 76% of patients were male. The mean age was 55.12 years. Cardiovascular risk factors were the most frequent (64.63%), followed by toxic habits (31%) and respiratory and infectious diseases (17.07% each) needing mechanical ventilation. The duration of the IMV was highly variable, its average was 8.63 days (51% less than 3 days). The most frequent complications found were adult respiratory distress syndrome (ARDS) and refractory hypoxemia (10.98% each). Conclusion: patients under IMV in the ICU of Poniente Hospital do not have a higher complication rate than those reported by other published series. ARDS and refractory hypoxemia are the main complications associated with IMV. Cardiovascular risk factors (CVRF) were the most frequent antecedents. The differences found with other series can be explained by differences in the methodology used to carry out the different studies and in the epidemiological characteristics of the studied population

Referencias bibliográficas

  • O’Gara B, Talmor D. Perioperative lung protective ventilation. BMJ. 2018; 362 k3030. DOI: 10.1136/bmj.k3030
  • Pham T, Brochard LJ, Slutsky AS. Mechanical Ventilation: State of the Art. Mayo Clin Proc. 2017; 92 (9):1382-1400. DOI: 10.1016/j.mayocp.2017.05.004
  • Amado-Rodríguez L, del Busto C, García-Prieto E, Albaiceta GM. Mechanical ventilation in acute respiratory distress syndrome: The open lung revisited. Med Intensiva. 2017; 41 (9): 550-8. DOI: 10.1016/j.medin.2016.12.012
  • Tonetti T, Vasques F, Rapetti F, Maiolo G, Collino F, Romitti F, et al. Driving pressure and mechanical power: new targets for VILI prevention. Ann Transl Med 2017; 5 (14):286. DOI: 10.21037/atm.2017.07.08
  • Ball L, Costantino F, Orefice G, Chandrapatham K, Pelosi P. Intraoperative mechanical ventilation: state of the art. Minerva Anestesiol. 2017; 83 (10):1075-1088. DOI: 10.23736/S0375-9393.17.11970-X
  • Kapil S, Wilson JG. Mechanical ventilation in hypoxemic respiratory failure. Emerg Med Clin N Am. 2019; 37 (3): 431– 444. DOI: 10.1016/j.emc.2019.04.005
  • Pérez-Calatayud AA, Anica-Malagón ED, Navarrete-Pérez, JJ, et al. Hallazgos histopatológicos en síndrome de dificultad respiratoria aguda. Med Crit 2017; 31 (4):218-223.
  • Shinn JR, Kimura KS, Campbell BR, Sun Lowery A, Wootten CT, et al. Incidence and outcomes of acute laryngeal injury after prolonged mechanical ventilation. Crit Care Med. 2019; 47 (12): 1699-1706. DOI: 10.1097/ CCM.0000000000004015
  • Brochard L, Slutsky A, Pesenti A. Mechanical ventilation to minimize progression of lung injury in acute respiratory failure. Am J Respir Crit Care Med. 2017; 195 (4):438–442. DOI: 10.1164/rccm.201605-1081CP
  • Goligher EC, Dres M, Fan E, Rubenfeld GD, Scales DC, Herridge MS, et al. Mechanical ventilation–induced diaphragm atrophy strongly impacts clinical outcomes. Am J Respir Crit Care Med. 2018; 197 (2):204–213. DOI: 10.1164/rccm.201703-0536OC
  • Rittayamai N, Wilcox E, Drouot X, Mehta S, Goffi A, Brochard L. Positive and negative effects of mechanical ventilation on sleep in the ICU: a review with clinical recommendations. Intensive Care Med. 2016; 42 (4):531–541. DOI: 10.1007/s00134-015-4179-1
  • Frutos F, Alía I, Lorenzo MR, García-Pardo J, Nolla M, Ibáñez J, et al. Utilización de la ventilación mecánica en 72 unidades de cuidados intensivos en España. Med Intensiva. 2013; 27 (1):1–12.
  • Grau M, Elosua R, Cabrera De León A, Guembe, Baena-Díez JM, Vega Alonso, T, et al. Factores de riesgo cardiovascular en España en la primera década del siglo XXI: Análisis agrupado con datos individuales de 11 estudios de base poblacional, estudio DARIOS. Rev Esp Cardiol. 2011; 64 (4):295–304. DOI: 10.1016/j.recesp.2010.11.005
  • Encuesta EDADES. Plan nacional sobre drogas. Ministerio de Sanidad. Disponible en: https://pnsd.sanidad.gob.es/profesionales/sistemasInformacion/sistemaInformacion/pdf/2019_Estadisticas_EDADES.pdf
  • Selvan K, Edriss H, Sigler M, Nugent KM. Complications and resource utilization associated with mechanical ventilation in a medical Intensive Care Unit in 2013. J Intensive Care Med. 2017; 32 (2):146–50. DOI: 10.1177/0885066615612413
  • Amato MB, Barbas CS, Medeiros DM, Magaldi RG, Schettino GP, Lorenzi-Filho G, et al. Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med. 1998; 338 (6):347-354. DOI: 10.1056/NEJM199802053380602
  • Mireles-Cabodevila E, Duggal A, Chatburn RL. Modes of Mechanical Ventilation. In: Esquinas A, Pravinkumar S, Soubani A. (eds) Mechanical Ventilation in Critically Ill Cancer Patients. Springer, Cham. DOI: 10.1007/978-3- 319-49256-8_17 177–88.
  • Acute Respiratory Distress Syndrome Network, Roy G, Brower RG, Matthay MA, Morris A, Schoenfeld D, et al. 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. 2000; 342 (18):1301-1308. DOI: 10.1056/ NEJM200005043421801
  • Needham DM, Yang T, Dinglas VD, Mendez-Tellez PA, Shanholtz C, Sevransky JE, et al. Timing of low tidal volume ventilation and intensive care unit mortality in acute respiratory distress syndrome: a prospective cohort study. Am J Respir Crit Care Med. 2015; 191 (2):177-185. DOI: 10.1164/rccm.201409-1598OC
  • Pettenuzzo T, Fan E. 2016 Year in Review: Mechanical Ventilation. Respir Care. 2017; 62 (5):629-635. DOI: 10.4187/ respcare.05545
Fonte de datos: Dialnet