Modos de ventilación mecánica invasiva prevalentes dentro de las unidades de cuidados intensivos del Ecuador
Resumen
Introducción: El síndrome de distrés respiratorio agudo se enmarca como una patología de características hipoxémicas de alta incidencia dentro de cuidados intensivos cuyo diagnóstico se apoya en diversas herramientas clínicas, se estima una presentación del 10,4% con una elevada tasa de mortalidad cerca del 63%, razón por la cual se hace mandatorio la instauración de ventilación mecánica. Los principales modos ventilatorios son los controlados por presión y volumen, de los cuales se desglosa una amplia variedad. Objetivo: identificar los modos ventilatorios de preferencia dentro de cuidados intensivos del Ecuador utilizados en síndrome de distrés respiratorio. Metodología: se desenvolvió bajo las directrices correspondientes a uno de tipo observacional, de carácter descriptivo y de corte transversal. Resultados: La región costa fue donde se obtuvo la mayor parte del registro con un 52,73% seguida de la sierra con 40% y oriente con 7,27%. Destacando el modo VCP como el más usado con un 41,8% (n=23), el VCV y A/C con 18,2% (n=10), el SIMV alcanzo 10.9% (n=6), IPPV 9,1% (n=5) y el modo PRVC 1,8% (n=1). Conclusión: En el actual estudio se recolectaron un total de 5 modos ventilatorios utilizados dentro de cuidados intensivos de 3 regiones del Ecuador con mayor porcentaje de preferencia al modo VCP.
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Mauri, T., Lazzeri, M., Bellani, G., Zanella, A., & Grasselli, G. (2017). Respiratory mechanics to understand ARDS and guide mechanical ventilation. Physiological measurement, 38(12), R280–H303. https://doi.org/10.1088/1361-6579/aa9052
Singer, B. D., & Corbridge, T. C. (2011). Pressure modes of invasive mechanical ventilation. Southern medical journal, 104(10), 701–709. https://doi.org/10.1097/SMJ.0b013e31822da7fa
Sklar, M. C., Patel, B. K., Beitler, J. R., Piraino, T., & Goligher, E. C. (2019). Optimal Ventilator Strategies in Acute Respiratory Distress Syndrome. Seminars in respiratory and critical care medicine, 40(1), 81–93. https://doi.org/10.1055/s-0039-1683896
Sakuraya, M., Okano, H., Masuyama, T., Kimata, S., & Hokari, S. (2021). Efficacy of non-invasive and invasive respiratory management strategies in adult patients with acute hypoxaemic respiratory failure: a systematic review and network meta-analysis. Critical care (London, England), 25(1), 414. https://doi.org/10.1186/s13054-021-03835-8
Ranieri, V. M., Suter, P. M., Tortorella, C., De Tullio, R., Dayer, J. M., Brienza, A., Bruno, F., & Slutsky, A. S. (1999). Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome: a randomized controlled trial. JAMA, 282(1), 54–61. https://doi.org/10.1001/jama.282.1.54
Esteban, A., Ferguson, N. D., Meade, M. O., Frutos-Vivar, F., Apezteguia, C., Brochard, L., Raymondos, K., Nin, N., Hurtado, J., Tomicic, V., González, M., Elizalde, J., Nightingale, P., Abroug, F., Pelosi, P., Arabi, Y., Moreno, R., Jibaja, M., D'Empaire, G., Sandi, F., … VENTILA Group (2008). Evolution of mechanical ventilation in response to clinical research. American journal of respiratory and critical care medicine, 177(2), 170–177. https://doi.org/10.1164/rccm.200706-893OC
Fan, E., Brodie, D., & Slutsky, A. S. (2018). Acute Respiratory Distress Syndrome: Advances in Diagnosis and Treatment. JAMA, 319(7), 698–710. https://doi.org/10.1001/jama.2017.21907
Abrams, D., Schmidt, M., Pham, T., Beitler, J. R., Fan, E., Goligher, E. C., McNamee, J. J., Patroniti, N., Wilcox, M. E., Combes, A., Ferguson, N. D., McAuley, D. F., Pesenti, A., Quintel, M., Fraser, J., Hodgson, C. L., Hough, C. L., Mercat, A., Mueller, T., Pellegrino, V., … Brodie, D. (2020). Mechanical Ventilation for Acute Respiratory Distress Syndrome during Extracorporeal Life Support. Research and Practice. American journal of respiratory and critical care medicine, 201(5), 514–525. https://doi.org/10.1164/rccm.201907-1283CI
Dianti, J., Matelski, J., Tisminetzky, M., Walkey, A. J., Munshi, L., Del Sorbo, L., Fan, E., Costa, E. L., Hodgson, C. L., Brochard, L., & Goligher, E. C. (2021). Comparing the Effects of Tidal Volume, Driving Pressure, and Mechanical Power on Mortality in Trials of Lung-Protective Mechanical Ventilation. Respiratory care, 66(2), 221–227. https://doi.org/10.4187/respcare.07876
Tomicic, V., Espinoza, M., Andresen, M., Molina, J., Calvo, M., Ugarte, H., ... & Esteban, A. (2008). Characteristics and factors associated with mortality in patients receiving mechanical ventilation: first Chilean multicenter study. Revista medica de Chile, 136(8), 959-967. http://dx.doi.org/10.4067/S0034-98872008000800001
Acute Respiratory Distress Syndrome Network, Brower, R. G., Matthay, M. A., Morris, A., Schoenfeld, D., Thompson, B. T., & Wheeler, A. (2000). Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The New England journal of medicine, 342(18), 1301–1308. https://doi.org/10.1056/NEJM200005043421801
Amato, M. B., Barbas, C. S., Medeiros, D. M., Schettino, G., Lorenzi Filho, G., Kairalla, R. A., Deheinzelin, D., Morais, C., Fernandes, E., & Takagaki, T. Y. (1995). Beneficial effects of the "open lung approach" with low distending pressures in acute respiratory distress syndrome. A prospective randomized study on mechanical ventilation. American journal of respiratory and critical care medicine, 152(6 Pt 1), 1835–1846. https://doi.org/10.1164/ajrccm.152.6.8520744
Goligher, E. C., Jonkman, A. H., Dianti, J., Vaporidi, K., Beitler, J. R., Patel, B. K., Yoshida, T., Jaber, S., Dres, M., Mauri, T., Bellani, G., Demoule, A., Brochard, L., & Heunks, L. (2020). Clinical strategies for implementing lung and diaphragm-protective ventilation: avoiding insufficient and excessive effort. Intensive care medicine, 46(12), 2314–2326. https://doi.org/10.1007/s00134-020-06288-9
Bertoni, M., Spadaro, S., & Goligher, E. C. (2020). Monitoring Patient Respiratory Effort During Mechanical Ventilation: Lung and Diaphragm-Protective Ventilation. Critical care (London, England), 24(1), 106. https://doi.org/10.1186/s13054-020-2777-y
Brochard, L., Slutsky, A., & Pesenti, A. (2017). Mechanical Ventilation to Minimize Progression of Lung Injury in Acute Respiratory Failure. American journal of respiratory and critical care medicine, 195(4), 438–442. https://doi.org/10.1164/rccm.201605-1081CP
Wilcox, S. R., Richards, J. B., Fisher, D. F., Sankoff, J., & Seigel, T. A. (2016). Initial mechanical ventilator settings and lung protective ventilation in the ED. The American journal of emergency medicine, 34(8), 1446–1451. https://doi.org/10.1016/j.ajem.2016.04.027
Rackley C. R. (2020). Monitoring During Mechanical Ventilation. Respiratory care, 65(6), 832–846. https://doi.org/10.4187/respcare.07812
Storre, J. H., & Dellweg, D. (2014). Monitoring des Beatmungspatienten [Monitoring of patients receiving mechanical ventilation]. Pneumologie (Stuttgart, Germany), 68(8), 532–541. https://doi.org/10.1055/s-0034-1365742
Guo, L., Wang, W., Zhao, N., Guo, L., Chi, C., Hou, W., Wu, A., Tong, H., Wang, Y., Wang, C., & Li, E. (2016). Mechanical ventilation strategies for intensive care unit patients without acute lung injury or acute respiratory distress syndrome: a systematic review and network meta-analysis. Critical care (London, England), 20(1), 226. https://doi.org/10.1186/s13054-016-1396-0
Yao, W., Yang, M., Cheng, Q., Shan, S., Yang, B., Han, Q., & Ma, J. (2020). Effect of Pressure-Controlled Ventilation-Volume Guaranteed on One-Lung Ventilation in Elderly Patients Undergoing Thoracotomy. Medical science monitor : international medical journal of experimental and clinical research, 26, e921417. https://doi.org/10.12659/MSM.921417
Burns, K. E., Adhikari, N. K., Slutsky, A. S., Guyatt, G. H., Villar, J., Zhang, H., Zhou, Q., Cook, D. J., Stewart, T. E., & Meade, M. O. (2011). Pressure and volume limited ventilation for the ventilatory management of patients with acute lung injury: a systematic review and meta-analysis. PloS one, 6(1), e14623. https://doi.org/10.1371/journal.pone.0014623
Delong, P., Murray, J. A., & Cook, C. K. (2006). Mechanical ventilation in the management of acute respiratory distress syndrome. Seminars in dialysis, 19(6), 517–524. https://doi.org/10.1111/j.1525-139X.2006.00215.xChoi, S., Yang, S.Y., Choi, G.J. et al. Comparison of pressure- and volume-controlled ventilation during laparoscopic colectomy in patients with colorectal cancer. Sci Rep 9, 17007 (2019). https://doi.org/10.1038/s41598-019-53503-9
Rittayamai, N., Katsios, C. M., Beloncle, F., Friedrich, J. O., Mancebo, J., & Brochard, L. (2015). Pressure-Controlled vs Volume-Controlled Ventilation in Acute Respiratory Failure: A Physiology-Based Narrative and Systematic Review. Chest, 148(2), 340–355. https://doi.org/10.1378/chest.14-3169
Schick, V., Dusse, F., Eckardt, R., Kerkhoff, S., Commotio, S., Hinkelbein, J., & Mathes, A. (2021). Comparison of Volume-Guaranteed or -Targeted, Pressure-Controlled Ventilation with Volume-Controlled Ventilation during Elective Surgery: A Systematic Review and Meta-Analysis. Journal of clinical medicine, 10(6), 1276. https://doi.org/10.3390/jcm10061276
Esteban, A., Frutos-Vivar, F., Muriel, A., Ferguson, N. D., Peñuelas, O., Abraira, V., Raymondos, K., Rios, F., Nin, N., Apezteguía, C., Violi, D. A., Thille, A. W., Brochard, L., González, M., Villagomez, A. J., Hurtado, J., Davies, A. R., Du, B., Maggiore, S. M., Pelosi, P., … Anzueto, A. (2013). Evolution of mortality over time in patients receiving mechanical ventilation. American journal of respiratory and critical care medicine, 188(2), 220–230. https://doi.org/10.1164/rccm.201212-2169OC
Hassan, B.Ed.E., El-Shaer, A.N., Elbeialy, M.A.K. et al. Comparison between volume-controlled ventilation and pressure-controlled volume-guaranteed ventilation in postoperative lung atelectasis using lung ultrasound following upper abdominal laparotomies: a prospective randomized study. Ain-Shams J Anesthesiol 12, 27 (2020). https://doi.org/10.1186/s42077-020-00076-9
Kim, K. N., Kim, D. W., Jeong, M. A., Sin, Y. H., & Lee, S. K. (2016). Comparison of pressure-controlled ventilation with volume-controlled ventilation during one-lung ventilation: a systematic review and meta-analysis. BMC anesthesiology, 16(1), 72. https://doi.org/10.1186/s12871-016-0238-6
Chacko, B., Peter, J. V., Tharyan, P., John, G., & Jeyaseelan, L. (2015). Pressure-controlled versus volume-controlled ventilation for acute respiratory failure due to acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). The Cochrane database of systematic reviews, 1(1), CD008807. https://doi.org/10.1002/14651858.CD008807.pub2
Derechos de autor 2022 Stalin Javier Caiza Lema;Robinson Adrián Rumiguano Jiménez;Hemily Daniela Ortiz Loma ;Jhonatan Sebastián Paneluisa Lema
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.