Estructuración de un algoritmo para el uso adecuado de ventilación mecánica en pacientes con insuficiencia respiratoria aguda
Fecha
2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
El uso de soporte ventilatorio mecánico es un tratamiento de la Insuficiencia
Respiratoria Aguda que no responde a tratamientos no invasivos, la protocolización de su uso
se ha extendido en menor grado que otros procesos en el manejo de pacientes agudos. El
objetivo de este estudio es demostrar la asociación entre el manejo de la Insuficiencia
Respiratoria y la necesidad de Soporte Ventilatorio Mecánico y estructurar un algoritmo para
el uso adecuado de ventilación mecánica en pacientes con insuficiencia respiratoria aguda.
Tiene un enfoque cuantitativo, no experimental, tipo transversal analítico, buscando establecer
una correlación causal, analítico tipo caso controles, retrospectivo. Se analizaron 3747
pacientes, se encontraron problemas respiratorios como causa de atención en emergencias en
un 5,15 %, De éstos el 7,25 % fue diagnosticado de Insuficiencia Respiratoria aguda, el 50 %
de sexo femenino, el 35,7 % de los pacientes diagnosticados con Insuficiencia Respiratoria
Aguda necesitó intubación orotraqueal y Ventilación Mecánica. El 28,6 % falleció, en ningún
paciente se utilizó Ventilación Mecánica No Invasiva. El uso de criterios fundamentados en
guías internacionales para el manejo inicial de la IRA se asoció a una menor necesidad de
Intubación. Se concluye que el uso de un algoritmo como guía en el manejo de la falla
respiratoria aguda disminuye la necesidad de intubación orotraqueal
The use of mechanical ventilatory support is a treatment of Acute Respiratory Failure (ARF) does not respond to non-invasive treatments, the protocolization of its use has spread to a lesser extent than other processes in the management of acute patients. The aim of this study is to demonstrate the association between the management of Respiratory Failure and the need for mechanical ventilatory support and to structure an algorithm for the proper use of mechanical ventilation in these patients. It has a non-experimental quantitative approach, analytical transversal, seeking to establish a causal correlation analytic retrospective case control. 3747 patients were analyzed, respiratory problems as a cause of emergency attention was founded in 5.15%, 7.25% of these was diagnosed with ARF, 50% female, 35.7% of patients diagnosed with ARF needed endotracheal intubation and mechanical ventilation. 28.6% died, in any patient Noninvasive Mechanical Ventilation was utilized. Using substantiated criteria in international guidelines for initial management of AKI was associated with a decreased need for intubation. It is concluded that the use of an algorithm to guide management of acute respiratory failure decreases the need for endotracheal intubation
The use of mechanical ventilatory support is a treatment of Acute Respiratory Failure (ARF) does not respond to non-invasive treatments, the protocolization of its use has spread to a lesser extent than other processes in the management of acute patients. The aim of this study is to demonstrate the association between the management of Respiratory Failure and the need for mechanical ventilatory support and to structure an algorithm for the proper use of mechanical ventilation in these patients. It has a non-experimental quantitative approach, analytical transversal, seeking to establish a causal correlation analytic retrospective case control. 3747 patients were analyzed, respiratory problems as a cause of emergency attention was founded in 5.15%, 7.25% of these was diagnosed with ARF, 50% female, 35.7% of patients diagnosed with ARF needed endotracheal intubation and mechanical ventilation. 28.6% died, in any patient Noninvasive Mechanical Ventilation was utilized. Using substantiated criteria in international guidelines for initial management of AKI was associated with a decreased need for intubation. It is concluded that the use of an algorithm to guide management of acute respiratory failure decreases the need for endotracheal intubation
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INSUFICIENCIA RESPIRATORIA, RESPIRACIÓN ARTIFICIAL, ALGORITMO DE DIAGNÓSTICO, EPIDEMIOLOGÍA ANALÍTICA, HOSPITAL GENERAL DEL IESS MANTA, CANTÓN MANTA, ECUADOR