Terapia respiratoria en pacientes con distres respiratorio en el recién nacido, Unidad de Cuidados Intensivos Neonatales, Hospital del Niño Dr. Francisco de Icaza Bustamante
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2020
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Tecnología Médica
Resumen
Esta investigación es realizada con el objetivo de Analizar el uso de la terapia respiratoria en pacientes recién nacidos con Distrés respiratorio tipo I del hospital Francisco de Icaza Bustamante desde Noviembre del 2019 hasta Febrero del 2020, estos pacientes llegan a esta Unidad después de haber presentado insuficiencia respiratoria causada por disminución de niveles de surfactante del pulmón, sustancia química del tipo de las grasas (dipalmitoil lecitina o esfingomielina) producida por los neumocitos tipo II que recubre los alvéolos, llegando al distrés respiratorio, en este estudio la incidencia de este aumenta con respecto a la edad de gestación de manera que afecta al 46% de 32 semanas de EG y a menos del 6% de 26 semanas de EG. Al nacimiento o poco tiempo después los pacientes presentan sintomatología como taquipnea, dificultad respiratoria progresiva requiriendo el uso de oxígeno. Se realizan pruebas gasométricas donde se encuentran pacientes con hipoxemia, diversos grados de acidosis respiratoria por hipercapnia; radiológicamente aparece opacidad del parénquima pulmonar con broncograma aéreo con un característico de “vidrio esmerilado” que se da en casos más graves, donde se habla ya de un distrés de tipo severo. Estos pacientes requieren un tratamiento multidisciplinar de soporte tanto respiratorio como ventilatorio. Con administración de corticoides prenatales acelerando la maduración pulmonar y un tratamiento postnatal con surfactante, disminuyendo su morbimortalidad. Para efectos de la investigación se realizó recolección de datos, clasificación de parámetros que conllevan a la patología, aplicación de instrumentos de valoración dirigidos a la eficacia de las técnicas respiratorias que se utilizan para este tipo de patología. Este estudio que es presentado a continuación es de carácter descriptivo, analítico, de corte transversal, retrospectivo, para lo cual se realizó una propuesta: Proponer la creación de un tríptico informativo para dar a conocer y poder disminuir los factores de riesgo que conllevan a esta patología. El universo fueron 33 recién nacidos con dificultad respiratoria que ingresaron al área de Unidad de Cuidados Intensivos Neonatales, de los cuales se tomó una muestra de 15 que se hallaban dentro de los criterios de inclusión.
This research is carried out with the sole objective of To analyze the use of respiratory therapy in newborn patients with respiratory distress type I in the Neonatal Intensive Care Unit Area at the Francisco de Icaza Bustamante Hospital from November 2019 to February 2020, these patients This Unit will be affected after having presented respiratory insufficiency caused by decreased levels of surfactant of the lung, chemical substance of the type of fats (dipalmitoyl lecithin or sphingomyelin) produced by the type II pneumocytes that cover the alveoli, reaching the respiratory distress, in this study the incidence of this increases with respect to the age of pregnancy so that it affects 46% of 32 weeks of EG and less than 6% of 26 weeks of EG. At birth or shortly after the patients, he presents symptoms such as tachypnea, progressive respiratory difficulty requiring the use of oxygen. Gasometric tests are performed where patients with hypoxemia are found, varying degrees of respiratory acidosis due to hypercapnia; radiologically, opacity of the pulmonary parenchyma with air bronchogram appears with a characteristic of "frosted glass" that occurs in more severe cases, where it is spoken and of a severe type distributor. These patients require a multidisciplinary treatment of both respiratory and ventilatory support. With administration of prenatal corticosteroids accelerating lung maturation and a postnatal surfactant treatment, decreasing morbidity and mortality. For the purposes of the investigation, data collection, classification of parameters involving the pathology, application of assessment instruments aimed at the efficacy of the respiratory techniques used for this type of pathology were performed. This study presented below is descriptive, analytical, cross-sectional, retrospective, for which a proposal was made: Propose the creation of an informative triptych to publicize and reduce the risk factors involved in this pathology The universe was 33 newborns with respiratory distress who entered the Neonatal Intensive Care Unit area, from which a sample of 15 that were within the inclusion criteria was taken.
This research is carried out with the sole objective of To analyze the use of respiratory therapy in newborn patients with respiratory distress type I in the Neonatal Intensive Care Unit Area at the Francisco de Icaza Bustamante Hospital from November 2019 to February 2020, these patients This Unit will be affected after having presented respiratory insufficiency caused by decreased levels of surfactant of the lung, chemical substance of the type of fats (dipalmitoyl lecithin or sphingomyelin) produced by the type II pneumocytes that cover the alveoli, reaching the respiratory distress, in this study the incidence of this increases with respect to the age of pregnancy so that it affects 46% of 32 weeks of EG and less than 6% of 26 weeks of EG. At birth or shortly after the patients, he presents symptoms such as tachypnea, progressive respiratory difficulty requiring the use of oxygen. Gasometric tests are performed where patients with hypoxemia are found, varying degrees of respiratory acidosis due to hypercapnia; radiologically, opacity of the pulmonary parenchyma with air bronchogram appears with a characteristic of "frosted glass" that occurs in more severe cases, where it is spoken and of a severe type distributor. These patients require a multidisciplinary treatment of both respiratory and ventilatory support. With administration of prenatal corticosteroids accelerating lung maturation and a postnatal surfactant treatment, decreasing morbidity and mortality. For the purposes of the investigation, data collection, classification of parameters involving the pathology, application of assessment instruments aimed at the efficacy of the respiratory techniques used for this type of pathology were performed. This study presented below is descriptive, analytical, cross-sectional, retrospective, for which a proposal was made: Propose the creation of an informative triptych to publicize and reduce the risk factors involved in this pathology The universe was 33 newborns with respiratory distress who entered the Neonatal Intensive Care Unit area, from which a sample of 15 that were within the inclusion criteria was taken.
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Síndrome de dificultad respiratoria del recién nacido, Surfactante pulmonar, Enfermedad de la membrana hialina, Terapia Respiratoria, Epidemiología descriptiva, Unidades de Cuidado Intensivo Neonatal, Hospital del Niño Francisco de Icaza Bustamante, Cantón Guayaquil, Ecuador