Ventilación mecánica y sus complicaciones por el uso de surfactante en niños prematuros. Estudio realizado en UCIN del Hospital Gineco-Obstétrico Enrique C. Sotomayor enero del 2013 a junio 2013
Fecha
2014
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Tecnología Médica
Resumen
El estudio se trata sobre el tratamiento de reemplazo de surfactante, tanto profiláctico como temprano, comparado con la administración tardía del surfactante selectivo, reduce la mortalidad y las complicaciones pulmonares en los recién nacidos con síndrome de dificultad respiratoria ventilados. Sin embargo, la intubación y la asistencia respiratoria continua después del uso del surfactante son factores de riesgo para la enfermedad pulmonar crónica. La administración temprana de surfactante con asistencia respiratoria mecánica breve (menos de una hora) seguida de extubación, versus la administración tardía y selectiva de surfactante, asistencia respiratoria mecánica continua y extubación a partir de un apoyo respiratorio bajo. Se consideraron dos poblaciones de recién nacidos que recibieron surfactante temprano: recién nacidos que respiraban espontáneamente y presentaban signos de SDR (administración de surfactante durante la evolución del SDR7 antes de necesitar intubación para la insuficiencia respiratoria) y recién nacidos que
se encontraban en alto riesgo de SDR (administración profiláctica de surfactante dentro de los 15 minutos posteriores al nacimiento). Se buscaron datos relacionados con los efectos sobre la incidencia de la asistencia respiratoria mecánica (asistencia respiratoria continua o iniciada después de una hora de la administración del surfactante), la incidencia de displasia broncopulmonar (DBP), la enfermedad pulmonar crónica (EPC), la mortalidad, la duración de la asistencia respiratoria mecánica, la duración de la hospitalización, el tiempo con oxígeno, la duración del apoyo respiratorio. La metodología que se empleo en este estudio fue de tipo Hipotético Deductivo, con modalidad factible, con el apoyo del trabajo de campo, observación y participación, con las técnicas de encuesta. Cuyo instrumento fue el cuestionario y para su validación se realizo verificación por experto
The study is about surfactant replacement therapy, both prophylactic and early, compared with late administration of selective surfactant, reduces mortality and pulmonary complications in neonates with ventilated respiratory distress syndrome. However, intubation and continuous ventilation after surfactant use are risk factors for chronic lung disease. Early surfactant administration with brief mechanical ventilation (less than one hour) followed by extubation, versus late and selective surfactant administration, continuous mechanical ventilation, and extubation from low respiratory support. Two populations of newborns who received early surfactant were considered: newborns who breathed spontaneously and showed signs of RDS (surfactant administration during the course of RDS7 before requiring intubation for respiratory failure) and newborns who vii they were at high risk for RDS (prophylactic surfactant administration within 15 minutes of birth). We searched for data related to the effects on the incidence of mechanical ventilation (continuous or initiated ventilation within one hour of surfactant administration), the incidence of bronchopulmonary dysplasia (BPD), chronic lung disease (CLD), mortality, duration of mechanical ventilation, duration of hospitalization, time on oxygen, duration of respiratory support. The methodology used in this study was of the Hypothetical Deductive type, with a feasible modality, with the support of field work, observation and participation, with survey techniques. Whose instrument was the questionnaire and for its validation an expert verification was carried out
The study is about surfactant replacement therapy, both prophylactic and early, compared with late administration of selective surfactant, reduces mortality and pulmonary complications in neonates with ventilated respiratory distress syndrome. However, intubation and continuous ventilation after surfactant use are risk factors for chronic lung disease. Early surfactant administration with brief mechanical ventilation (less than one hour) followed by extubation, versus late and selective surfactant administration, continuous mechanical ventilation, and extubation from low respiratory support. Two populations of newborns who received early surfactant were considered: newborns who breathed spontaneously and showed signs of RDS (surfactant administration during the course of RDS7 before requiring intubation for respiratory failure) and newborns who vii they were at high risk for RDS (prophylactic surfactant administration within 15 minutes of birth). We searched for data related to the effects on the incidence of mechanical ventilation (continuous or initiated ventilation within one hour of surfactant administration), the incidence of bronchopulmonary dysplasia (BPD), chronic lung disease (CLD), mortality, duration of mechanical ventilation, duration of hospitalization, time on oxygen, duration of respiratory support. The methodology used in this study was of the Hypothetical Deductive type, with a feasible modality, with the support of field work, observation and participation, with survey techniques. Whose instrument was the questionnaire and for its validation an expert verification was carried out
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Respiración artificial, Surfactantes pulmonares, Recién nacido prematuro, Complicaciones neonatales, Unidades de Cuidado Intensivo Neonatal, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Cantón Guayaquil, Ecuador