Ventilación mecánica no invasiva vs ventilación mecánica invasiva para la asistencia respiratoria de cuidados anestésicos postiroidectomía
Fecha
2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Antecedentes: el cuidado ventilatorio postquirúrgico del paciente tiroidectomizado es un reto debido a que su ejecución determina la manipulación del cuello. Existen dos métodos para proveer estos cuidados, la ventilación mecánica no invasiva (VMNI) y la invasiva (VMI). Objetivos: Determinar si la ventilación mecánica no invasiva ofrece ventajas sobre la ventilación mecánica invasiva con tubo endotraqueal para la asistencia respiratoria anestésica de los pacientes en el postquirúrgico de tiroidectomía atendidos en el hospital Teodoro Maldonado Carbo en el Periodo 2015 - 2016 Metodología: Se realizó un estudio observacional analítico prospectivo en el que se incluyeron de manera no aleatoria por conveniencia 50 pacientes en los que se utilizó VMI y 50 en los que se empleó VMNI. Resultados: En la SO2, la PCO2, la PAS, la PAD y la FC no se evidenciaron diferencias estadísticamente significativas entre los grupos (P > 0.05) En relación a las manifestaciones clínicas existió una tendencia a un mayor número de intubación difícil entre la VMNI (P 0,079), tos (P 0,169), laringo-espasmo (P 0,079) y obstrucción de la vía aérea (P 0,558) pero no existieron diferencias estadísticamente significativas. Existió una diferencias estadísticamente significativa en relación al número de odinofagia (36& vs 0%) (P 0.000). Conclusiones: la VMNI ofrece ventajas sobre la VMI para el cuidado ventilatorio postquirúrgico ya que disminuye las complicaciones clínicas.
Background: Postoperative ventilatory care of the thyroidectomized patient is a challenge because its execution determines the manipulation of the neck. There are two methods to provide this care, non-invasive mechanical ventilation (NIV) and invasive ventilation (IMV). Objectives: To determine if non-invasive mechanical ventilation offers advantages over invasive mechanical ventilation with endotracheal tube for the anesthetic respiratory assistance of patients in the postoperative thyroidectomy treated at the Teodoro Maldonado Hospital in the period 2015-2016 Methodology: A A prospective analytical observational study in which 50 patients in whom IMV was used and 50 in whom NIMV was used were included non-randomly for convenience. Results: There were no statistically significant differences between the groups in SO2, PCO2, SBP, DBP and HR (P> 0.05). In relation to clinical manifestations, there was a tendency for a greater number of difficult intubation between NIMV (P 0.079), cough (P 0,169), laryngospasm (P 0.079), and airway obstruction (P 0.558), but there were no statistically significant differences. There was a statistically significant difference in relation to the number of odynophagia (36 & vs 0%) (P 0.000). Conclusions: NIMV offers advantages over VMI for postoperative ventilatory care as it decreases clinical complications.
Background: Postoperative ventilatory care of the thyroidectomized patient is a challenge because its execution determines the manipulation of the neck. There are two methods to provide this care, non-invasive mechanical ventilation (NIV) and invasive ventilation (IMV). Objectives: To determine if non-invasive mechanical ventilation offers advantages over invasive mechanical ventilation with endotracheal tube for the anesthetic respiratory assistance of patients in the postoperative thyroidectomy treated at the Teodoro Maldonado Hospital in the period 2015-2016 Methodology: A A prospective analytical observational study in which 50 patients in whom IMV was used and 50 in whom NIMV was used were included non-randomly for convenience. Results: There were no statistically significant differences between the groups in SO2, PCO2, SBP, DBP and HR (P> 0.05). In relation to clinical manifestations, there was a tendency for a greater number of difficult intubation between NIMV (P 0.079), cough (P 0,169), laryngospasm (P 0.079), and airway obstruction (P 0.558), but there were no statistically significant differences. There was a statistically significant difference in relation to the number of odynophagia (36 & vs 0%) (P 0.000). Conclusions: NIMV offers advantages over VMI for postoperative ventilatory care as it decreases clinical complications.
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Respiración artificial, Asistencia respiratoria, Período posoperatorio, Tiroidectomía, Epidemiología analítica, Estudios prospectivos, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador, Respiración artificial no invasiva, Estudios prospectivos