Martínez-Leyva E, Álvarez-Martínez I, Gallardo-Alonso LA, Jiménez-Zepeda VH, Alonso-Mercado A, Gutiérrez GA, Guadarrama-Quijada F

Idioma: Español
Referencias bibliográficas: 35
Paginas: 174-180
Archivo PDF: 130.87 Kb.

RESUMEN

Las estrategias de ventilación mecánica son usadas para prevenir el daño pulmonar, optimizando el intercambio gaseoso. Recientemente se ha descrito que el soporte mecánico limitado por el volumen y la presión reduce la sobredistensión pulmonar. El objetivo de este estudio fue comparar la ventilación controlada por presión y por volumen en pacientes sometidos a cirugía laparoscópica. Material y métodos: Previa aprobación del Comité de Ética e informe de consentimiento escrito y firmado, se incluyeron 40 pacientes (ASA I/II) programados para cirugía laparoscópica electiva. Los pacientes se encontraban en ayuno desde media noche antes del día de la cirugía. Se realizó inducción anestésica con fentanil (2 µg/kg), propofol (2 mg/kg) y atracurio (150 µg/kg). La intubación endotraqueal se realizó con relajación muscular completa, valorada por tren de cuatro. Se mantuvo anestesia con sevoflurano a 1 MAC. Los pacientes fueron asignados de manera aleatoria para recibir ventilación controlada por presión (VCP) o ventilación controlada por volumen (VCV). Resultados: Los parámetros hemodinámicos fueron similares en ambos grupos durante los diferentes periodos registrados. Las presiones sistólica, distólica y media fueron similares. Durante el neumoperitoneo la SpO₂ presentó un aumento de 97.61 ± 1.29 para VCP comparado con 97.25 ± 1.2 para VCV (p 0.368). Diez minutos después de la insuflación, la SpO₂ se mantuvo similar en los dos grupos. Conclusión: Tanto la VCP como la VCV son modalidades de ventilación bien toleradas para pacientes sometidos a cirugía laparoscópica.

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