2015, Número 3
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Med Crit 2015; 29 (3)
Delta de saturación venosa central de O2 como pronóstico de disfunción diastólica y fracaso del retiro del ventilador
Martínez MM, Cendejas GM, Brito ZOR
Idioma: Español
Referencias bibliográficas: 32
Paginas: 145-151
Archivo PDF: 209.58 Kb.
RESUMEN
La ventilación mecánica se asocia a complicaciones, por lo que debe descontinuarse lo antes posible. Algunos pacientes presentan falla al retiro a pesar de tener criterios de extubación, existiendo otros predictores que deben ser estudiados, como la saturación venosa central de oxígeno (SvcO
2).
Objetivo: Determinar la delta de SvcO
2 (D-SvcO
2) como pronóstico de disfunción diastólica y fracaso del retiro del ventilador.
Material y métodos: Investigación clínica, diseño: prueba pronóstica. Realizado de marzo a agosto de 2013 en una Unidad de Cuidados Intensivos en pacientes con ventilación mecánica asistida por más de 48 horas y criterios para prueba de ventilación espontánea. Se realizó gasometría venosa central al inicio y dos horas posteriores de la prueba para medir la D-SvcO
2. En pacientes con destete fallido se midió péptido natriurético tipo B (BNP).
Resultados: En el grupo de pacientes con extubación exitosa la media fue de 2.73 ± 1.28% y en los pacientes con destete fallido fue de 6.33 ± 1.37%, (p = 0.001) obteniendo una sensibilidad para la D-SvcO
2 de 96.3% y especificidad de 100%.
Conclusiones: Podemos considerar la D-SvcO
2 durante el destete ventilatorio como un nuevo parámetro pronóstico temprano e independiente del éxito o fracaso de la extubación.
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