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>Revistas >Medicina Crítica >Año 2017, No. 4


Hernández-López GD, Cerón-Juárez R, Escobar-Ortiz D, Graciano-Gaytán L, Gorordo-Delsol LA, Merinos-Sánchez G, Castañón-González JA, Amezcua-Gutiérrez MA, Cruz-Montesinos S, Garduño-López J, Lima-Lucero IM, Montoya-Rojo JO
Retiro de la ventilación mecánica
Rev Asoc Mex Med Crit y Ter Int 2017; 31 (4)

Idioma: Español
Referencias bibliográficas: 44
Paginas: 238-245
Archivo PDF: 172.54 Kb.

[Texto completo - PDF]

RESUMEN

La mayoría de los pacientes que requieren ventilación › 24 horas y mejoran pueden ser extubados tras la primera prueba de ventilación espontánea. El reto es mejorar la desconexión de los pacientes que fracasan. El retiro de la ventilación mecánica es un elemento esencial en el cuidado de los pacientes críticamente enfermos. Se revisa el proceso de liberar al paciente del soporte mecánico y de la cánula endotraqueal. El tiempo empleado en el proceso de destete representa de 40 a 50% de la duración total de la ventilación. Se recomienda: 1) Prever tres grupos en función de la dificultad y duración del destete, 2) Retiro lo más pronto posible, 3) Utilizar la prueba de ventilación espontánea para determinar si los pacientes pueden ser extubados con éxito, 4) La prueba inicial debe durar 30 minutos en respiración en tubo en T o con bajos niveles de soporte, 5) La presión de soporte y los modos de ventilación AC deben preferirse cuando han fracasado en la primera prueba, 6) Considerar ventilación no invasiva en pacientes seleccionados para acortar la duración de la intubación, pero no debe usarse de forma rutinaria como herramienta para el fracaso de la extubación.


Palabras clave: Respiración artificial, destete de ventilador, cuidados intensivos.


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>Revistas >Medicina Crítica >Año2017, No. 4
 

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