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2006, Número 4

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Med Crit 2006; 20 (4)


Asistencia mecánica ventilatoria de largo plazo en la Unidad de Terapia Intensiva: definición, causas y pronóstico

Cerda GP, Olvera GC, Aguirre SJ, Franco GJ, Elizalde GJ, Martínez SJ

Idioma: Español
Referencias bibliográficas: 26
Paginas: 157-163
Archivo PDF: 76.43 Kb.


RESUMEN

Objetivo: Identificar las causas de asistencia mecánica ventilatoria de largo plazo (AMVLP) en la UTI y caracterizar su pronóstico.
Diseño: Prospectivo y observacional
Lugar: UTI de un hospital de tercer nivel.
Intervenciones: Ninguna.
Mediciones y resultados principales: 39 pacientes con AMVLP (edad media 59.4 ± 26) se agruparon en: pacientes con insuficiencia respiratoria aguda en pulmones previamente sanos (categoría I), y en pulmones con neumopatía crónica preexistente (categoría II). Se obtuvieron datos demográficos, APACHE II, duración de AMV, necesidad de traqueostomía y tiempo de realización, necesidad de AMV no invasiva (AMVni) postextubación inmediata, egresados con y sin AMV, mortalidad y días de estancia hospitalaria y sobrevida después de 1 mes de egreso. Los pacientes de la categoría I requirieron menor AMVni (27 vs 54%, p ‹ 0.01), tuvieron mayor éxito de retiro de la AMV (58 vs 0%, IC 95% 0.1-1, p ‹ 0.001), menor mortalidad hospitalaria (31% vs 75%, IC 95%, 1.3-5, p ‹ 0.01) y mayor sobrevida al mes del egreso (62% vs 0%, p ‹ 0.01). No hubo otras diferencias estadísticas significativas.
Conclusiones: La AMVLP en pacientes con neumopatía crónica, debe valorarse y puede no justificarse, ya que no demostró reducir la mortalidad a corto ni a largo plazo.


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