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2000, Número 6

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Med Crit 2000; 14 (6)


Síndrome de insuficiencia respiratoria aguda tardío Una entidad emergente

Carrillo ER

Idioma: Español
Referencias bibliográficas: 68
Paginas: 203-214
Archivo PDF: 389.04 Kb.


RESUMEN

Objetivo: Reportar nuestra experiencia en el tratamiento del SIRA tardío con metilprednisolona.
Diseño: Serie de casos.
Lugar: UCI de un hospital de tercer nivel de la Ciudad de México.
Pacientes: Seis pacientes (tres mujeres, tres hombres, edad media 35.1 años) con SIRA.
Intervenciones: Monitoreo invasivo, biopsias pulmonares, broncoscopias, ventilación mecánica y metilprednisolona.
Mediciones y resultados principales: Dos pacientes murieron. En la 4ª semana de estancia se observó en los sobrevivientes, PaO2/ FIO2 380, Qs/Qt 5%, índice de Murray 0 puntos, índice de resistencias vasculares pulmonares 100 din. s/cm-5 , índice cardiaco 3 L/min, distensibilidad 63 cm H2O, daño alveolar difuso y trombosis de vasos pequeños pulmonares; y en los no sobrevivientes PaO2/FIO2 110, Qs/Qt 43%, índice de Murray 4 puntos, índice de resistencias vasculares pulmonares 280 din. s/cm-5, índice cardiaco 4 L/min, distensibilidad 23 cm H2O, fibrosis extensa con pérdida de la arquitectura alveolar y vascular.
Conclusión: La metilprednisolona puede ser útil en el tratamiento del SIRA tardío.


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