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2014, Number 1

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Rev Hosp Jua Mex 2014; 81 (1)

Utilidad de la prueba de fuga de volumen durante el retiro de la ventilación mecánica en pacientes sometidos a cirugía de columna cervical

Hernández-López DG, López-Reséndiz A, Estrada-Carreón M, Díaz-Torres MC, Hernández-Vázquez F

Language: Spanish
References: 18
Page: 27-31
PDF size: 198.69 Kb.


ABSTRACT

Introduction. The airway obstruction is a neck surgery complication. Obstruction can occur due to hematoma development, pharyngeal edema or graft displacement. The main function of balloon tracheal cannula (BTC) is to provide an adequate airway closure, preventing passage of air or liquid around the BTC. The need for reintubation after neck surgery is around 4%. Although the delay in the weaning and extubation increases the complications inherent in these procedures, the stay and cost of hospitalization in the intensive care units, on the other hand, the premature weaning and extubation with a volume cuff-leak percentage of inadequate volume, can bring deleterious consequences, such as the urgent need to restore again an artificial airway in a patient with impaired respiratory function by an obstructive process. Material and methods. Seventy-three patients who underwent surgery for anterior and/or posterior cervical spine route and required mechanical ventilation management were included. Prior to extubation the volume cuff-leak test was performed. Results. In five patients the cuff-leak test volume was less than 25 % (6.8 %), in 2 cases (2.7 %) the presence of hematoma and in 3 (4.1 %) soft tissue edema was demonstrated by neck tomography. In five patients a surgical time average of 3.5 h and correction of three or more levels was found. Statistical analysis showed a significant relationship between the two variables, a volume cuff-leak test less than 25% and need for reintubation. Conclusion. In patients undergoing cervical spine surgery with a volume cuff-leak test less than of 25%, the assessment post-surgical complications is necessary, because this findings may be associated with the need of reintubation.


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