Efectos de la ventilación mecánica con heliox en niños y adolescentes con patología bronquial obstructiva
Contribuinte(s) |
Fernández, Jaime Godoy, Javier Mullet, Hernando |
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Data(s) |
10/07/2012
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Resumo |
Evaluar si el Heliox reduce la resistencia en la vía aérea en niños y adolescentes con patología bronquial obstructiva que requieren ventilación mecánica. Materiales y Métodos: Estudio prospectivo observacional descriptivo en niños y adolescentes con patología bronquial obstructiva y ventilación mecánica con Fi02 ≤ 0,5. Medición de variables: resistencia, presión pico, presión media de la vía aérea, presión meseta, volumen corriente, autoPEEP, distensibilidad, PetCO2, ventilación de espacio muerto antes de inicio de heliox y a los 30 minutos, 2, 4, 6, 12, 18 y 24 horas y diariamente hasta suspenderlo por extubación o FiO2 > 0,5. Resultados: Resultados parciales, incluyó 9 pacientes encontrando descenso significativo de resistencia espiratoria a los 30 minutos (51,2 vs 32,3; p=0,0008 ), 2 horas ( 51,2 vs 33,4; p=0,0019) y 4 horas (51,2 vs 30,7; p=0,0012) así como de la resistencia inspiratoria a la hora 2 (48,6 vs 36,2; p = 0,013) y hora 4 (48,6 vs 30 ; p=0,004). Se observó tendencia al descenso de la PetCO2 que no fue significativa (52,3 vs 34,3: p=0,06). No se evidenció cambios en las variables; autoPEEP, presión pico, presión media de la vía aérea, distensibilidad, ventilación de espacio muerto, presión meseta y volumen corriente antes y después del inicio del Heliox. Conclusión: La ventilación mecánica con Heliox en niños con patología bronquial obstructiva parece ser que reduce de manera significativa la resistencia de la vía aérea, con tendencia al descenso de la PetC02. Se necesitan estudios prospectivos al menos observacionales analíticos que corroboren estos hallazgos. Objective: To evaluate if the Heliox reduces the resistance in the airway in children and adolescents with obstructive bronchial pathology and mechanical ventilation. Materials and Methods: An observational prospective descriptive study was made in children and adolescents with obstructive bronchial pathology and mechanical ventilation with Fi02 ≤ 0,5. Different variables were measured: resistance, pressure peak, mean airway pressure, pressure plateau, tidal volume, AutoPEEP, compliance, PetCO2, dead space ventilation, before heliox and after 30 minutes, 2, 4, 6, 12, 18 and 24 hours, and daily until heliox suspension by extubation or FiO2 > 0,5. Results: This study with partial results included 9 patients finding significant reduction of expiratory resistance to 30 minutes (51.2 versus 32,3; p=0,0008), 2 hours (51.2 versus 33,4; p=0,0019) and 4 hours (51.2 versus 30,7; p=0,0012) as well as of the inspiratory resistance to hour 2 (48.6 versus 36,2; p = 0.013) and hour 4 (48.6 versus 30; p=0,004). PetCO2 no significant decreasing tendency was observed (52.3 versus 34,3: p=0,06). No changes in variables; autoPEEP, pressure peak, mean airway pressure, compliance, dead space, pressure plateau and tidal volume, before or after the Heliox were observed. Conclusion: Mechanical ventilation with Heliox in Children with bronchial obstructive pathology appears to be that it reduce in a significant way the resistance of the airway, with tendency to the reduction of the PetC02. Prospective studies are needed at least observational analytic that corroborate these findings. |
Formato |
application/pdf |
Identificador | |
Idioma(s) |
spa |
Publicador |
Facultad de medicina |
Direitos |
info:eu-repo/semantics/openAccess |
Fonte |
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Palavras-Chave | #TRASTORNOS DE LA RESPIRACION #INSUFICIENCIA RESPIRATORIA #ENFERMEDADES RESPIRATORIAS #Heliox #Mechanical ventilation #Respiratory failure #Children |
Tipo |
info:eu-repo/semantics/bachelorThesis info:eu-repo/semantics/acceptedVersion |