[Mechanical ventilation parameters associated to barotrauma in a neonatal intensive care unit].

Autor: Tapia-Rombo CA; Servicio de Neonatologia, Unidad Médica de Alta Especialidad, Hospital General Dr. Gaudencio González Garza, Centro Médico Nacional La Raza, IMSS. tapiachar@yahoo.com.mx, Quezada-Cuevas SE, Uscanga-Carrasco H, Aguilar-Solano AM, Castillo-Pérez JJ
Jazyk: Spanish; Castilian
Zdroj: Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion [Rev Invest Clin] 2012 Sep-Oct; Vol. 64 (5), pp. 407-19.
Abstrakt: Objective: To identify the parameters of mechanical ventilation related to barotrauma and to identify associated diseases.
Material and Methods: There was a partial retrospective study which included all the files and/or newborns (NB) who were in the Neonatal Intensive Care Unit during March 2003 to April 2008 met the inclusion criteria. Two groups were conformed, the group A, cases (those with barotrauma) and B controls (that did not show it). Area of significance was considered when p < 0.05.
Results: In multivariate analysis was only significant relevance in relation to the ventilatory parameters mean airway pressure (MAP) > 10 cm H20 on the eighth day, and as confronted all variables including one different from the ventilator as arterial blood gases in the multivariate analysis also, the oxygenation index (OI) with a value > 10 showed statistical significance as it preceded to the barotrauma. The pathology associated with barotrauma was patent ductus arteriosus (PDA) hemodynamically significant with p < 0.05.
Conclusions: Based on the foregoing its is concluded that when a NB patient with mechanical ventilatory support after the first days, to improve lung compliance should be going down different ventilatory parameters as soon as possible to avoid reaching a MAP > 10 cm H2O above the eighth day of ventilatory management, but OI > 10 at any time would be announcing the possibility of barotrauma and other side to treat the significant hemodynamically PDA either medically or surgically in the shortest time.
Databáze: MEDLINE