Ventilación espontánea en ventilación mecánica invasiva

Ventilación espontánea en ventilación mecánica invasiva

Introducción: El uso de la ventilación mecánica invasiva (VMI) convencionalmente con modos controlados y uso de sedantes conlleva a un aumento de complicaciones y eventos indeseados como la disfunción diafragmática al inhibir la ventilación espontanea. Este artículo revisara la viabilidad de la ventilación espontanea en VMI partiendo de la actividad muscular inspiratoria como mecanismo fisiológico para la ventilación pulmonar, los cambios al ser remplazado por un mecanismo donde la ventilación es generada por la VMI, la interacción entre los dos mecanismos “pulmón dual” y sus efectos a nivel pulmonar. La evidencia disponible se encuentra en SDRA con ventajas y desventajas, se propone estrategias de evaluación, monitoria, regula... Ver más

Guardado en:

Movimiento Científico

2011-7191

2463-2236

Libreros Arciniegas, Marcela

Bravo Díaz, Andrés Gonzalo

CORPORACIÓN UNIVERSITARIA IBEROAMERICANA

10.33881/2011-7191.mct.13105

13

2019-06-14

41

52

Colombia

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spelling Ventilación espontánea en ventilación mecánica invasiva
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Español
https://revmovimientocientifico.ibero.edu.co/article/view/mct.13105
Movimiento científico
Bogotá: Corporación Universitaria Iberoamericana
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Artículo de revista
1
13
Libreros Arciniegas, Marcela
Bravo Díaz, Andrés Gonzalo
Introducción: El uso de la ventilación mecánica invasiva (VMI) convencionalmente con modos controlados y uso de sedantes conlleva a un aumento de complicaciones y eventos indeseados como la disfunción diafragmática al inhibir la ventilación espontanea. Este artículo revisara la viabilidad de la ventilación espontanea en VMI partiendo de la actividad muscular inspiratoria como mecanismo fisiológico para la ventilación pulmonar, los cambios al ser remplazado por un mecanismo donde la ventilación es generada por la VMI, la interacción entre los dos mecanismos “pulmón dual” y sus efectos a nivel pulmonar. La evidencia disponible se encuentra en SDRA con ventajas y desventajas, se propone estrategias de evaluación, monitoria, regulación del impulso y esfuerzo inspiratorio que facilite la ventilación espontanea durante la VMI. Método: Se realizó una revisión documental en 4 fases: 1. Búsqueda de información, 2. Selección de publicaciones, 3. Procesamiento y análisis de la información seleccionada, 4. Redacción del documento. Conclusión: La ventilación espontánea en VMI es viable al reducir la incidencia de la debilidad muscular y podría disminuir la estancia en UCI. En estudios en SDRA el “pulmón dual” presenta más ventajas que desventajas y se reconoce su utilidad en SDRA leve o moderado. Hacen falta estudios en situaciones clínicas menos complejas y más comunes en UCI o pulmones sanos donde podría encontrarse más ventajas. Se sugiere realizar la evaluación del momento clínico y fisiopatológico, monitorear la VMI, monitorear y regular el impulso respiratorio y el esfuerzo muscular enfocándose en los principios de protección pulmonar y diafragmática.  
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Spontaneous ventilation in invasive mechanical ventilation
Journal article
Introduction: The use of invasive mechanical ventilation (IMV) conventionally with controlled modes and the use of sedatives leads to an increase in complications and unwanted events such as diaphragmatic dysfunction by  inhibiting spontaneous ventilation during IMV. This article will review spontaneous ventilation feasibility based on inspiratory muscle activity as a physiological mechanism for pulmonary ventilation; changes to be replaced by a mechanism where ventilation is generated by IMV; the interaction between the two mechanism “dual lung” and its effects at the pulmonary level. The available evidence is found in SDRA with advantages and disadvantages. It is proposed evaluation strategies, monitoring, impulse regulation and inspiratory effort that ease spontaneous ventilation during IMV. Method: a documental review was realize in four phases: 1. Information search, 2.  Publications selection, 3. Processing and analysis of the selected information, 4. Writing of the document. Conclusion: Spontaneous ventilation in IMV is viable by reducing the incidence of inspiratory muscle weakness and could reduce UIC stay. In studies in SDRA “dual lung” presents more advantages than disadvantages in light or moderate SDRA. Studies are needed in less complex clinical situations and more common in UIC or healthy lungs where more advantages could be found. It is suggested to evaluate the clinical and pathophysiological moment, monitor the IMV, monitor and regulate the respiratory drive and muscular effort focusing on the principles of   pulmonary and diaphragmatic protection.
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https://revmovimientocientifico.ibero.edu.co/article/download/mct.13105/pdf_1
2019-06-14T15:36:24Z
52
2019-06-14
2011-7191
2463-2236
10.33881/2011-7191.mct.13105
https://doi.org/10.33881/2011-7191.mct.13105
2019-06-14T15:36:24Z
institution CORPORACIÓN UNIVERSITARIA IBEROAMERICANA
thumbnail https://nuevo.metarevistas.org/CORPORACIONUNIVERSITARIAIBEROAMERICANA/logo.png
country_str Colombia
collection Movimiento Científico
title Ventilación espontánea en ventilación mecánica invasiva
spellingShingle Ventilación espontánea en ventilación mecánica invasiva
Libreros Arciniegas, Marcela
Bravo Díaz, Andrés Gonzalo
title_short Ventilación espontánea en ventilación mecánica invasiva
title_full Ventilación espontánea en ventilación mecánica invasiva
title_fullStr Ventilación espontánea en ventilación mecánica invasiva
title_full_unstemmed Ventilación espontánea en ventilación mecánica invasiva
title_sort ventilación espontánea en ventilación mecánica invasiva
title_eng Spontaneous ventilation in invasive mechanical ventilation
description Introducción: El uso de la ventilación mecánica invasiva (VMI) convencionalmente con modos controlados y uso de sedantes conlleva a un aumento de complicaciones y eventos indeseados como la disfunción diafragmática al inhibir la ventilación espontanea. Este artículo revisara la viabilidad de la ventilación espontanea en VMI partiendo de la actividad muscular inspiratoria como mecanismo fisiológico para la ventilación pulmonar, los cambios al ser remplazado por un mecanismo donde la ventilación es generada por la VMI, la interacción entre los dos mecanismos “pulmón dual” y sus efectos a nivel pulmonar. La evidencia disponible se encuentra en SDRA con ventajas y desventajas, se propone estrategias de evaluación, monitoria, regulación del impulso y esfuerzo inspiratorio que facilite la ventilación espontanea durante la VMI. Método: Se realizó una revisión documental en 4 fases: 1. Búsqueda de información, 2. Selección de publicaciones, 3. Procesamiento y análisis de la información seleccionada, 4. Redacción del documento. Conclusión: La ventilación espontánea en VMI es viable al reducir la incidencia de la debilidad muscular y podría disminuir la estancia en UCI. En estudios en SDRA el “pulmón dual” presenta más ventajas que desventajas y se reconoce su utilidad en SDRA leve o moderado. Hacen falta estudios en situaciones clínicas menos complejas y más comunes en UCI o pulmones sanos donde podría encontrarse más ventajas. Se sugiere realizar la evaluación del momento clínico y fisiopatológico, monitorear la VMI, monitorear y regular el impulso respiratorio y el esfuerzo muscular enfocándose en los principios de protección pulmonar y diafragmática.  
description_eng Introduction: The use of invasive mechanical ventilation (IMV) conventionally with controlled modes and the use of sedatives leads to an increase in complications and unwanted events such as diaphragmatic dysfunction by  inhibiting spontaneous ventilation during IMV. This article will review spontaneous ventilation feasibility based on inspiratory muscle activity as a physiological mechanism for pulmonary ventilation; changes to be replaced by a mechanism where ventilation is generated by IMV; the interaction between the two mechanism “dual lung” and its effects at the pulmonary level. The available evidence is found in SDRA with advantages and disadvantages. It is proposed evaluation strategies, monitoring, impulse regulation and inspiratory effort that ease spontaneous ventilation during IMV. Method: a documental review was realize in four phases: 1. Information search, 2.  Publications selection, 3. Processing and analysis of the selected information, 4. Writing of the document. Conclusion: Spontaneous ventilation in IMV is viable by reducing the incidence of inspiratory muscle weakness and could reduce UIC stay. In studies in SDRA “dual lung” presents more advantages than disadvantages in light or moderate SDRA. Studies are needed in less complex clinical situations and more common in UIC or healthy lungs where more advantages could be found. It is suggested to evaluate the clinical and pathophysiological moment, monitor the IMV, monitor and regulate the respiratory drive and muscular effort focusing on the principles of   pulmonary and diaphragmatic protection.
author Libreros Arciniegas, Marcela
Bravo Díaz, Andrés Gonzalo
author_facet Libreros Arciniegas, Marcela
Bravo Díaz, Andrés Gonzalo
citationvolume 13
citationissue 1
publisher Bogotá: Corporación Universitaria Iberoamericana
ispartofjournal Movimiento científico
source https://revmovimientocientifico.ibero.edu.co/article/view/mct.13105
language Español
format Article
rights http://purl.org/coar/access_right/c_abf2
info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/4.0/
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publishDate 2019-06-14
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url https://revmovimientocientifico.ibero.edu.co/article/view/mct.13105
url_doi https://doi.org/10.33881/2011-7191.mct.13105
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eissn 2463-2236
doi 10.33881/2011-7191.mct.13105
citationstartpage 41
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