Protocolo de Liberación del Ventilador Mecánico. Recomendación basada en una revisión de la evidencia

Aurio Fajardo-Campoverdi, Alejandro González-Castro, Rodrigo Adasme-Jeria, Angelo Roncalli-Rocha, Miguel Ibarra, Carmen Chica-Meza, William Cristancho-Gómez, Enrique Monares-Zepeda, Alberto Medina Villanueva, Vicent Modesto I Alapont, Fernando Paziencia, Juan Pérez, Yolanda Lopez-Fernandez. From the international group of mechanical ventilation (WeVent).

Abstract (English)

Mechanical ventilation is currently the most widely used supportive therapy for the treatment of moderate and severe hypoxemia of any etiology. However, the decision of “when” is the right time to initiate the withdrawal of this support is currently a matter of debate worldwide. Many authors describe that the disconnection process should be gradual and in compliance with standards that provide safety to this process; while other authors report that it is not feasible to establish a universal standard since each patient would have a unique behavior that would be difficult to establish in a protocolized manner.

The present review represents an extensive search for evidence in an attempt to clarify this issue, generating evidence from a consensus of experts at international level, based on a broad review of the literature.

Keywords

Weaning, Spontaneous breathing trial, Rapid shallow breathing index, P0.1

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Resumen (Spanish)

La ventilación mecánica es actualmente la terapia de soporte más ampliamente usada para el tratamiento de la hipoxemia moderada y severa de cualquier etiología. Sin embargo, la decisión de “cuándo” es el momento adecuado para iniciar el retiro de este soporte, es actualmente motivo de discusión a nivel mundial. Muchos autores describen que el proceso de desconexión debe ser paulatino y mediante el cumplimiento de normas que le otorguen seguridad a dicho proceso; mientras que otros autores reportan que no es factible establecer una normativa universal ya que cada paciente tendría un comportamiento único y difícil de establecer en forma protocolizada.

La presente revisión representa una extensa búsqueda de la evidencia, para intentar esclarecer este tema, generando evidencia a partir de un consenso de expertos a nivel internacional, basados en una amplia revisión de la literatura.

Palabras clave

liberación del ventilador mecánico, weaning, destete, ventilación mecánica

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