Dead space and weaning from invasive mechanical ventilation in high-altitude residents

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Objective: To determine the predictive value of the dead space calculation through the dead space/tidal volume fraction at weaning from invasive mechanical ventilation in critically ill patients at high altitude. Materials and methods: An epidemiological, observational, analytical and prospective st...

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Detalles Bibliográficos
Autores: Viruez-Soto, José Antonio, Tinoco-Solórzano, Amílcar, Cerezo Gonzales, Julian
Formato: artículo
Fecha de Publicación:2020
Institución:Universidad de San Martín de Porres
Repositorio:Horizonte médico
Lenguaje:español
OAI Identifier:oai:horizontemedico.usmp.edu.pe:article/958
Enlace del recurso:https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/958
Nivel de acceso:acceso abierto
Materia:Altitud
Destete
Espacio muerto respiratorio
Ventilación mecánica
Altitude
Weaning
Respiratory dead space
Artificial respiration
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oai_identifier_str oai:horizontemedico.usmp.edu.pe:article/958
network_acronym_str REVHM
network_name_str Horizonte médico
repository_id_str
dc.title.none.fl_str_mv Dead space and weaning from invasive mechanical ventilation in high-altitude residents
Espacio muerto y destete de ventilación mecánica invasiva en residentes de la gran altitud
title Dead space and weaning from invasive mechanical ventilation in high-altitude residents
spellingShingle Dead space and weaning from invasive mechanical ventilation in high-altitude residents
Viruez-Soto, José Antonio
Altitud
Destete
Espacio muerto respiratorio
Ventilación mecánica
Altitude
Weaning
Respiratory dead space
Artificial respiration
title_short Dead space and weaning from invasive mechanical ventilation in high-altitude residents
title_full Dead space and weaning from invasive mechanical ventilation in high-altitude residents
title_fullStr Dead space and weaning from invasive mechanical ventilation in high-altitude residents
title_full_unstemmed Dead space and weaning from invasive mechanical ventilation in high-altitude residents
title_sort Dead space and weaning from invasive mechanical ventilation in high-altitude residents
dc.creator.none.fl_str_mv Viruez-Soto, José Antonio
Tinoco-Solórzano, Amílcar
Cerezo Gonzales, Julian
author Viruez-Soto, José Antonio
author_facet Viruez-Soto, José Antonio
Tinoco-Solórzano, Amílcar
Cerezo Gonzales, Julian
author_role author
author2 Tinoco-Solórzano, Amílcar
Cerezo Gonzales, Julian
author2_role author
author
dc.subject.none.fl_str_mv Altitud
Destete
Espacio muerto respiratorio
Ventilación mecánica
Altitude
Weaning
Respiratory dead space
Artificial respiration
topic Altitud
Destete
Espacio muerto respiratorio
Ventilación mecánica
Altitude
Weaning
Respiratory dead space
Artificial respiration
description Objective: To determine the predictive value of the dead space calculation through the dead space/tidal volume fraction at weaning from invasive mechanical ventilation in critically ill patients at high altitude. Materials and methods: An epidemiological, observational, analytical and prospective study carried out in the Adult Intensive Care Unit of the Hospital del Norte in the city of El Alto, Bolivia (4,090 m a.s.l.; barometric pressure: 453 mm Hg) from November 01, 2016 to March 31, 2017. High-altitude residents under invasive mechanical ventilation were studied. The inclusion criteria were: a) Altitude residents hospitalized in the Invasive Mechanical Ventilation Therapy Intensive Care Unit. b) Patients with evidence of resolution of the cause that prompted their connection to the invasive mechanical ventilator. c) Patients with positive weaning criteria and rates. d) Positive spontaneous respiration test. The study variables were the dead space through the Vd/Vt fraction and its relationship with the success or failure of the weaning process from mechanical ventilation. The Vd/Vt fraction was calculated in the study patients and then weaning from invasive mechanical ventilation was performed. Patients were divided into two groups according to the need for reintubation and reconnection to themechanical ventilator within 72 hours. Results: Twenty-one (21) patients were included: 7 (33 %) women and 14 men (67 %). The mean age was 41 years with a standard deviation of 22.38 years. Eighteen (18) patients (86 %) succeeded and 3 (14 %) failed in the weaning process from invasive mechanical ventilation. The Vd/Vt values in the success and failure groups were 0.43 and 0.53 (p < 0.011109), respectively, with a sensitivity of 0.61 and specificity of 1; a positive predictive value of 1 and a negative predictive value of 0.3. Conclusions: The calculation of the dead space through the measurement of the dead space/tidal volume fraction predicts the success of weaning of critically ill patients under invasive mechanical ventilation at high altitude.
publishDate 2020
dc.date.none.fl_str_mv 2020-12-28
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/958
10.24265/horizmed.2020.v20n4.02
url https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/958
identifier_str_mv 10.24265/horizmed.2020.v20n4.02
dc.language.none.fl_str_mv spa
language spa
dc.relation.none.fl_str_mv https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/958/803
https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/958/843
https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/958/872
dc.rights.none.fl_str_mv Derechos de autor 2020 Horizonte Médico (Lima)
https://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Derechos de autor 2020 Horizonte Médico (Lima)
https://creativecommons.org/licenses/by/4.0
eu_rights_str_mv openAccess
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dc.publisher.none.fl_str_mv Universidad de San Martín de Porres. Facultad de Medicina Humana
publisher.none.fl_str_mv Universidad de San Martín de Porres. Facultad de Medicina Humana
dc.source.none.fl_str_mv Horizonte Médico (Lima); Vol. 20 No. 4 (2020): October - December; e958
Horizonte Médico (Lima); Vol. 20 Núm. 4 (2020): Octubre - Diciembre; e958
Horizonte Médico (Lima); v. 20 n. 4 (2020): Octubre - Diciembre; e958
2227-3530
1727-558X
10.24265/horizmed.2020.v20n4
reponame:Horizonte médico
instname:Universidad de San Martín de Porres
instacron:USMP
instname_str Universidad de San Martín de Porres
instacron_str USMP
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spelling Dead space and weaning from invasive mechanical ventilation in high-altitude residentsEspacio muerto y destete de ventilación mecánica invasiva en residentes de la gran altitudViruez-Soto, José Antonio Tinoco-Solórzano, Amílcar Cerezo Gonzales, Julian AltitudDesteteEspacio muerto respiratorioVentilación mecánicaAltitudeWeaningRespiratory dead spaceArtificial respirationObjective: To determine the predictive value of the dead space calculation through the dead space/tidal volume fraction at weaning from invasive mechanical ventilation in critically ill patients at high altitude. Materials and methods: An epidemiological, observational, analytical and prospective study carried out in the Adult Intensive Care Unit of the Hospital del Norte in the city of El Alto, Bolivia (4,090 m a.s.l.; barometric pressure: 453 mm Hg) from November 01, 2016 to March 31, 2017. High-altitude residents under invasive mechanical ventilation were studied. The inclusion criteria were: a) Altitude residents hospitalized in the Invasive Mechanical Ventilation Therapy Intensive Care Unit. b) Patients with evidence of resolution of the cause that prompted their connection to the invasive mechanical ventilator. c) Patients with positive weaning criteria and rates. d) Positive spontaneous respiration test. The study variables were the dead space through the Vd/Vt fraction and its relationship with the success or failure of the weaning process from mechanical ventilation. The Vd/Vt fraction was calculated in the study patients and then weaning from invasive mechanical ventilation was performed. Patients were divided into two groups according to the need for reintubation and reconnection to themechanical ventilator within 72 hours. Results: Twenty-one (21) patients were included: 7 (33 %) women and 14 men (67 %). The mean age was 41 years with a standard deviation of 22.38 years. Eighteen (18) patients (86 %) succeeded and 3 (14 %) failed in the weaning process from invasive mechanical ventilation. The Vd/Vt values in the success and failure groups were 0.43 and 0.53 (p < 0.011109), respectively, with a sensitivity of 0.61 and specificity of 1; a positive predictive value of 1 and a negative predictive value of 0.3. Conclusions: The calculation of the dead space through the measurement of the dead space/tidal volume fraction predicts the success of weaning of critically ill patients under invasive mechanical ventilation at high altitude.Objetivo: Determinar el valor predictivo del cálculo del espacio muerto a través de la fracción espacio muerto/volumen corriente en el destete de la ventilación mecánica invasiva en pacientes críticamente enfermos en la gran altitud. Materiales y métodos: Estudio epidemiológico, observacional, analítico y prospectivo realizado en la Unidad de Terapia Intensiva Adultos del Hospital del Norte de la ciudad de El Alto, Bolivia (4090 m s. n. m. y presión barométrica de 453 mmHg) del 01 de noviembre de 2016 al 31 de marzo de 2017. Se estudiaron a los residentes de la gran altitud en ventilación mecánica invasiva. Los criterios de inclusión fueron los siguientes: a) residentes de la altitud hospitalizados en la Unidad de Terapia Intensiva en ventilación mecánica invasiva, b) pacientes con evidencia de resolución de la causa que motivó su conexión al ventilador mecánico invasivo, c) paciente con criterios e índices de destete positivos, d) prueba de respiración espontanea positivo. Las variables estudiadas fueron el espacio muerto a través de la fracción Vd/Vt y su relación con el éxito o fracaso del proceso de destete de ventilación mecánica. Se calculó la fracción Vd/Vt en los pacientes incluidos en el estudio para luego proceder al destete de la ventilación mecánica invasiva. Se dividió a los pacientes en dos grupos según la necesidad de reintubación y reconexión al ventilador mecánico dentro de las 72 horas. Resultados: Se incluyeron 21 pacientes: 7 mujeres (33 %) y 14 varones (67 %). La media de edad fue 41 años con desviación estándar de 22,38 años. Dieciocho pacientes (86 %) presentaron éxito y tres (14,00 %) fracasaron en el proceso de destete de la ventilación mecánica invasiva. El valor de Vd/Vt en el grupo éxito y fracaso correspondió a 0,43 vs. 0,53 (p < 0,011109), con una sensibilidad de 0,61 y especificidad de 1; con valor predictivo positivo de 1 y valor predictivo negativo de 0,3. Conclusiones: El cálculo del espacio muerto a través de la medida de la fracción espacio muerto/volumen corriente predice el éxito del destete de pacientes críticamente enfermos bajo ventilación mecánica invasiva a gran altitud.Universidad de San Martín de Porres. Facultad de Medicina Humana2020-12-28info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdftext/xmltext/htmlhttps://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/95810.24265/horizmed.2020.v20n4.02Horizonte Médico (Lima); Vol. 20 No. 4 (2020): October - December; e958Horizonte Médico (Lima); Vol. 20 Núm. 4 (2020): Octubre - Diciembre; e958Horizonte Médico (Lima); v. 20 n. 4 (2020): Octubre - Diciembre; e9582227-35301727-558X10.24265/horizmed.2020.v20n4reponame:Horizonte médicoinstname:Universidad de San Martín de Porresinstacron:USMPspahttps://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/958/803https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/958/843https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/958/872Derechos de autor 2020 Horizonte Médico (Lima)https://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessoai:horizontemedico.usmp.edu.pe:article/9582020-12-30T18:20:34Z
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