NCT
INICIO RECIENTES ARCHIVO COVID-19
INICIO RECIENTES ARCHIVO PUBLICAR INSTRUCCIONES
PARA AUTORES COVID-19 ENTRAR / REGISTRARSE HISTORIA NOSOTROS DIRECTORIO CONTACTO
Efecto de tres modos ventilatorios como único soporte en un modelo experimental de inflamación sistémica por lipopolisacárido sobre la hemodinamia, fisiología pulmonar e histología

Guzmán-Cedillo, Axel E; Olmos-Zúñiga, J Raúl; Jasso-Victoria, Rogelio; García-Torrentera, Rogelio; Gaxiola-Gaxiola, Miguel; Silva-Martínez, Mariana; Vázquez-Justiniano, Luis Florentino; Baltazares-Lipp, Matilde; Hernández-Jiménez, Claudia; Zenteno-Galindo, Edgar; Vadillo-Ortega, Felipe; González-Camarena, Ramón





2020, Número 1

2020; 79 (1)






RESUMEN

Introducción: La asistencia mecánica ventilatoria (AMV) en modo liberación por presión de la vía aérea (APRV) y ventilación de alta frecuencia oscilatoria (VAFO) favorecen la protección pulmonar, pero no se utilizan en pacientes con sepsis. Objetivo: Comparar el efecto de la AMV en modo de ventilación controlada por presión (VCP), APRV y VAFO como única terapia sobre la hemodinamia, gasometría, mecánica e histología pulmonar en un modelo porcino de inflamación sistémica inducida por lipopolisacárido de Escherichia coli (E. coli). Material y métodos: Dieciocho cerdos con inflamación sistémica lipopolisacárido (LPS) E. coli, se trataron únicamente con AMV: grupo I: VCP, grupo II: APRV y grupo III: VAFO. Durante seis horas se evaluó la hemodinamia, gasometría, mecánica e histología pulmonar. Resultados: Los tres modos ventilatorios alteran la hemodinamia pulmonar, pero mantienen la gasometría y mecánica pulmonar. El modo VAFO mantiene estables los valores hemodinámicos sistémicos, disminuye la hiperlactatemia (p ‹ 0.05, ANDEVA-MR) y produce menor daño histológico (p ‹ 0.05, Kruskal-Wallis). Conclusión: Los modos VCP, APRV y VAFO utilizados como único soporte en las fases iniciales de inflamación sistémica inducida con LPS en cerdos, mantienen los valores gasométricos y ventilatorios dentro de los parámetros normales; pero, el modo VAFO favorece la recuperación de los valores hemodinámicos sistémicos y produce menor daño histológico.

PALABRAS CLAVE

Inflamación sistémica, lipopolisacárido, ventilación controlada por presión, ventilación con liberación por presión de la vía aérea, ventilación de alta frecuencia oscilatoria.

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2020, Número 1

2020; 79 (1)