Ventilación mecánica en pacientes con síndrome de distrés respiratorio agudo. Lo que ya sabíamos
Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med 2017;195(9):1253-1263
Keywords:
Síndrome de distrés respiratorio agudo, insuficiencia respiratoria, ventilación mecánica, guía de práctica clínicaAbstract
Se trata de una guía de práctica clínica con recomendaciones en el uso de estrategias ventilatorias y algunas cointervenciones en pacientes adultos con SDRA, avaladas por relevantes sociedades internacionales de Cuidados Críticos: American Thoracic Society (ATS), Society of Critical Care Medicine (SCCM), y European Society of Intensive Care Medicine (ESICM). Un panel de expertos analizó la mejor evidencia disponible abordando 6 cuestiones relacionadas con la VM: ventilación protectora (bajo volumen tidal, baja presión inspiratoria), ventilación en prono, ventilación oscilatoria de alta frecuencia, uso de presión positiva al final de la espiración (PEEP) alta o baja, uso de maniobras de reclutamiento (MR) y oxigenación por membrana extracorpórea. Las recomendaciones fueron desarrolladas aplicando el sistema GRADE (Grading of Recommendations, Assessment, Development, and Evaluation).
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