[Ventilation strategies in the child with severe hypoxemic respiratory failure]. / Estrategias ventilatorias ante el niño con síndrome de distress respiratorio agudo e hipoxemia grave.
Gac Med Mex
; 151(1): 75-84, 2015.
Article
em Es
| MEDLINE
| ID: mdl-25739487
In this review, we assemble the fundamental concepts of the use of mechanical ventilation (MV) in children with acute respiratory failure (ARDS) and refractory hypoxemia. We also discusses topics of protective ventilation and recruitment potential, and specifically examine the options of ventilation and/or maneuvers designed to optimize the non-aerated lung tissue: alveolar recruitment maneuvers, positive end-expiratory pressure (PEEP) titulation, high frequency oscillatory ventilation (HFOV), airway pressure release ventilation (APRV), aimed at correcting the mismatch ventilation/perfusion (V/Q): use of prone position. The only pharmacological intervention analyzed is the use of neuromuscular blockers. In clinical practice, the protective MV concept involves using an individual adjustment of the PEEP and volume tidal (V(T)). Use of recruitment maneuvers and PEEP downward titration can improve lung function in patients with ARDS and severe hypoxemia. We must keep in mind HFOV instauration as early as possible in response to failure of MV. The use of early and prolonged prone can improve gas exchange in hopes of a better control of what caused the use of MV.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Respiração Artificial
/
Insuficiência Respiratória
/
Hipóxia
Limite:
Child
/
Humans
Idioma:
Es
Revista:
Gac Med Mex
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Chile
País de publicação:
México