Ventilación mecánica artificial en el paciente cardioquirúrgicoo
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Introducción: La ventilación mecánica artificial es una intervención frecuente y necesaria en el escenario cardioquirúrgico.
Objetivo: Actualizar elementos de interés relacionados con el manejo ventilatorio en el paciente cardioquirúrgico.
Métodos: Se realizó una revisión narrativa de la literatura, basada en una búsqueda en Google Scholar, PubMed/Medline, SciELO regional y Google Académico, mediante los términos: ventilación mecánica durante la cirugía cardíaca/modalidades, complicaciones pulmonares poscirugía cardiovascular, ventilación mecánica durante la circulación extracorpórea.
Resultados: En los pacientes sometidos a cirugía cardíaca y con soporte ventilatorio se genera daño pulmonar con repercusión hemodinámica, si no se utiliza una estrategia ventilatoria adecuada. El verdadero desafío consiste en la implementación de estrategias terapéuticas para minimizar su impacto clínico.
Conclusiones: Durante la última década se han producido cambios en la práctica de la ventilación pulmonar durante la cirugía cardiotorácica, como la reducción del volumen corriente alto, el mantenimiento de la ventilación durante la circulación extracorpórea en asociación con maniobras de reclutamiento perioperatorias y niveles altos de presión positiva al final de la espiración.
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Referencias
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