Cuidado respiratorio en COVID-19
Identifieur interne : 000573 ( 2020/Analysis ); précédent : 000572; suivant : 000574Cuidado respiratorio en COVID-19
Auteurs : Carmen Chica-Meza [Colombie] ; Luis Alexander Pe A-L Pez [Colombie] ; Héctor Fabio Villamarín-Guerrero [Colombie] ; Jorge Enrique Moreno-Collazos [Colombie] ; Lizeth Catherine Rodríguez-Corredor [Colombie] ; Wilson Mauricio Lozano [Espagne] ; M Nica Patricia Vargas-Ordo Ez [Colombie]Source :
- Acta Colombiana de Cuidado Intensivo [ 0122-7262 ] ; 2020.
Abstract
El COVID-19 forma parte de la familia de los virus conocida como
Revisar la evidencia científica disponible relacionada con el cuidado del sistema respiratorio, estableciendo pautas generales de tratamiento.
Revisión narrativa de la literatura. Se realizó una búsqueda, selección y revisión de artículos originales y secundarios escritos en inglés o español, en las diferentes bases de datos: NCBI, CENTRAL, MEDLINE y EMBASE, publicados hasta marzo del 2020.
No se ha definido un tratamiento específico ante la nueva enfermedad, teniendo como principal medida terapéutica el control sintomático. Se recomienda utilizar elementos de bioseguridad: gafas, gorros, guantes, bata larga impermeable, tapabocas de alta eficiencia en personal sanitario (FFP2 o N95). En el paciente sintomático, utilizar tapabocas quirúrgico, jabón hospitalario, toallas de papel y alcohol al 70% o isopropílico. Utilizar oxígeno mediante sistemas de bajo flujo. En ventilación mecánica, programar modos VCP o VCV, Vt 4-6 ml/kg, Fr ≤ 35, FiO2 para PaO2 de 60 mmHg o SpO2 de 92-96%, PEEP 12-17 cmH2O, ventilación prono si PAFI ≤ 150 con una relación 16/8 o 18/6, óxido nítrico 5-20 ppm.
Usar equipos de bioseguridad con el fin de interrumpir la transmisión. En hipoxemia, utilizar sistemas de oxigenoterapia a bajo flujo. Usar estrategias de protección pulmonar, disminución de volúmenes corrientes, presiones de meseta y frecuencias respiratorias, implementación de valores de PEEP elevados, bajos valores de presión de conducción y ventilación en prono, los cuales han demostrado mejoraría en la hipoxemia y la sobrevida en pacientes con síndrome de dificultad respiratoria aguda.
Url:
DOI: 10.1016/j.acci.2020.04.001
PubMed: NONE
PubMed Central: 7144845
Affiliations:
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PMC:7144845Le document en format XML
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type="wicri:Area/Main/Exploration">000573</idno><idno type="wicri:Area/2020/Extraction">000573</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Cuidado respiratorio en COVID-19</title><author><name sortKey="Chica Meza, Carmen" sort="Chica Meza, Carmen" uniqKey="Chica Meza C" first="Carmen" last="Chica-Meza">Carmen Chica-Meza</name><affiliation wicri:level="1"><nlm:aff id="aff0005">Asociación Colombiana de Medicina Crítica y Cuidado Intensivo (AMCI), Bogotá, Colombia</nlm:aff><country xml:lang="fr">Colombie</country><wicri:regionArea>Asociación Colombiana de Medicina Crítica y Cuidado Intensivo (AMCI), Bogotá</wicri:regionArea><wicri:noRegion>Bogotá</wicri:noRegion></affiliation></author><author><name sortKey="Pe A L Pez, Luis Alexander" sort="Pe A L Pez, Luis Alexander" uniqKey="Pe A L Pez L" first="Luis Alexander" last="Pe A-L Pez">Luis Alexander Pe A-L Pez</name><affiliation wicri:level="1"><nlm:aff id="aff0010">Departamento de Cuidado Intensivo, Hospital Susana López de Valencia, Popayán, Colombia</nlm:aff><country xml:lang="fr">Colombie</country><wicri:regionArea>Departamento de Cuidado Intensivo, Hospital Susana López de Valencia, Popayán</wicri:regionArea><wicri:noRegion>Popayán</wicri:noRegion></affiliation></author><author><name sortKey="Villamarin Guerrero, Hector Fabio" sort="Villamarin Guerrero, Hector Fabio" uniqKey="Villamarin Guerrero H" first="Héctor Fabio" last="Villamarín-Guerrero">Héctor Fabio Villamarín-Guerrero</name><affiliation wicri:level="1"><nlm:aff id="aff0015">Departamento de Cuidado Intensivo, Fundación Valle del Lili, Cali, Colombia</nlm:aff><country xml:lang="fr">Colombie</country><wicri:regionArea>Departamento de Cuidado Intensivo, Fundación Valle del Lili, Cali</wicri:regionArea><wicri:noRegion>Cali</wicri:noRegion></affiliation></author><author><name sortKey="Moreno Collazos, Jorge Enrique" sort="Moreno Collazos, Jorge Enrique" uniqKey="Moreno Collazos J" first="Jorge Enrique" last="Moreno-Collazos">Jorge Enrique Moreno-Collazos</name><affiliation wicri:level="1"><nlm:aff id="aff0020">Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia</nlm:aff><country xml:lang="fr">Colombie</country><wicri:regionArea>Fundación Universitaria de Ciencias de la Salud, Bogotá</wicri:regionArea><wicri:noRegion>Bogotá</wicri:noRegion></affiliation></author><author><name sortKey="Rodriguez Corredor, Lizeth Catherine" sort="Rodriguez Corredor, Lizeth Catherine" uniqKey="Rodriguez Corredor L" first="Lizeth Catherine" last="Rodríguez-Corredor">Lizeth Catherine Rodríguez-Corredor</name><affiliation wicri:level="1"><nlm:aff id="aff0020">Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia</nlm:aff><country xml:lang="fr">Colombie</country><wicri:regionArea>Fundación Universitaria de Ciencias de la Salud, Bogotá</wicri:regionArea><wicri:noRegion>Bogotá</wicri:noRegion></affiliation></author><author><name sortKey="Lozano, Wilson Mauricio" sort="Lozano, Wilson Mauricio" uniqKey="Lozano W" first="Wilson Mauricio" last="Lozano">Wilson Mauricio Lozano</name><affiliation wicri:level="1"><nlm:aff id="aff0025">Departamento de Fisiología, Universidad de Valencia, Valencia, España</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Departamento de Fisiología, Universidad de Valencia, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Vargas Ordo Ez, M Nica Patricia" sort="Vargas Ordo Ez, M Nica Patricia" uniqKey="Vargas Ordo Ez M" first="M Nica Patricia" last="Vargas-Ordo Ez">M Nica Patricia Vargas-Ordo Ez</name><affiliation wicri:level="1"><nlm:aff id="aff0015">Departamento de Cuidado Intensivo, Fundación Valle del Lili, Cali, Colombia</nlm:aff><country xml:lang="fr">Colombie</country><wicri:regionArea>Departamento de Cuidado Intensivo, Fundación Valle del Lili, Cali</wicri:regionArea><wicri:noRegion>Cali</wicri:noRegion></affiliation></author></analytic><series><title level="j">Acta Colombiana de Cuidado Intensivo</title><idno type="ISSN">0122-7262</idno><idno type="eISSN">0122-7262</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Resumen</title><sec><title>Antecedentes</title><p>El COVID-19 forma parte de la familia de los virus conocida como <italic>Coronaviridae.</italic> El nuevo patógeno β-coronavirus del subgénero Sarbecovirus se denominó inicialmente como el nuevo coronavirus (2019-nCoV); fue identificado en un brote de neumonía en Wuhan. Los pacientes desarrollan alteraciones en el sistema respiratorio, pudiendo llegar a padecer neumonía severa, edema pulmonar o síndrome de dificultad respiratoria aguda.</p></sec><sec><title>Objetivo</title><p>Revisar la evidencia científica disponible relacionada con el cuidado del sistema respiratorio, estableciendo pautas generales de tratamiento.</p></sec><sec><title>Métodos</title><p>Revisión narrativa de la literatura. Se realizó una búsqueda, selección y revisión de artículos originales y secundarios escritos en inglés o español, en las diferentes bases de datos: NCBI, CENTRAL, MEDLINE y EMBASE, publicados hasta marzo del 2020.</p></sec><sec><title>Resultados</title><p>No se ha definido un tratamiento específico ante la nueva enfermedad, teniendo como principal medida terapéutica el control sintomático. Se recomienda utilizar elementos de bioseguridad: gafas, gorros, guantes, bata larga impermeable, tapabocas de alta eficiencia en personal sanitario (FFP2 o N95). En el paciente sintomático, utilizar tapabocas quirúrgico, jabón hospitalario, toallas de papel y alcohol al 70% o isopropílico. Utilizar oxígeno mediante sistemas de bajo flujo. En ventilación mecánica, programar modos VCP o VCV, Vt 4-6 ml/kg, Fr ≤ 35, FiO<sub>2</sub> para PaO<sub>2</sub> de 60 mmHg o SpO<sub>2</sub> de 92-96%, PEEP 12-17 cmH<sub>2</sub>O, ventilación prono si PAFI ≤ 150 con una relación 16/8 o 18/6, óxido nítrico 5-20 ppm.</p></sec><sec><title>Conclusiones</title><p>Usar equipos de bioseguridad con el fin de interrumpir la transmisión. En hipoxemia, utilizar sistemas de oxigenoterapia a bajo flujo. Usar estrategias de protección pulmonar, disminución de volúmenes corrientes, presiones de meseta y frecuencias respiratorias, implementación de valores de PEEP elevados, bajos valores de presión de conducción y ventilación en prono, los cuales han demostrado mejoraría en la hipoxemia y la sobrevida en pacientes con síndrome de dificultad respiratoria aguda.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Wang, D" uniqKey="Wang D">D. Wang</name></author><author><name sortKey="Hu, B" uniqKey="Hu B">B. Hu</name></author><author><name sortKey="Hu, C" uniqKey="Hu C">C. Hu</name></author><author><name sortKey="Zhu, F" uniqKey="Zhu F">F. Zhu</name></author><author><name sortKey="Liu, X" uniqKey="Liu X">X. Liu</name></author><author><name sortKey="Zhang, J" uniqKey="Zhang J">J. Zhang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Huang, C" uniqKey="Huang C">C. 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Blanch</name></author><author><name sortKey="Romero, P V" uniqKey="Romero P">P.V. Romero</name></author><author><name sortKey="Lucangelo, U" uniqKey="Lucangelo U">U. Lucangelo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tusman, G" uniqKey="Tusman G">G. Tusman</name></author><author><name sortKey="Areta, M" uniqKey="Areta M">M. Areta</name></author><author><name sortKey="Climente, C" uniqKey="Climente C">C. Climente</name></author><author><name sortKey="Plit, R" uniqKey="Plit R">R. Plit</name></author><author><name sortKey="Suarez Sipmann, F" uniqKey="Suarez Sipmann F">F. Suarez-Sipmann</name></author><author><name sortKey="Rodriguez Nieto, M J" uniqKey="Rodriguez Nieto M">M.J. Rodríguez-Nieto</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Perez, M" uniqKey="Perez M">M. Pérez</name></author><author><name sortKey="Mancebo, J" uniqKey="Mancebo J">J. Mancebo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tomicic, V" uniqKey="Tomicic V">V. Tomicic</name></author><author><name sortKey="Fuentealba, A" uniqKey="Fuentealba A">A. Fuentealba</name></author><author><name sortKey="Martinez, E" uniqKey="Martinez E">E. Martínez</name></author><author><name sortKey="Graf, J" uniqKey="Graf J">J. Graf</name></author><author><name sortKey="Batista Borges, J" uniqKey="Batista Borges J">J. Batista Borges</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Putensen, C" uniqKey="Putensen C">C. Putensen</name></author><author><name sortKey="Wrigge, H" uniqKey="Wrigge H">H. Wrigge</name></author><author><name sortKey="Zinserling, J" uniqKey="Zinserling J">J. Zinserling</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hahn, G" uniqKey="Hahn G">G. Hahn</name></author><author><name sortKey="Sipinkova, I" uniqKey="Sipinkova I">I. Sipinkova</name></author><author><name sortKey="Baisch, F" uniqKey="Baisch F">F. Baisch</name></author><author><name sortKey="Hellige, G" uniqKey="Hellige G">G. Hellige</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Colombie</li><li>Espagne</li></country></list><tree><country name="Colombie"><noRegion><name sortKey="Chica Meza, Carmen" sort="Chica Meza, Carmen" uniqKey="Chica Meza C" first="Carmen" last="Chica-Meza">Carmen Chica-Meza</name></noRegion><name sortKey="Moreno Collazos, Jorge Enrique" sort="Moreno Collazos, Jorge Enrique" uniqKey="Moreno Collazos J" first="Jorge Enrique" last="Moreno-Collazos">Jorge Enrique Moreno-Collazos</name><name sortKey="Pe A L Pez, Luis Alexander" sort="Pe A L Pez, Luis Alexander" uniqKey="Pe A L Pez L" first="Luis Alexander" last="Pe A-L Pez">Luis Alexander Pe A-L Pez</name><name sortKey="Rodriguez Corredor, Lizeth Catherine" sort="Rodriguez Corredor, Lizeth Catherine" uniqKey="Rodriguez Corredor L" first="Lizeth Catherine" last="Rodríguez-Corredor">Lizeth Catherine Rodríguez-Corredor</name><name sortKey="Vargas Ordo Ez, M Nica Patricia" sort="Vargas Ordo Ez, M Nica Patricia" uniqKey="Vargas Ordo Ez M" first="M Nica Patricia" last="Vargas-Ordo Ez">M Nica Patricia Vargas-Ordo Ez</name><name sortKey="Villamarin Guerrero, Hector Fabio" sort="Villamarin Guerrero, Hector Fabio" uniqKey="Villamarin Guerrero H" first="Héctor Fabio" last="Villamarín-Guerrero">Héctor Fabio Villamarín-Guerrero</name></country><country name="Espagne"><noRegion><name sortKey="Lozano, Wilson Mauricio" sort="Lozano, Wilson Mauricio" uniqKey="Lozano W" first="Wilson Mauricio" last="Lozano">Wilson Mauricio Lozano</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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