Evaluation the oxygenation prognosis factors in critical patients with airway adjuncts

Authors

Keywords:

oxigenación, paciente crítico, intubación, traqueostomía. Abstract

Abstract

Background: the use of the airway intubation devices in the critical patient with mechanic ventilation in a Unit of Intensive Cares is related to survival.
Objective:
to evaluate the oxygenation prognosis factors in critical patients with the airway intubation devices.
Methods:
analytic prospective study was carried outin critical patients with airway devices admitted to the Intensive Care Unit of the University Hospital Manuel Ascunce Domenech. The universe was constituted with 1039 patients and the sample by 526 patients, of them 314 alive and 212 deceased through simple random sampling.
Results:
the shock was the main diagnosis that motivated the use of airway adjuncts.It was two times more probable that a critical patient with orotracheal intubation had an inadequate oxygenation state than one critical patient with tracheostomy.
Conclusions: most of the patients enter with the diagnosis of shock. The oxygenation prognosis factors in the critical patients with airway intubation devices that were associated are: arterial pressure of oxygen, total concentration of oxygen, P50, Px, tracheostomy and orotracheal intubation. More than half of the patients withdrew in live condition.


DeCS: PROGNOSIS; OXYGENATION; CRITICAL ILLNESS; RESPIRATION, ARTIFICIAL; INTUBATION, INTRATRACHEAL.

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Author Biography

Zaily Fuentes-Díaz, Hospital Universitario Manuel Ascunce Domenech

Doctora en Ciencias Médicas. Especialista de Medicina General Integral. Especialista de  II grado en Anestesiología y Reanimación.Master en Urgencias Médicas.Investigador Agregado. Profesor Asistente.

References

1.Esteban A, Anzueto A, Alía I, Gordo F, Apezteguía C, Pálizas F, et al. How ismechanical ventilation employed in the intensivecare unit? An international utilization review. Am J Respir Crit Care Med [Internet]. 2000 [citado 7 Dic 2017];161:[aprox. 8 p.]. Disponible en: http://www.atsjournals.org/doi/pdf/10.1164/ajrccm.161.5.9902018

2.Plummer AL, Gracey DR. Consensus conference on artificial airways in patients receiving mechanical ventilation. Chest. 1989 Jul; 96(1):178-80.

3.Stauffer JL, Olson DE, Petty TL. Complications and consequences of endotracheal intubation and tracheotomy. A prospective study of 150 critically ill adult patients. Am J Med.1981 Jan;70(1):65-76.

4.Bouderka MA, Fakhir B, Bouaggad A, Hmamouchi B, Hamoudi D, Harti A. Early tracheostomy versus prolonged endotracheal intubation in severe head injury. J Trauma. 2004 Aug;57(2):251-4.

5.Blot F. A study of early tracheostomy in patients undergoing prolonged mechanical ventilation. Rev Mal Respir [Internet]. 2003 Jun [citado 7 Dic 2017];20(3 Pt 1):[aprox. 10 p.]. Disponible en: http://www.masson.fr/masson/MDOI-RMR-06-2003-20-3-0761-8425-101019-ART16

6.Silva Ayçaquer LC. Excursión a la regresión logística en ciencias de la salud. Madrid: Díaz de Santos; 1994.

7.Raith EP, Udy AA, Bailey M, McGloughlin S, MacIsaac C, Bellomo R, et al. Prognostic Accuracy of the SOFA Score, SIRS Criteria, and qSOFA Score for In-Hospital Mortality Among Adults With Suspected Infection Admitted to the Intensive Care Unit. JAMA [Internet]. 2017 Jan [citado 7 Dic 2017];317(3):[aprox. 8 p.]. Disponible en: https://jamanetwork.com/journals/jama/fullarticle/2598267

8.Knaus WA, Draper E, Wagner D. APACHE II. A severity of disease classification system. Crit Care Med 1985;13:818-829.

9.Knaus WA. Prognosis with mechanical ventilation: the influence of disease severety disease, age and chronic health status and survival from and acute illness. Am Rev Respir Dis.1989 Aug;140(2Pt 2):8-13.

10.Longworth A, Veitch D, Gudibande S, Whitehouse T, Snelson C, Veenith T. Tracheostomy in special groups of critically ill patients: Who, when, and where? Indian J Crit Care Med [Internet]. 2016 May [citado 7 Dic 2017];20(5):[aprox. 10 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4876649/.

11.Bösel J, Schiller P, Hook Y, Andes M, Neumann JO, Poli S, et al. Stroke-related Early Tracheostomy versus Prolonged Orotracheal Intubation in Neurocritical Care Trial (SETPOINT): a randomized pilot trial. Stroke [Internet]. 2013 Jan [citado 7 Dic 2017];44(1):[aprox. 13 p.]. Disponible en: http://stroke.ahajournals.org/content/44/1/21.long

12.Esteban A, Alía I, Ibañez J, Benito S, Tobin MJ. Modes of Mechanical Ventilation and Weaning: A National Survey of Spanish Hospitals. The Spanish Lung Failure Collaborative Group. Chest.1994 Oct;106(4):1188-93.

13.Pedrosa Guerrero A. El incremento del diámetro efectivo de la vía aérea disminuye el tiempo de ventilación mecánica en pacientes traqueostomizados estudio aleatorizado [tesis doctoral]. Ciudad Real: Universidad de Castilla la Mancha; 2016 [citado 7 Dic 2017]. Disponible en: https://ruidera.uclm.es/xmlui/bitstream/handle/10578/12593/TESIS%20Pedrosa%20Guerrero.pdf?sequence=1

14.Zheng Y, Sui F, Chen XK, Zhang GC, Wang XW, Zhao S, et al. Early versus late percutaneous dilational tracheostomy in critically ill patients anticipated requiring prolonged mechanical ventilation. Chin Med J (Engl). 2012 Jun;125(11):1925-30.

15.Pattnaik SK, Ray B, Sinha S. Percutaneous tracheostomy without bronchoscopic guidance is a safe method: A case series of 300 patients in a tertiary care Intensive Care Unit. Indian J Crit Care Med [Internet]. 2014 Dec [citado 7 Dic 2017];18(12):[aprox. 9 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4271276/.

16.Andriolo BN, Andriolo RB, Saconato H, Atallah ÁN, Valente O. Early versus late tracheostomy for critically ill patients. Cochrane Database of Systematic Reviews [Internet]. 2015 Jan [citado 7 Dic 2017];1:[aprox. 10 p.]. Disponible en: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007271.pub3/pdf

17.Machado García JL, Fuentes Díaz Z, Rodríguez Salazar O. Monitorización de la oxigenación en pacientes críticos. Arch Med Camagüey [Internet]. Jul-Ago 2011 [citado 27 Ago 2016];15(4):[aprox. 7 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1025-02552011000400007

18.Siempos II, Ntaidou TK, Filippidis FT, Choi AMK. Effect of early versus late or no tracheostomy on mortality and pneumonia of critically ill patients receiving mechanical ventilation: a systematic review and meta-analysis. Lancet Respir Med. 2015 Feb; 3(2):150-8.

19.Rumbak MJ, Newton M, Truncale T, Schwartz SW, Adams JW, Hazard PB. A prospective, randomized, study comparing early percutaneous dilational tracheotomy to prolonged translaryngeal intubation (delayed tracheotomy) in critically ill medical patients. Crit Care Med.2004 Aug;32(8):1689-94.

20.Longworth A, Veitch D, Gudibande S, Whitehouse T, Snelson C, Veenith T. Tracheostomy in special groups of critically ill patients: Who, when, and where? Indian J Crit Care Med [Internet]. 2016 May [citado 7 Dic 2017];20(5):[aprox. 10 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4876649/.

21.Bösel J, Schiller P, Hook Y, Andes M, Neumann JO, Poli S, et al. Stroke-related Early Tracheostomy versus Prolonged Orotracheal Intubation in Neurocritical Care Trial (SETPOINT): a randomized pilot trial. Stroke [Internet]. 2013 Jan [citado 7 Dic 2017];44(1):[aprox. 13 p.]. Disponible en: http://stroke.ahajournals.org/content/44/1/21.long

22.Young D, Harrison DA, Cuthbertson BH, Rowan K; TracMan Collaborators. Effect of early vs late tracheostomy placement on survival in patients receiving mechanical ventilation: theTracMan randomized trial. JAMA [Internet]. 2013 May 22 [citado 7 Dic 2017];309(20):[aprox. 9 p.]. Disponible en: https://jamanetwork.com/journals/jama/fullarticle/1690674

Published

2018-11-29

How to Cite

1.
Fuentes-Díaz Z, Díaz-Fonseca Y, Rodríguez-Salazar O, Roura-Carrasco JO. Evaluation the oxygenation prognosis factors in critical patients with airway adjuncts. Arch méd Camagüey [Internet]. 2018 Nov. 29 [cited 2025 Aug. 9];22(6):715-24. Available from: https://revistaamc.sld.cu/index.php/amc/article/view/5864

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Original Articles