Predictores de extubación fallida en el paciente pediátrico y neonatal
Predictors of failed extubation in the pediatric and neonatal patient
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Introducción: uno de los aspectos de mayor relevancia en el cuidado intensivo pediátrico y neonatal, es el manejo de la ventilación. Los efectos adversos de la ventilación prolongada son deletéreos, principalmente a nivel pulmonar y están relacionados con aumento de la morbilidad y mortalidad. La decisión de extubar un paciente tiene consecuencias considerables, ya que tanto retrasar la extubación, como la extubación fallida también se asocia con una mayor duración de la ventilación mecánica y un aumento de la morbimortalidad. Las diferencias anatómicas de esta población hacen que sea más susceptible a resultados adversos o fracasos en el manejo de la vía aérea, y muchas de estas decisiones médicas se basan en experiencia y carecen de un adecuado soporte científico.
Objetivo: hacer una revisión acerca de los predictores de extubación fallida en pacientes en edad pediátrica y neonatal.
Métodos: se realizó una búsqueda de la literatura a través de PubMed, la búsqueda web de Google Scholar y la base de datos Cochrane de revisiones sistemáticas utilizando términos de búsqueda relevantes.
Resultados: el mayor conocimiento de la anatomía y la estandarización de protocolos en el manejo de la vía aérea del paciente pediátrico permite disminuir la incidencia de extubación fallida.
Conclusión: el desarrollo de prácticas seguras con suficiente evidencia científica permite disminuir la morbimortalidad de esta población.
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