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Acta Médica Peruana
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Traqueostomía percutánea por dilatación sin fibrobroncoscopio en la Unidad de Cuidados Intensivos del Hospital Carlos Alberto Seguín Escobedo, Arequipa 2011-2014

فغر القصبة الهوائية عن طريق الجلد عن طريق التمدد دون تنظير قصبي ليفي في وحدة العناية المركزة في مستشفى كارلوس ألبرتو سيغوين إسكوبيدو، أريكويبا 2011-2014
Authors: Rafael Tapia-Pérez; Miguel Barreda-de la Cruz; Pedro Alcázar-Zuzunaga; Luis Fajardo-Karlo; Fabricio Oporto-Gonzales; Yvan Pérez-Vargas;

Traqueostomía percutánea por dilatación sin fibrobroncoscopio en la Unidad de Cuidados Intensivos del Hospital Carlos Alberto Seguín Escobedo, Arequipa 2011-2014

Abstract

Objetivo: Describir la experiencia de traqueostomía percutánea por dilatación (TPD) sin fibrobroncospio en la Unidad de Cuidados Intensivos (UCI) del Hospital Nacional Carlos Alberto Seguín Escobedo (EsSalud), Arequipa. Materiales y métodos: Estudio restrospectivo y descriptivo. Se recolectaron los registros de pacientes desde el 2011 hasta el 2014, a los que serealizó TPD sin fibrobroncoscopio. Se evaluaron variables demográficas, tiempo de realización de las TPD, diagnóstico de ingreso, comorbilidades asociadas, APACHE II, indicaciones de raqueostomía y complicaciones. Resultados: De las 94 TPD, el 48.9% fueron varones; la edad promedio fue 60,3 ± 19,7 años; el 35,1 % procedieron del servicio de emergencia; el score APACHE II fue de 18,1 ± 5,8 puntos. Se estimó un tiempo promedio de 14,6 ± 12,6 días para la realización de las traqueostomías. Al 97,9% se les realizó traqueostomía tardía. A 17 pacientes (18,1%) se les practicó una ecografía cervical; el 14,9 % tuvieron como diagnóstico de ingreso a la UCI TEC grave; la mayor indicación fue la falla neurológica con el 47,8%. Las complicaciones perioperatorias immediatas no mortales fueron: hemorragia leve, infección del estoma, hipotensión, enfisema subcutáneo y falsa vía. Se presentó una complicación mortal por hemorragia severa relacionada al procedimiento y la complicación tardía más frecuente fue estenosis subglótica. Finalmente, se halló una sobrevida global del 71,3%. Conclusiones: La TPD mediante la técnica Ciaglia Blue Rhino sin la asistencia de fibrobroncoscopio y a la cabecera del paciente sería un procedimiento seguro y con baja incidencia de complicaciones severas.

Keywords

Pulmonary and Respiratory Medicine, dilatación, Clinical Characteristics of Deep Neck Infections, Clinical Management of Tracheal and Airway Disorders, R, FOS: Humanities, Traqueostomía, FOS: Health sciences, Dilatation, FOS: Philosophy, ethics and religion, Humanities, Philosophy, Anesthesiology and Pain Medicine, Infectious Diseases, Tracheostomy, Dilatación, Cirugía, Management of Difficult Airway in Anesthesia Practice, Health Sciences, Medicine, dilatation, https://purl.org/pe-repo/ocde/ford#3.05.00

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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