Complicaciones pulmonares en pacientes con ventilación mecánica en un departamento de urgencias

Abstract

Objective: To analyze pulmonary complications in patients with mechanical ventilation who are in the observation area of ​​the Emergency Department of the High Specialty Hospital Dr. Gustavo A. Rovirosa Pérez. Materials and method: A quantitative, descriptive, cross-sectional study was conducted to describe pulmonary complications associated with mechanical ventilation in patients admitted to the observation area of ​​the Emergency Department of the Regional Hospital of High Specialty Dr. Gustavo A. Rovirosa Pérez, from March 2016 to March 2018. The study consisted of 36 cases, of a review of 200 cases, according to the inclusion and exclusion criteria. Results: It was identified that 52.78% of the patients presented complications associated with possible pneumonia, 33.33% presented complications associated with probable pneumonia, in 13.89% of the patients, there were no complications secondary to an infectious condition associated with mechanical ventilation. 50% of the causes of mechanical ventilation requirement were of traumatic origin, 30.56% in relation to respiratory pathology, 16.67% in relation to neurological pathology and 2.78% in cardiovascular pathology. In relation to the severity using the APACHE II scale, the predicted mortality was lower than that observed, for a cut-off point of 20 points, prevailing as the most frequent causes of mortality in ventilated patients of respiratory etiology. The APACHE II score showed an intermediate positive predictive value and an intermediate negative predictive value. Conclusions: It was concluded that the requirement of mechanical ventilation is greater in relation to causes of traumatic origin, in comparison to causes of respiratory origin as reported in the reviewed publications. It was concluded that an APACHE II result ≥20 points corresponds to a much higher mortality. Likewise, it is concluded that the APACHE II system has a high sensitivity and low specificity to determine its diagnostic efficacy, which is comparable in multiple international studies.