{"id":26935,"date":"2018-03-09T09:18:59","date_gmt":"2018-03-09T09:18:59","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/soporte-respiratorio-no-invasivo-en-pacientes-con-edema-agudo-de-pulmon-cardiogenico\/"},"modified":"2018-03-09T09:18:59","modified_gmt":"2018-03-09T09:18:59","slug":"soporte-respiratorio-no-invasivo-en-pacientes-con-edema-agudo-de-pulmon-cardiogenico","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/sevilla\/soporte-respiratorio-no-invasivo-en-pacientes-con-edema-agudo-de-pulmon-cardiogenico\/","title":{"rendered":"Soporte respiratorio no invasivo en pacientes con edema agudo de pulm\u00f3n cardiog\u00e9nico"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Rafael Martin Bermudez <\/strong><\/h2>\n<p>La presi\u00f3n continua positiva en v\u00eda a\u00e9rea (cpap) y la presi\u00f3n de soporte (ps) aplicadas de forma no invasiva son opciones terap\u00e9\u00faticas en la insuficiencia respiratoria aguda asociada al edema agudo de pulm\u00f3n cardiog\u00e9nico (eap). el \u00fanico ensayo cl\u00ednico controlado publicado que ha comparado ambas modalidades despert\u00f3 dudas sobre una mayor incidencia de infarto de miocardio con la aplicaci\u00f3n de ps, aunque \u00e9sta podr\u00eda ser m\u00e1s eficaz. Las gu\u00edas cl\u00ednicas y conferencias de consenso recientes consideran por ello a la cpap como la t\u00e9cnica inicial de elecci\u00f3n en el eap, reservando el uso de ps para los pacientes refractarios o hiperc\u00e1pnicos. Dise\u00f1amos \u00e9ste estudio para evaluar al eficacia y seguridad de ambas modalidades ventilatorias en \u00e9ste tipo de pacientes.  adem\u00e1s del tratamiento convencional protocolizado, asignamos de forma aleatoria a 80 pacientes consecutivos con la insuficiencia respiratoria aguda grave secundaria a un eap a recibir cpap (39 pacientes) o presi\u00f3n de soporte + peep (41 pacientes), de forma no invasiva mediante m\u00e1scara facial. Se recogieron los par\u00e1metros ventilatorios y las variables fisiol\u00f3gicas durante las 24 horas siguientes, haciendo un seguimiento hasta el alta hospitalaria.  no encontramos ninguna diferencia significativa entre los dos grupos terap\u00e9uticos a su entrada el estudio. Tras 10 minutos, la frecuencia respiratoria )32.2+-6 vs 24.4+-7, p=0.019) y el grado de disnea (66.7% vs 33.3% pacientes presentaban el m\u00e1ximo grado de disnea, p=0.002) mostraron una mayor reducci\u00f3n entre los pacientes que recibieron ps. Tras 30 minutos, observamos una mejor\u00eda significativamente superior en el grupo de ps en al paco2 (46.9+-9 vs 55+-11 mmhg respectivamente, p=0.001), pao2\/fio2 (241+-97 vs 200+-76 respectivamente, p=0.045) y ph (7.27+-0.058 vs 7.22+-0.067 respectivamente, p=0.0002). Durante los 60 minutos iniciales, el grupo asignado a ps mostr\u00f3 de forma consistente un mayor volumen corriente<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Soporte respiratorio no invasivo en pacientes con edema agudo de pulm\u00f3n cardiog\u00e9nico<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Soporte respiratorio no invasivo en pacientes con edema agudo de pulm\u00f3n cardiog\u00e9nico <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Rafael Martin Bermudez <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Sevilla<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 20\/11\/2003<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Francisco Murillo Cabezas<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: guillermo Vazquez mata <\/li>\n<li> Soto espinosa de los monteros basilio (vocal)<\/li>\n<li> Mu\u00f1oz sanchez Mar\u00eda  angeles (vocal)<\/li>\n<li>Rafael Sierra camerino (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Rafael Martin Bermudez La presi\u00f3n continua positiva en v\u00eda a\u00e9rea (cpap) y la presi\u00f3n de soporte (ps) [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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