{"id":72178,"date":"2018-03-09T23:16:58","date_gmt":"2018-03-09T23:16:58","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/ventilacion-no-invasiva-por-soporte-de-presion-bipap-en-el-paciente-con-epoc-en-insuficiencia-respiratoria-aguda-hipercapnica\/"},"modified":"2018-03-09T23:16:58","modified_gmt":"2018-03-09T23:16:58","slug":"ventilacion-no-invasiva-por-soporte-de-presion-bipap-en-el-paciente-con-epoc-en-insuficiencia-respiratoria-aguda-hipercapnica","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/ventilacion-no-invasiva-por-soporte-de-presion-bipap-en-el-paciente-con-epoc-en-insuficiencia-respiratoria-aguda-hipercapnica\/","title":{"rendered":"Ventilaci\u00f3n no invasiva por soporte de presi\u00f3n bipap en el paciente con epoc en insuficiencia respiratoria aguda hiperc\u00e1pnica."},"content":{"rendered":"<h2>Tesis doctoral de <strong> Daniel Del Castillo Otero <\/strong><\/h2>\n<p>Introducci\u00f3n:  la ventilaci\u00f3n no invasiva vni se est\u00e1 utilizando cada vez con m\u00e1s frecuencia en el tratamiento de la insuficiencia respiratoria debida a agudizaci\u00f3n de la enfermedad pulmonar obstructiva cr\u00f3nica epoc. Sin embargo , el lugar de aplicaci\u00f3n , la selecci\u00f3n de pacientes y el mecanismo de acci\u00f3n de la vni no estan bien establecidos.  objetivos:  evaluar los efectos de la vni sobre par\u00e1metros cl\u00ednicos , intercambio de gases morbimortalidad , necesidad de intubaci\u00f3n y estancia hospitalaria en pacientes ingresados en planta de neuromolog\u00eda por agudizaci\u00f3n de su epoc e insuficiencia respiratoria hiperc\u00e1pnica.Se analiza en un subgrupo de enfermos , el efecto sobre la funci\u00f3n muscular inspiratoria.  pacientes y metodolog\u00eda:  estudio prospectivo controlado aleatorizado que compara el tratamiento m\u00e9dico convencional (21 pacientes) con la vni por presi\u00f3n de soporte (bipap, respironics inc) m\u00e1s tratamiento convencional (20 pacientes).  resultados:  en el grupo tratado con vni se observ\u00f3 una mejor\u00eda cl\u00ednica (nivel de conciencia, frecuencia respiratoria) en las primeras 2 horas de estudio , respecto al grupo control (p menor 0,001).La vni se asoci\u00f3 a mejor\u00eda significativa de la presi\u00f3n parcial de co2 en sangre arterial (paco2) y del ph arterial de las 6 horas de inicio de tratamiento (p mayor 0,05).Tres pacientes (14%) del grupo control requiriendo soporte ventilatorio y s\u00f3lo uno (5%) del grupo vni necesit\u00f3 intubaci\u00f3n endotraqueal .La estancia hospitalaria se redujo en el grupo que recibi\u00f3 vni (7 d\u00edas) respecto al control (10 d\u00edas)(p mayor 0,01).  conclusiones:  en pacientes seleccionados con agudizaci\u00f3n hiperc\u00e1pnica de epoc , la vni produce una mejor\u00eda cl\u00ednica, gasom\u00e9trica y de la funci\u00f3n muscular, inspiratoria m\u00e1s precoz que el tratamiento convencional , reduciendo la estancia media hospitalaria de estos enfermos.El uso de vni es factible en una planta de neumolog\u00eda que cuente con person<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Ventilaci\u00f3n no invasiva por soporte de presi\u00f3n bipap en el paciente con epoc en insuficiencia respiratoria aguda hiperc\u00e1pnica.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Ventilaci\u00f3n no invasiva por soporte de presi\u00f3n bipap en el paciente con epoc en insuficiencia respiratoria aguda hiperc\u00e1pnica. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Daniel Del Castillo Otero <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Sevilla<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 21\/12\/2004<\/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>Emilia Barrot Cort\u00e9s<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: ram\u00f3n P\u00e9rez cano <\/li>\n<li>\u00e1ngeles S\u00e1nchez armengol (vocal)<\/li>\n<li>Fernando Fuentes otero (vocal)<\/li>\n<li>Jos\u00e9 Fern\u00e1ndez guerra (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Daniel Del Castillo Otero Introducci\u00f3n: la ventilaci\u00f3n no invasiva vni se est\u00e1 utilizando cada vez con m\u00e1s [&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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