Relación ETCO2/PaCO2, herramienta al pie de cama para el manejo del síndrome de dificultad respiratoria aguda
DOI:
https://doi.org/10.31790/inspilip.v8i26.673Palabras clave:
ETCO2/PaCO2, Síndrome de dificultad respiratoria aguda, VV-ECMO, Espacio muertoResumen
La medición del volumen de espacio muerto en relación al volumen corriente (VD/VT) es una herramienta de pronóstico cada vez más relevante en el cuidado y monitoreo de pacientes del síndrome de dificultad respiratoria aguda (SDRA), sin embargo, aún es relativamente poco utilizada en la atención clínica de rutina, por lo cual ha sido necesario evaluar el uso de subrogados respecto al espacio muerto, accesible, de rápida medición a pie de cama, en este escenario la relación ETCO2/PaCO2 cumple un papel determinante en el seguimiento y comprensión de esta entidad. La relación anteriormente mencionada refleja el deterioro progresivo del intercambio de gases en sus dos componentes de oxigenación y ventilación, que funciona como marcador de gravedad y mortalidad en el SDRA, además de otras utilidades en el manejo del mismo, como la liberación del soporte ventilatorio e incluso en el retiro de oxigenación por membrana extracorpórea veno venosa (V-V ECMO). Este artículo ofrece un análisis actualizado acerca de la eficacia del uso de la relación ETCO2/PaCO2 en el tratamiento del SDRA.
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