Uso de cánula nasal de alto flujo en falla respiratoria en adultos
Use of high flow nasal cannula in respiratory failure in adults
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Valero Ortiz A, Umbacía Salas FA, Palencia Mojica CL, Suárez Saavedra MT, Silva Rodriguez LJ. Uso de cánula nasal de alto flujo en falla respiratoria en adultos. Revista Investig. Salud Univ. Boyacá [Internet]. 11 de enero de 2019 [citado 21 de diciembre de 2024];6(1):170-87. Disponible en: https://revistasdigitales.uniboyaca.edu.co/index.php/rs/article/view/406
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Introducción. La oxigenoterapia brinda un gran número de beneficios para aquellos pacientes que presentan enfermedades cardiorrespiratorias, mejora procesos fundamentales como ventilación, oxigenación y perfusión clínica. El objetivo de esta revisión de tema es analizar la evidencia de la literatura relacionada con la utilidad y uso de la cánula nasal de alto flujo, en pacientes adultos bajo cuidado intensivo, con falla respiratoria. Materiales y métodos. Se realizó una revisión bibliográfica de 100 artículos publicados en las bases de datos Science Direct, Scopus, Ovid, Medline, Proquest y Cochrane, durante una ventana de tiempo comprendida entre 2011 y 2017. Se seleccionaron 50 artículos originales y se excluyeron 50 estudios correspondientes a revisiones de tema, de caso y a la utilización de la cánula nasal en servicios diferentes a la unidad de cuidado intensivo adulto. Resultados. La cánula nasal de alto flujo fue utilizada en mayor proporción para el manejo terapéutico en falla hipoxémica entre leve y moderada, en falla hipercápnica y en procesos de preintubación y postextubación, con lo cual se evidenció mejoría en los parámetros clínicos y gasométricos y en el confort del paciente; además, se convirtió en una alternativa terapéutica que tiene efectos positivos sobre procesos fisiológicos. Conclusiones. El uso de la cánula nasal de alto flujo ha demostrado beneficios en la evolución clínica de los pacientes, gracias a los efectos terapéuticos que genera en procesos como la oxigenación y ventilación, comparados con otros sistemas de oxigenación convencional; sin embargo, es necesario aumentar los estudios que validen los beneficios de este dispositivo, sobre todo en los pacientes con falla respiratoria tipo hipercápnica.
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2. Pilar Orive FJ, López Fernández YM. Oxigenoterapia de alto flujo. An Pediatr Contin. 2014;12(1):25-9.
3. Lee J, Rehder K, Willifor L, Cheifetz I, Turner D. Use of high flow nasal cannula in critically ill infants, children, and adults: a critical review of the literature. Intensive Care Med. 2013;39(2):247-257. https://doi.org/10.1007/s00134-012-2743-5
4. Ward J. High flow oxygen administration by nasal cannula for adults and perinatal patients. Respir Care. 2013;58(1):98-122. https://doi.org/10.4187/respcare.01941
5. McKiernan C, Chua LC, Visintainer P, Allen H. High flow nasal cannulae therapy in infants with bronchiolitis. J Pediatr. 2010;156(4):634-8. https://doi.org/10.1016/j.jpeds.2009.10.039
6. Milési C, Baleine J, Matecki S, Durand S, Combes C, Batista Novais A, et al. Is treatment with a high flow nasal cannula effective in acute viral bronchiolitis. A physiologic study. Intensive Care Med. 2013;39(6):1088-94. https://doi.org/10.1007/s00134-013-2879-y
7. Nishimura M. High-flow nasal cannula oxygen therapy in adults. J Intensive Care. 2015;3(1): 15.
https://doi.org/10.1186/s40560-015-0084-5
8. Masclans JR, Pérez Terán P, Roca O. The role of high-flow oxygen therapy in acute respiratory failure. Medicina Intensiva. 2015;39(8): 505-15. https://doi.org/10.1016/j.medin.2015.05.009
9. Riera J, Pérez P, Cortés J, et al: Effect of high-flow nasal can-nula and body position on end-expiratory lung volume: A cohort study using electrical impedance tomography. Respir Care 2013; 58:589–59.
10. Velasco Sanz TR, Sánchez de la Ventana AB. La oxigenoterapia de alto flujo con cánula nasal en pacientes críticos. Estudio prospectivo. Enfermería Intensiva. 2014;25(4):131-136. https://doi.org/10.1016/j.enfi.2014.06.001
11. Bérmudez Barrezueta L. Eficacia de la oxigenoterapia de alto flujo para el tratamiento de la bronquiolitis moderada-grave en neonatos. [Tesis de Maestría]. [España]: Universidad Miguel Hernández de Elche; 2015.
12. Patiño J F, Celis E, Díaz J C. Gases sanguíneos, Fisiología de la respiración e Insuficiencia Respiratoria Aguda. 2015;85-115.
13. Dueñas Castell C, Mejía Bermúdez J, Coronel C, Ortiz Ruiz G. Insuficiencia respiratoria aguda. Acta Colomb Cuid Intensivo. 2016;16(S1):1-24. https://doi.org/10.1016/j.acci.2016.05.001
14. Ferrer M. Tratamiento de la insuficiencia respiratoria aguda. Med Integr. 2001;38:2007.
15. Iglesias I, Lera E. Uso de las cánulas de alto flujo en las urgencias pediátricas. Arch Pediatr Urug. 2016;87(2):84-86.
16.Kernick J, Magarey J. What is the evidence for the use of high flow nasal cannula oxygen in adult patients admitted to critical care units? A systematic review. Aust Crit Care. 2010;23(2):53-70. https://doi.org/10.1016/j.aucc.2010.01.001
17. Roca O, Riera J, Torres F, Masclans J R. High-flow oxygen therapy in acute respiratory failure. Respir Care. 2010;55(4):408-13.
18. Millar J, Lutton S, O’Connor P. The use of high-flow nasal oxygen therapy in the management of hypercarbic respiratory failure. Therapeutic advances in respiratory disease. Ther Adv Respir Dis. 2014;8(2), 63-64.
19. Rello J, Pérez M, Roca O, Poulakou G, Souto J, Laborda C, et al. High-flow nasal therapy in adults with severe acute respiratory infection: a cohort study in patients with 2009 influenza A/H1N1v. J Crit Care. 2012;27(5):434-439. https://doi.org/10.1016/j.jcrc.2012.04.006
20. Peters SG, Holets SR, Gay PC. High-flow nasal cannula therapy in do-not-intubate patients with hypoxemic respiratory distress. Respir Care. 2013;58(4):597-600. https://doi.org/10.4187/respcare.01887
21. Spoletini G, Mega C, Khoja A, Khoja A, Alotaibi M, Blasi F, et al. Better comfort and dyspnea scores with high-flow nasal cannula (HFNC) vs standard oxygen (SO) during breaks off noninvasive ventilation (NIV). European Respiratory Society. 2015;46: OA505. https://doi.org/10.1183/13993003.congress-2015.OA505
22. Futier E, Paugam-Burtz C, Constantin JM, Pereira B, Jaber S. The OPERA trial - comparison of early nasal high flow oxygen therapy with standard care for prevention of postoperative hypoxemia after abdominal surgery: study protocol for a multicenter randomized controlled trial. 2013;14:341.
https://doi.org/10.1186/1745-6215-14-341
23. Spoletini G, Alotaibi M, Blasi F, Hill NS. Heated humidified high-flow nasal oxygen in adults: mechanisms of action and clinical implications. Chest. 2015;148(1):253-261. https://doi.org/10.1378/chest.14-2871
24. Delorme M, Bouchard PA, Simon M, Simard M, Lellouche F. Effects of High-Flow Nasal Cannula on the Work of Breathing in Patients Recovering From Acute Respiratory Failure. Crit Care Med. 2017;45(12):1981-1988. https://doi.org/10.1097/CCM.0000000000002693
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