Ecografía del diafragma y destete ventilatorio

15 Páginas.

Autores:: López Osorio, Gildardo Mauricio

Tipo de recurso:: Trabajo de grado de pregrado

Fecha de publicación:: 2017

Institución:: Universidad de la Sabana

Repositorio:: Repositorio Universidad de la Sabana

Idioma:: spa

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dc.title.es_CO.fl_str_mv	Ecografía del diafragma y destete ventilatorio
title	Ecografía del diafragma y destete ventilatorio
spellingShingle	Ecografía del diafragma y destete ventilatorio Respiración artificial Ultrasonido Atención al enfermo Diagnóstico
title_short	Ecografía del diafragma y destete ventilatorio
title_full	Ecografía del diafragma y destete ventilatorio
title_fullStr	Ecografía del diafragma y destete ventilatorio
title_full_unstemmed	Ecografía del diafragma y destete ventilatorio
title_sort	Ecografía del diafragma y destete ventilatorio
dc.creator.fl_str_mv	López Osorio, Gildardo Mauricio
dc.contributor.advisor.none.fl_str_mv	Díaz Quijano, Diana Marcela
dc.contributor.author.none.fl_str_mv	López Osorio, Gildardo Mauricio
dc.subject.none.fl_str_mv	Respiración artificial Ultrasonido Atención al enfermo Diagnóstico
topic	Respiración artificial Ultrasonido Atención al enfermo Diagnóstico
description	15 Páginas.
publishDate	2017
dc.date.accessioned.none.fl_str_mv	2017-11-16T14:53:20Z
dc.date.available.none.fl_str_mv	2017-11-16T14:53:20Z
dc.date.created.none.fl_str_mv	2017
dc.date.issued.none.fl_str_mv	2017-11-16
dc.type.none.fl_str_mv	Tesis/Trabajo de grado - Especialización
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dc.identifier.citation.none.fl_str_mv	Epstein SK. Extubation. Respir Care [Internet]. 2002 Apr [cited 2014 Aug 19];47(4):483¿92; discussion 493¿5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11929619 Yang KL, Tobin MJ. A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation. N Engl J Med [Internet]. 1991 May 23 [cited 2014 Sep 27];324(21):1445¿50. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2023603 Petrof BJ, Jaber S, Matecki S. Ventilator-induced diaphragmatic dysfunction. Curr Opin Crit Care [Internet]. 2010 Feb [cited 2014 Aug 18];16(1):19¿25. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19935062 Matamis D, Soilemezi E, Tsagourias M, Akoumianaki E, Dimassi S, Boroli F, et al. Sonographic evaluation of the diaphragm in critically ill patients. Technique and clinical applications. Intensive Care Med [Internet]. 2013 May [cited 2014 Jul 16];39(5):801¿10. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23344830 Dysfunction of the Diaphragm ¿ NEJM [Internet]. [cited 2014 Aug 18]. Available from: http://www.nejm.org/doi/full/10.1056/NEJMra1007236 Vassilakopoulos T, Petrof BJ. Ventilator-induced diaphragmatic dysfunction. Am J Respir Crit Care Med [Internet]. 2004 Feb 1 [cited 2014 Aug 18];169(3):336¿41. Available from: http://www.ncbi.nlm.nih.gov/pubmed/14739134 Rapid Disuse Atrophy of Diaphragm Fibers in Mechanically Ventilated Humans ¿ NEJM [Internet]. [cited 2014 Aug 18]. Available from: http://www.nejm.org/doi/full/10.1056/NEJMoa070447. 8. Effect of Mechanical Ventilation on the Diaphragm ¿ NEJM [Internet]. [cited 2014 Aug 18]. Available from: http://www.nejm.org/doi/full/10.1056/NEJMe0801226. Daniel Martin A, Smith BK, Gabrielli A. Mechanical ventilation, diaphragm weakness and weaning: a rehabilitation perspective. Respir Physiol Neurobiol [Internet]. 2013 Nov 1 [cited 2014 Jul 10];189(2):377¿83. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23692928 Vivier E, Mekontso Dessap A, Dimassi S, Vargas F, Lyazidi A, Thille AW, et al. Diaphragm ultrasonography to estimate the work of breathing during non-invasive ventilation. Intensive Care Med [Internet]. 2012 May [cited 2014 Aug 12];38(5):796¿803. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22476448 DiNino E, Gartman EJ, Sethi JM, McCool FD. Diaphragm ultrasound as a predictor of successful extubation from mechanical ventilation. Thorax [Internet]. 2014 May [cited 2014 Jul 30];69(5):423¿7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24365607. Kim WY, Suh HJ, Hong S-B, Koh Y, Lim C-M. Diaphragm dysfunction assessed by ultrasonography: influence on weaning from mechanical ventilation. Crit Care Med [Internet]. 2011 Dec [cited 2014 Aug 7];39(12):2627¿30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21705883. Jiang J-R, Tsai T-H, Jerng J-S, Yu C-J, Wu H-D, Yang P-C. Ultrasonographic evaluation of liver/spleen movements and extubation outcome. Chest [Internet]. 2004 Jul [cited 2014 Aug 19];126(1):179¿85. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15249460. Vassilakopoulos T, Zakynthinos S. The tension - time index and the frequency / tidal volumen ratio are the major pathophysiologic determinants of weaning failure and success. Am J Respir Crit Care Med. 1998: 158 (2): 378 - 85. Vassilakopoulos T, Petrof BJ. Ventilator - induced diaphragmatic dysfunction. Am J Respir Crit Care Med. 2004: 169 (3): 336 - 41. Laghi F, Cattapan SE, Jubran A, et al. Is weaning failure caused by low - frecuency fatigue of the diaphram? Am J Resp Crit Care Med. 2003: 167 (2);120-7. Dreem S. Acquired neuromuscular disorders in the intensive care unit. In: Thoracic trauma and critical care. Springer; 2002:529 - 534. Accessed 5/13/2014 3:07;11 AM. Anzureto A, Peters JI, Tobin Mj, et al. Effects of prolonged controlled mechanical ventilation on diapghragmatic function in healthy adult baboons. Crit Care Med. 1997;28(3):358-54. Bellemare F, Grassino A. Force reserve of the diaphragm in patient with chronic obstructive pulmonary disease. J Appl Physiol Respir Environ Exerc Physiol. 1983; 55(1 Pt1) 8-15. Shanely RA, Zergeroglu MA, Lennon SL, et al. Mechanical ventilation çinduced diaphragmatic atrophy is associated with oxidative injury and increased proteolytic activity. Am J Resp Crit Care Med. 2002; 166 (10):1369 - 74. Ferrari Giovanni, De Filippi. Diaphragm ultrasound as a new index of discontinuation from mechanical ventilation. Critical Ultrasound Journal 2014, 6:8. Ramirez-Sarmiento A, Orozco-Levi M, Barreiro E, Mendez R, Ferrer A, Broquetas J, et al. Expiratory muscle endurance in chronic obstructive pulmonary disease. Thorax. 2002;57:132¿6. Sinderby C, Beck J, Spahija J, Weinberg J, Grassino A. Voluntary activation of the human diaphragm in health and disease. J Appl Physiol. 1998;85:2146¿58. Moxham JR, Edwards RH, Aubier M, De Troyer A, Farkas G, Macklem PT, et al. Changes in the EMG power spectrum (high_to_low ratio) with forced fatigue n humans. J Appl Physiol. 1982;53:1094¿9. Tom Schepens, Walter V. Schepens et al. The course of diaphragm atrophy in ventilated patients assessed with ultrasound: a longitudinal cohort study; Critical Care (2015) 19:422. M. Umbrello, P. Formenti, et al. Diaphragm ultrasound as indicator of respiratory effort in critically ill patients undergoing assisted mechanical ventilation: a pilot clinical study. 2014, 6:8 (21). EpsteinSK. Weaning, Respir Care Clin North Am [Internet] 2000;6(2):253-301) [cited2014 Aug 18]; Available from:https://www.ncbi.nlm.nih.gov/pubmed/10757963 Meade MO , Guayatt GH, Cook Dj. Weaning from mechanical ventilation: the evidence from clinical research. Respir Care 2001;46(12):1408-15 Neil R. MacIntyre. Evidence-Based Guidelines for Weaning and Discontinuing Ventilatory Support : A Collective Task Force Facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine. Chest 2001;120 (6 suppl) : 375s - 848s William m. coplin , david j. pierson , kathy d. cooley. Implications of Extubation Delay in Brain-Injured Patients Meeting Standard Weaning Criteria. AJRCCM 2000;161:1530-6
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identifier_str_mv	Epstein SK. Extubation. Respir Care [Internet]. 2002 Apr [cited 2014 Aug 19];47(4):483¿92; discussion 493¿5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11929619 Yang KL, Tobin MJ. A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation. N Engl J Med [Internet]. 1991 May 23 [cited 2014 Sep 27];324(21):1445¿50. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2023603 Petrof BJ, Jaber S, Matecki S. Ventilator-induced diaphragmatic dysfunction. Curr Opin Crit Care [Internet]. 2010 Feb [cited 2014 Aug 18];16(1):19¿25. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19935062 Matamis D, Soilemezi E, Tsagourias M, Akoumianaki E, Dimassi S, Boroli F, et al. Sonographic evaluation of the diaphragm in critically ill patients. Technique and clinical applications. Intensive Care Med [Internet]. 2013 May [cited 2014 Jul 16];39(5):801¿10. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23344830 Dysfunction of the Diaphragm ¿ NEJM [Internet]. [cited 2014 Aug 18]. Available from: http://www.nejm.org/doi/full/10.1056/NEJMra1007236 Vassilakopoulos T, Petrof BJ. Ventilator-induced diaphragmatic dysfunction. Am J Respir Crit Care Med [Internet]. 2004 Feb 1 [cited 2014 Aug 18];169(3):336¿41. Available from: http://www.ncbi.nlm.nih.gov/pubmed/14739134 Rapid Disuse Atrophy of Diaphragm Fibers in Mechanically Ventilated Humans ¿ NEJM [Internet]. [cited 2014 Aug 18]. Available from: http://www.nejm.org/doi/full/10.1056/NEJMoa070447. 8. Effect of Mechanical Ventilation on the Diaphragm ¿ NEJM [Internet]. [cited 2014 Aug 18]. Available from: http://www.nejm.org/doi/full/10.1056/NEJMe0801226. Daniel Martin A, Smith BK, Gabrielli A. Mechanical ventilation, diaphragm weakness and weaning: a rehabilitation perspective. Respir Physiol Neurobiol [Internet]. 2013 Nov 1 [cited 2014 Jul 10];189(2):377¿83. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23692928 Vivier E, Mekontso Dessap A, Dimassi S, Vargas F, Lyazidi A, Thille AW, et al. Diaphragm ultrasonography to estimate the work of breathing during non-invasive ventilation. Intensive Care Med [Internet]. 2012 May [cited 2014 Aug 12];38(5):796¿803. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22476448 DiNino E, Gartman EJ, Sethi JM, McCool FD. Diaphragm ultrasound as a predictor of successful extubation from mechanical ventilation. Thorax [Internet]. 2014 May [cited 2014 Jul 30];69(5):423¿7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24365607. Kim WY, Suh HJ, Hong S-B, Koh Y, Lim C-M. Diaphragm dysfunction assessed by ultrasonography: influence on weaning from mechanical ventilation. Crit Care Med [Internet]. 2011 Dec [cited 2014 Aug 7];39(12):2627¿30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21705883. Jiang J-R, Tsai T-H, Jerng J-S, Yu C-J, Wu H-D, Yang P-C. Ultrasonographic evaluation of liver/spleen movements and extubation outcome. Chest [Internet]. 2004 Jul [cited 2014 Aug 19];126(1):179¿85. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15249460. Vassilakopoulos T, Zakynthinos S. The tension - time index and the frequency / tidal volumen ratio are the major pathophysiologic determinants of weaning failure and success. Am J Respir Crit Care Med. 1998: 158 (2): 378 - 85. Vassilakopoulos T, Petrof BJ. Ventilator - induced diaphragmatic dysfunction. Am J Respir Crit Care Med. 2004: 169 (3): 336 - 41. Laghi F, Cattapan SE, Jubran A, et al. Is weaning failure caused by low - frecuency fatigue of the diaphram? Am J Resp Crit Care Med. 2003: 167 (2);120-7. Dreem S. Acquired neuromuscular disorders in the intensive care unit. In: Thoracic trauma and critical care. Springer; 2002:529 - 534. Accessed 5/13/2014 3:07;11 AM. Anzureto A, Peters JI, Tobin Mj, et al. Effects of prolonged controlled mechanical ventilation on diapghragmatic function in healthy adult baboons. Crit Care Med. 1997;28(3):358-54. Bellemare F, Grassino A. Force reserve of the diaphragm in patient with chronic obstructive pulmonary disease. J Appl Physiol Respir Environ Exerc Physiol. 1983; 55(1 Pt1) 8-15. Shanely RA, Zergeroglu MA, Lennon SL, et al. Mechanical ventilation çinduced diaphragmatic atrophy is associated with oxidative injury and increased proteolytic activity. Am J Resp Crit Care Med. 2002; 166 (10):1369 - 74. Ferrari Giovanni, De Filippi. Diaphragm ultrasound as a new index of discontinuation from mechanical ventilation. Critical Ultrasound Journal 2014, 6:8. Ramirez-Sarmiento A, Orozco-Levi M, Barreiro E, Mendez R, Ferrer A, Broquetas J, et al. Expiratory muscle endurance in chronic obstructive pulmonary disease. Thorax. 2002;57:132¿6. Sinderby C, Beck J, Spahija J, Weinberg J, Grassino A. Voluntary activation of the human diaphragm in health and disease. J Appl Physiol. 1998;85:2146¿58. Moxham JR, Edwards RH, Aubier M, De Troyer A, Farkas G, Macklem PT, et al. Changes in the EMG power spectrum (high_to_low ratio) with forced fatigue n humans. J Appl Physiol. 1982;53:1094¿9. Tom Schepens, Walter V. Schepens et al. The course of diaphragm atrophy in ventilated patients assessed with ultrasound: a longitudinal cohort study; Critical Care (2015) 19:422. M. Umbrello, P. Formenti, et al. Diaphragm ultrasound as indicator of respiratory effort in critically ill patients undergoing assisted mechanical ventilation: a pilot clinical study. 2014, 6:8 (21). EpsteinSK. Weaning, Respir Care Clin North Am [Internet] 2000;6(2):253-301) [cited2014 Aug 18]; Available from:https://www.ncbi.nlm.nih.gov/pubmed/10757963 Meade MO , Guayatt GH, Cook Dj. Weaning from mechanical ventilation: the evidence from clinical research. Respir Care 2001;46(12):1408-15 Neil R. MacIntyre. Evidence-Based Guidelines for Weaning and Discontinuing Ventilatory Support : A Collective Task Force Facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine. Chest 2001;120 (6 suppl) : 375s - 848s William m. coplin , david j. pierson , kathy d. cooley. Implications of Extubation Delay in Brain-Injured Patients Meeting Standard Weaning Criteria. AJRCCM 2000;161:1530-6 267048 TE09374
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spelling	Díaz Quijano, Diana MarcelaLópez Osorio, Gildardo MauricioEspecialista en Neumología2017-11-16T14:53:20Z2017-11-16T14:53:20Z20172017-11-16Epstein SK. Extubation. Respir Care [Internet]. 2002 Apr [cited 2014 Aug 19];47(4):483¿92; discussion 493¿5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11929619Yang KL, Tobin MJ. A prospective study of indexes predicting the outcome of trials of weaning frommechanical ventilation. N Engl J Med [Internet]. 1991 May 23 [cited 2014 Sep 27];324(21):1445¿50. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2023603Petrof BJ, Jaber S, Matecki S. Ventilator-induced diaphragmatic dysfunction. Curr Opin Crit Care [Internet]. 2010 Feb [cited 2014 Aug 18];16(1):19¿25. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19935062Matamis D, Soilemezi E, Tsagourias M, Akoumianaki E, Dimassi S, Boroli F, et al. Sonographic evaluation of the diaphragm in critically ill patients. Technique and clinical applications. Intensive Care Med [Internet]. 2013 May [cited 2014 Jul 16];39(5):801¿10. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23344830Dysfunction of the Diaphragm ¿ NEJM [Internet]. [cited 2014 Aug 18]. Available from: http://www.nejm.org/doi/full/10.1056/NEJMra1007236Vassilakopoulos T, Petrof BJ. Ventilator-induced diaphragmatic dysfunction. Am J Respir Crit Care Med [Internet]. 2004 Feb 1 [cited 2014 Aug 18];169(3):336¿41. Available from: http://www.ncbi.nlm.nih.gov/pubmed/14739134Rapid Disuse Atrophy of Diaphragm Fibers in Mechanically Ventilated Humans ¿ NEJM [Internet]. [cited 2014 Aug 18]. Available from: http://www.nejm.org/doi/full/10.1056/NEJMoa070447. 8. Effect of Mechanical Ventilation on the Diaphragm ¿ NEJM [Internet]. [cited 2014 Aug 18]. Available from: http://www.nejm.org/doi/full/10.1056/NEJMe0801226.Daniel Martin A, Smith BK, Gabrielli A. Mechanical ventilation, diaphragm weakness and weaning: a rehabilitation perspective. Respir Physiol Neurobiol [Internet]. 2013 Nov 1 [cited 2014 Jul 10];189(2):377¿83. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23692928Vivier E, Mekontso Dessap A, Dimassi S, Vargas F, Lyazidi A, Thille AW, et al. Diaphragm ultrasonography to estimate the work of breathing during non-invasive ventilation. Intensive Care Med [Internet]. 2012 May [cited 2014 Aug 12];38(5):796¿803. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22476448DiNino E, Gartman EJ, Sethi JM, McCool FD. Diaphragm ultrasound as a predictor of successful extubation from mechanical ventilation. Thorax [Internet]. 2014 May [cited 2014 Jul 30];69(5):423¿7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24365607.Kim WY, Suh HJ, Hong S-B, Koh Y, Lim C-M. Diaphragm dysfunction assessed by ultrasonography: influence on weaning from mechanical ventilation. Crit Care Med [Internet]. 2011 Dec [cited 2014 Aug 7];39(12):2627¿30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21705883.Jiang J-R, Tsai T-H, Jerng J-S, Yu C-J, Wu H-D, Yang P-C. Ultrasonographic evaluation of liver/spleen movements and extubation outcome. Chest [Internet]. 2004 Jul [cited 2014 Aug 19];126(1):179¿85. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15249460.Vassilakopoulos T, Zakynthinos S. The tension - time index and the frequency / tidal volumen ratio are the major pathophysiologic determinants of weaning failure and success. Am J Respir Crit Care Med. 1998: 158 (2): 378 - 85.Vassilakopoulos T, Petrof BJ. Ventilator - induced diaphragmatic dysfunction. Am J Respir Crit Care Med. 2004: 169 (3): 336 - 41.Laghi F, Cattapan SE, Jubran A, et al. Is weaning failure caused by low - frecuency fatigue of the diaphram? Am J Resp Crit Care Med. 2003: 167 (2);120-7.Dreem S. Acquired neuromuscular disorders in the intensive care unit. In: Thoracic trauma and critical care. Springer; 2002:529 - 534. Accessed 5/13/2014 3:07;11 AM.Anzureto A, Peters JI, Tobin Mj, et al. Effects of prolonged controlled mechanical ventilation on diapghragmatic function in healthy adult baboons. Crit Care Med. 1997;28(3):358-54.Bellemare F, Grassino A. Force reserve of the diaphragm in patient with chronic obstructive pulmonary disease. J Appl Physiol Respir Environ Exerc Physiol. 1983; 55(1 Pt1) 8-15.Shanely RA, Zergeroglu MA, Lennon SL, et al. Mechanical ventilation çinduced diaphragmatic atrophy is associated with oxidative injury and increased proteolytic activity. Am J Resp Crit Care Med. 2002; 166 (10):1369 - 74.Ferrari Giovanni, De Filippi. Diaphragm ultrasound as a new index of discontinuation from mechanical ventilation. Critical Ultrasound Journal 2014, 6:8.Ramirez-Sarmiento A, Orozco-Levi M, Barreiro E, Mendez R, Ferrer A, Broquetas J, et al. Expiratory muscle endurance in chronic obstructive pulmonary disease. Thorax. 2002;57:132¿6.Sinderby C, Beck J, Spahija J, Weinberg J, Grassino A. Voluntary activation of the human diaphragm in health and disease. J Appl Physiol. 1998;85:2146¿58.Moxham JR, Edwards RH, Aubier M, De Troyer A, Farkas G, Macklem PT, et al. Changes in the EMG power spectrum (high_to_low ratio) with forced fatigue n humans. J Appl Physiol. 1982;53:1094¿9.Tom Schepens, Walter V. Schepens et al. The course of diaphragm atrophy in ventilated patients assessed with ultrasound: a longitudinal cohort study; Critical Care (2015) 19:422.M. Umbrello, P. Formenti, et al. Diaphragm ultrasound as indicator of respiratory effort in critically ill patients undergoing assisted mechanical ventilation: a pilot clinical study. 2014, 6:8 (21).EpsteinSK. Weaning, Respir Care Clin North Am [Internet] 2000;6(2):253-301) [cited2014 Aug 18]; Available from:https://www.ncbi.nlm.nih.gov/pubmed/10757963Meade MO , Guayatt GH, Cook Dj. Weaning from mechanical ventilation: the evidence from clinical research. Respir Care 2001;46(12):1408-15Neil R. MacIntyre. Evidence-Based Guidelines for Weaning and Discontinuing Ventilatory Support : A Collective Task Force Facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine. Chest 2001;120 (6 suppl) : 375s - 848sWilliam m. coplin , david j. pierson , kathy d. cooley. Implications of Extubation Delay in Brain-Injured Patients Meeting Standard Weaning Criteria. AJRCCM 2000;161:1530-6https://hdl.handle.net/10818/31979267048TE0937415 Páginas.Introduccion: El 20% de los pacientes críticos tienen un proceso de retiro difícil de la Ventilación Mecánica (VM) describiendose la disfunción diafragmática como una de las principales causas de este proceso. El ultrasonido es una técnica no invasiva útil para evaluar y diagnósticar las alteraciones diafragmáticas. Objetivo: Determinar las medidas ecográficas que permitan establecer la presencia de disfunción diafragmática y que puedan ser predictoras de fracaso en el retiro de la VM. Materiales y metodos: Estudio de pruebas diagnósticas en pacientes con más de 48 horas en VM en quienes inicia el proceso de retiro de la ventilación, previo al desarrollo de la prueba de respiración espontánea se realizó la ecografía diafragmática. Se incluyeron variables clínicas, mediciones de ecografía y desenlaces. La estadística fue descriptiva e inferencial calculando sensibilidad, especificidad, valor predictivo positivo y negativo y construyendo una curva ROC. Resultados: Fueron incluidos 97 pacientes sometidos al proceso de retiro de la VM. La edad promedio fue 58 años, La principal causa de intubación fue la falla respiratoria hipoxémica (63%)., el tiempo de VM previo al retiro fue 4 días y el tiempo del proceso de retiro del ventilador fueron 2 días en promedio. Los pacientes que fracasarón en el retiro del ventilador presentarón mayor tiempo en VM y estancia en la UCI (5 Vs 7 días, p 0.026 y 10 Vs 14 días, p 0.032). El fracaso se presentó en el 21% de los casos y la disfunción diafragmática fue observada en el 10% de ellos. Los hallazgos ecográficos en quienes fracasaron fueron el menor desplazamiento del diafragma, mayor tiempo inspiratorio con menor velocidad de contracción del músculo, siendo esta última significativa (2.9 Vs 1.77cm/seg, p <0.001).spaUniversidad de La SabanaEspecialización en NeumologíaFacultad de MedicinaAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/http://purl.org/coar/access_right/c_16ecUniversidad de La SabanaIntellectum Repositorio Universidad de La SabanaRespiración artificialUltrasonidoAtención al enfermoDiagnósticoEcografía del diafragma y destete ventilatorioTesis/Trabajo de grado - Especializaciónhttp://purl.org/coar/resource_type/c_7a1fTextoinfo:eu-repo/semantics/otherhttp://purl.org/redcol/resource_type/COtherinfo:eu-repo/semantics/acceptedVersionPublicationORIGINALGildardo Mauricio López Osorio (Tesis).pdfGildardo Mauricio López Osorio (Tesis).pdfVer documento en PDFapplication/pdf458764https://intellectum.unisabana.edu.co/bitstreams/7bdf9f62-df6d-52b7-e053-7e0910accd73/download3ea6412d4c9c922eccf3d2757360d693MD51trueCC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-81223https://intellectum.unisabana.edu.co/bitstreams/7bdf9f62-df6e-52b7-e053-7e0910accd73/download7c9ab7f006165862d8ce9ac5eac01552MD52falseAdministratorREADAnonymousREADLICENSElicense.txtlicense.txttext/plain; charset=utf-8498https://intellectum.unisabana.edu.co/bitstreams/7bdf9f62-df97-52b7-e053-7e0910accd73/downloadf52a2cfd4df262e08e9b300d62c85cabMD53falseAdministratorREADAnonymousREADGildardo Mauricio López Osorio (Carta).pdfGildardo Mauricio López Osorio (Carta).pdfapplication/pdf736191https://intellectum.unisabana.edu.co/bitstreams/7bdf9f62-de4a-52b7-e053-7e0910accd73/downloadcd1a43c7a9da0814c51f113f87be9beeMD54falseTEXTGildardo Mauricio López Osorio (Tesis).pdf.txtGildardo Mauricio López Osorio (Tesis).pdf.txtExtracted Texttext/plain37236https://intellectum.unisabana.edu.co/bitstreams/7bdf9f62-e00f-52b7-e053-7e0910accd73/downloada24ee10324e3b59bf59e4c2b9c153c0cMD55falseTHUMBNAILGildardo Mauricio López Osorio (Tesis).pdf.jpgGildardo Mauricio López Osorio (Tesis).pdf.jpgGenerated Thumbnailimage/jpeg14787https://intellectum.unisabana.edu.co/bitstreams/4afce71e-9118-40ba-8923-29a69f6b701f/downloadce05739d1c1471f8767c2d8a32a08563MD56false10818/31979oai:intellectum.unisabana.edu.co:10818/319792025-12-11 13:17:20.964http://creativecommons.org/licenses/by-nc-nd/4.0/Attribution-NonCommercial-NoDerivatives 4.0 Internationalrestrictedhttps://intellectum.unisabana.edu.coIntellectum Repositorio Universidad de La Sabanacontactointellectum@unisabana.edu.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

Ecografía del diafragma y destete ventilatorio

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