Distrés Respiratorio y Ventilación Mecánica: Su historia.
Palabras clave:
DISTRES, PEEPResumen
El Síndrome de Distrés Respiratorio Agudo (SDRA) constituye una entidad de etiología muy variable, conocida desde hace más de 30 años y a la que se han dedicado innumerables esfuerzos. Estos han hecho que se conozca más a fondo dicha enfermedad, permitiendo ganar conocimientos en diagnóstico y tratamiento, los cuales han tenido diferentes períodos en estos últimos años. Es la ventilación mecánica uno de los pilares fundamentales de la terapéutica después del enfrentamiento causal. Múltiples son los avances que se han logrado con el uso de nuevas técnicas y formas de ventilación, tal es así, que hoy la ventilación en el distrés difiere mucho de lo que se realizaba en sus inicios. Sin lugar a dudas los últimos 15 años han sido revolucionarios en este sentido. Son aceptados los bajos volúmenes para evitar sobredistensión pulmonar y PEEP para combatir las atelectasias que se producen. Esta última con gran variabilidad de criterios pues los estudiosos del tema no se ponen de acuerdo en el valor de la misma. No obstante, estas dos medidas han logrado mejorar la mortalidad de forma importante, pero continua siendo una entidad de alta morbimortalidad en las salas de terapia de cuba y el mundo.Descargas
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Citas
1- Caballero López A. Terapia Intensiva. 2da ed. Ciudad Habana, Editorial Ciencias Médicas; 2002: sec. 5
2- Rozman C. Medicina Interna. 14ta ed. Barcelona, Ediciones Harcourt, S.A; 2000: sec 5.
3- Roca Goderich R. Temas de Medicina Interna. T1 4ta ed. La Habana: Editorial ECIMED; 2002. [En línea]; Acceso 5 de marzo 2004. Disponible en: URL www.Infomed.bvs,libros. Cuba
4- Ashbaugh DG, Bigelow DB, Petty TL, Levine BE. Acute respiratory distress in adults. Lancet 1967; 2:319-23. [Medline]
5- Downs JB, Klein EF, Modell JH. The effect of incremental PEEP on PaO2 in patients with respiratory failure. Anesth Analg 1973;52:210-5. [Medline]
6- Douglas ME, Downs JB. Pulmonary function following severe acute respiratory failure and high levels of positive end-expiratory pressure. Chest 1977;71:18-23. [Medline]
7- Dreyfuss D, Saumon G. Ventilator-induced lung injury: lessons from experimental studies. Am J Respir Crit Care Med 1998;157:294-323. [Medline]
8- Amato MB, Barbas CS, Medeiros DM, Magaldi RB, Schettino GP, Lorenzi-Filho G, et al. Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med 1998:338:347-54. [Medline]
9- Gattinoni L, Caironi P, Pelosi P, Goodman LR. What has computed tomography taught us about the acute respiratory distress syndrome? Am J Respir Crit Care Med 2001; 164: 1701-11. [ Medline ]
10- Pesenti A, Tagliabue P, Patroniti N, Fumagalli R. Computerised tomography scan imaging in acute respiratory distress syndrome. Intensive Care Med 2001; 27: 631-9. [ Medline ]
11- Gattinoni L, Pesenti A, Bombino M, Baglioni S, Rivolta M, Rossi F, et al. Relationships between lung computed tomographic density, gas exchange, and PEEP in acute respiratory failure. Anesthesiology 1988; 69: 824-32.
12- Gattinoni L, Pelosi P, Suter PM, Pedoto A, Vercesi P, Lissoni A. Acute respiratory distress syndrome caused by pulmonary and extrapulmonary disease. Different syndromes? Am J Respir Crit Care Med 1998; 158: 3-11. [ Medline ]
13- Camacho Assef VJ, et al. Temas de Ventilación Mecánica. Ciego de Avila, 2000.
14- Bernard GR, Artigas A, Brigham KL, and the Consensus Committee. The American-European Consensus Conference on ARDS: definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 1994;149:818-824
15- Consensus conferences in intensive care medicine (American Thoracic Society, The European Society of Intensive Care Medicine, and The Societe de Reanimation de Langue Francaise, the ATS Board of Directors. Am J Respir Crit Care Med, July 1999.
16- Pontoppidan, H., B. Geffin, and E. Lowestein. Acute respiratory failure in the adult.1972 N. Engl. J. Med. 287: 690-698 [Medline]
17- Gattinoni L, D’Andrea L, Pelosi P, Vitale G, Pesenti A, Fumagalli R. Regional effects and mechanism of positive end-expiratory pressure in early adult respiratory distress syndrome. JAMA 1993; 269: 2122-7. [ Medline ]
18- Gattinoni L, Bombino M, Pelosi P, Lissoni A, Pesenti A, Fumagalli R, Tagliabue M. Lung structure and function in different stages of severe adult respiratory distress syndrome. JAMA 1994 Jun 8;271(22):1772-9.
19- Gattinoni L, Pelosi P, Vitale G, Pesenti A, D’Andrea L, Mascheroni D. Body position changes redistribute lung computed-tomographic density in patients with acute respiratory failure. Anesthesioogy 1991 Jan;74(1):15-23.
20- Torresin A, Gattinoni L, Pesenti A, Baglioni S, Brambilla R, Eulisse G, Nastri G. Quantitative analysis of the lung CT in normal subjects and in patients with noncardiac pulmonary edema. Radiol Med (Torino) 1989 Dec;78(6):626-31
21- Gattinoni L, Mascheroni D, Torresin A, Marcolin R, Fumagalli R, Vesconi S. Morphological response to positive end expiratory pressure in acute respiratory failure. Computerized tomography study. Intensive Care Med 1986;12(3):137-42.
22- Pelosi P, Gattinoni L. Pulmonary and Extrapulmonary Forms of Acute Respiratory Distress Syndrome.2001, Sem Resp Crit Care Med 22(3):259-268.
23- Hickling K G, Joyce C: Permisive hypercapnia in ARDS and its effect on tissue oxygenationActa Anaesthesiol Scand 1995: 39 Supplementum 107,201-208.
24- Hickling K G,Henderson S J, Jackson R. Low mortality associated with low volume pressure limited ventilation with permissive hypercapnia in severe adult respiratory distress syndrome. Intensive Care Med 1990:16:372-377.
25- Hickling K G,Henderson S J, Walsh J. Low mortality using low voumen pressure limited ventilation with permissive hypercapnia in ARDS: a prospective study. Crit Care Med 1994: 22: 1568-1578.
26- Pelosi P, Cadringher P, Bottino N, Panigada M, Carrieri F, Riva E, Lissoni A, Gattinonil. Sigh in acute respiratory distress syndrome. Am J Respir Crit Care Med 1999 Mar;159(3):872-80.
27- Dreyfuss D, Basset G, Soler PS, Saumon G. Intermittent positive-pressure hyperventilation with high inflation pressures produces pulmonary microvascular injury in rats. Rev. Respir. Dis 1985; 132: 311-315.
28- Dreyfuss D, Basset G, Soler PS, Saumon G. High inflation pressure pulmonary edema: respective effects of high airway pressure, high tidal volume, and positive end expiratory pressure. Am. Rev. Respir DIS. 1988; 137:1159-1164.
29- Dreyfuss D, Saumon G.. Barotrauma is volutrauma, but which volume is the one responsible?. Intensive Care Med. 1992, 18: 139-141.
30- Marini JJ. Evolving Concepts in the Ventilatory Management of Acute Respiratory Distress Syndrome. Clinics in Chest Med. Sep1996; 17(3): 555
31- Brunet F, Jeanbourquin D, Monchi M. Should mechanical ventilation be optimized to blood gases, lung mechanics, or thoracic CT scan? Am J Respir Crit Care,1995; Med 152:524-530.
32- Tobin MJ. Advances in Mechanical Ventilation. Crit Care Med June 2001, 344(26). 536-542
33- Stewart TE, Meade MO, Cook DJ. Evaluation of a ventilation strategy to prevent barotrauma in patients at high risk for acute respiratory distress syndrome. N Engl J Med 1998;338:355-361.[Abstract/Full Text]
34- Brochard L, Roudot-Thoraval F, Roupie E. Tidal volume reduction for prevention of ventilator-induced lung injury in acute respiratory distress syndrome. Am J Respir Crit Care Med 1998;158:1831-1838.[Abstract/Full Text]
35- Brower RG, Shanholtz CB, Fessler HE. Prospective, randomized, controlled clinical trial comparing traditional versus reduced tidal volume ventilation in acute respiratory distress syndrome patients. Crit Care Med 1999;27:1492-1498.[Medline]
36- Rimensberger PC, Pristine G, Brendan J, Cox P, Slutski A. Lung recruitment during small tidal volume ventilation allows minimal positive end-expiratory pressure without augmenting lung injury .Critical Care Medicine, Sep 1999, 27(9):1940-4
37- Rimensberger PC, Cox PN, Frndova H, Bryan AC. The open lung during small tidal volume ventilation: Concepts of recruitment and “optimal” positive end-expiratory pressure. Crit Care Med 1999; 27: 1946-52
38- Rimensberger PC. Lung recruitment and lung volume maintenance: a strategy for improving oxygenation and preventing lung injury during both conventional mechanical ventilation and high—frecuency oscillation. Critical Care Medicine, Feb 2000, 27:745- 55.
39- Lachmann B. Open up the lung and keep the lung open. Intensive Care Med. 1992, 18: 319-321 [Medline].
40- Papadakos PJ, Lachmann B. The open lung concept of alveolar recruitment can improbé outcome in respiratory failure and ARDS. The Mountsinai Journal Medicine. 2002; 73-7
41- Lim Ch, Koh Y, Park W, Shim TS. A safe and effective method of lung volume recruitment using conventional mechanical ventilator in patients with early acute respiratory distrés síndrome. Crit Care Med.1999; 27: A21.
2- Rozman C. Medicina Interna. 14ta ed. Barcelona, Ediciones Harcourt, S.A; 2000: sec 5.
3- Roca Goderich R. Temas de Medicina Interna. T1 4ta ed. La Habana: Editorial ECIMED; 2002. [En línea]; Acceso 5 de marzo 2004. Disponible en: URL www.Infomed.bvs,libros. Cuba
4- Ashbaugh DG, Bigelow DB, Petty TL, Levine BE. Acute respiratory distress in adults. Lancet 1967; 2:319-23. [Medline]
5- Downs JB, Klein EF, Modell JH. The effect of incremental PEEP on PaO2 in patients with respiratory failure. Anesth Analg 1973;52:210-5. [Medline]
6- Douglas ME, Downs JB. Pulmonary function following severe acute respiratory failure and high levels of positive end-expiratory pressure. Chest 1977;71:18-23. [Medline]
7- Dreyfuss D, Saumon G. Ventilator-induced lung injury: lessons from experimental studies. Am J Respir Crit Care Med 1998;157:294-323. [Medline]
8- Amato MB, Barbas CS, Medeiros DM, Magaldi RB, Schettino GP, Lorenzi-Filho G, et al. Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med 1998:338:347-54. [Medline]
9- Gattinoni L, Caironi P, Pelosi P, Goodman LR. What has computed tomography taught us about the acute respiratory distress syndrome? Am J Respir Crit Care Med 2001; 164: 1701-11. [ Medline ]
10- Pesenti A, Tagliabue P, Patroniti N, Fumagalli R. Computerised tomography scan imaging in acute respiratory distress syndrome. Intensive Care Med 2001; 27: 631-9. [ Medline ]
11- Gattinoni L, Pesenti A, Bombino M, Baglioni S, Rivolta M, Rossi F, et al. Relationships between lung computed tomographic density, gas exchange, and PEEP in acute respiratory failure. Anesthesiology 1988; 69: 824-32.
12- Gattinoni L, Pelosi P, Suter PM, Pedoto A, Vercesi P, Lissoni A. Acute respiratory distress syndrome caused by pulmonary and extrapulmonary disease. Different syndromes? Am J Respir Crit Care Med 1998; 158: 3-11. [ Medline ]
13- Camacho Assef VJ, et al. Temas de Ventilación Mecánica. Ciego de Avila, 2000.
14- Bernard GR, Artigas A, Brigham KL, and the Consensus Committee. The American-European Consensus Conference on ARDS: definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 1994;149:818-824
15- Consensus conferences in intensive care medicine (American Thoracic Society, The European Society of Intensive Care Medicine, and The Societe de Reanimation de Langue Francaise, the ATS Board of Directors. Am J Respir Crit Care Med, July 1999.
16- Pontoppidan, H., B. Geffin, and E. Lowestein. Acute respiratory failure in the adult.1972 N. Engl. J. Med. 287: 690-698 [Medline]
17- Gattinoni L, D’Andrea L, Pelosi P, Vitale G, Pesenti A, Fumagalli R. Regional effects and mechanism of positive end-expiratory pressure in early adult respiratory distress syndrome. JAMA 1993; 269: 2122-7. [ Medline ]
18- Gattinoni L, Bombino M, Pelosi P, Lissoni A, Pesenti A, Fumagalli R, Tagliabue M. Lung structure and function in different stages of severe adult respiratory distress syndrome. JAMA 1994 Jun 8;271(22):1772-9.
19- Gattinoni L, Pelosi P, Vitale G, Pesenti A, D’Andrea L, Mascheroni D. Body position changes redistribute lung computed-tomographic density in patients with acute respiratory failure. Anesthesioogy 1991 Jan;74(1):15-23.
20- Torresin A, Gattinoni L, Pesenti A, Baglioni S, Brambilla R, Eulisse G, Nastri G. Quantitative analysis of the lung CT in normal subjects and in patients with noncardiac pulmonary edema. Radiol Med (Torino) 1989 Dec;78(6):626-31
21- Gattinoni L, Mascheroni D, Torresin A, Marcolin R, Fumagalli R, Vesconi S. Morphological response to positive end expiratory pressure in acute respiratory failure. Computerized tomography study. Intensive Care Med 1986;12(3):137-42.
22- Pelosi P, Gattinoni L. Pulmonary and Extrapulmonary Forms of Acute Respiratory Distress Syndrome.2001, Sem Resp Crit Care Med 22(3):259-268.
23- Hickling K G, Joyce C: Permisive hypercapnia in ARDS and its effect on tissue oxygenationActa Anaesthesiol Scand 1995: 39 Supplementum 107,201-208.
24- Hickling K G,Henderson S J, Jackson R. Low mortality associated with low volume pressure limited ventilation with permissive hypercapnia in severe adult respiratory distress syndrome. Intensive Care Med 1990:16:372-377.
25- Hickling K G,Henderson S J, Walsh J. Low mortality using low voumen pressure limited ventilation with permissive hypercapnia in ARDS: a prospective study. Crit Care Med 1994: 22: 1568-1578.
26- Pelosi P, Cadringher P, Bottino N, Panigada M, Carrieri F, Riva E, Lissoni A, Gattinonil. Sigh in acute respiratory distress syndrome. Am J Respir Crit Care Med 1999 Mar;159(3):872-80.
27- Dreyfuss D, Basset G, Soler PS, Saumon G. Intermittent positive-pressure hyperventilation with high inflation pressures produces pulmonary microvascular injury in rats. Rev. Respir. Dis 1985; 132: 311-315.
28- Dreyfuss D, Basset G, Soler PS, Saumon G. High inflation pressure pulmonary edema: respective effects of high airway pressure, high tidal volume, and positive end expiratory pressure. Am. Rev. Respir DIS. 1988; 137:1159-1164.
29- Dreyfuss D, Saumon G.. Barotrauma is volutrauma, but which volume is the one responsible?. Intensive Care Med. 1992, 18: 139-141.
30- Marini JJ. Evolving Concepts in the Ventilatory Management of Acute Respiratory Distress Syndrome. Clinics in Chest Med. Sep1996; 17(3): 555
31- Brunet F, Jeanbourquin D, Monchi M. Should mechanical ventilation be optimized to blood gases, lung mechanics, or thoracic CT scan? Am J Respir Crit Care,1995; Med 152:524-530.
32- Tobin MJ. Advances in Mechanical Ventilation. Crit Care Med June 2001, 344(26). 536-542
33- Stewart TE, Meade MO, Cook DJ. Evaluation of a ventilation strategy to prevent barotrauma in patients at high risk for acute respiratory distress syndrome. N Engl J Med 1998;338:355-361.[Abstract/Full Text]
34- Brochard L, Roudot-Thoraval F, Roupie E. Tidal volume reduction for prevention of ventilator-induced lung injury in acute respiratory distress syndrome. Am J Respir Crit Care Med 1998;158:1831-1838.[Abstract/Full Text]
35- Brower RG, Shanholtz CB, Fessler HE. Prospective, randomized, controlled clinical trial comparing traditional versus reduced tidal volume ventilation in acute respiratory distress syndrome patients. Crit Care Med 1999;27:1492-1498.[Medline]
36- Rimensberger PC, Pristine G, Brendan J, Cox P, Slutski A. Lung recruitment during small tidal volume ventilation allows minimal positive end-expiratory pressure without augmenting lung injury .Critical Care Medicine, Sep 1999, 27(9):1940-4
37- Rimensberger PC, Cox PN, Frndova H, Bryan AC. The open lung during small tidal volume ventilation: Concepts of recruitment and “optimal” positive end-expiratory pressure. Crit Care Med 1999; 27: 1946-52
38- Rimensberger PC. Lung recruitment and lung volume maintenance: a strategy for improving oxygenation and preventing lung injury during both conventional mechanical ventilation and high—frecuency oscillation. Critical Care Medicine, Feb 2000, 27:745- 55.
39- Lachmann B. Open up the lung and keep the lung open. Intensive Care Med. 1992, 18: 319-321 [Medline].
40- Papadakos PJ, Lachmann B. The open lung concept of alveolar recruitment can improbé outcome in respiratory failure and ARDS. The Mountsinai Journal Medicine. 2002; 73-7
41- Lim Ch, Koh Y, Park W, Shim TS. A safe and effective method of lung volume recruitment using conventional mechanical ventilator in patients with early acute respiratory distrés síndrome. Crit Care Med.1999; 27: A21.
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Pérez Calleja L, Guirola de la Parra J, Pollo Inda JD. Distrés Respiratorio y Ventilación Mecánica: Su historia. Mediciego [Internet]. 22 de septiembre de 2004 [citado 1 de febrero de 2025];10(2). Disponible en: https://revmediciego.sld.cu/index.php/mediciego/article/view/2673
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