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Control de la temperatura corporal a través del tracto respiratorio
Brian J Ring1, François Lellouche2,3, Robert Chatburn4
1Dr. Ring, Dr. Goodman, and Mr. Branson are affiliated with Division of Trauma Surgery and Critical Care, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Respiratory care
|August 25, 2025
Resumen
Los pacientes con ventilación mecánica enfrentan un mayor riesgo de hipotermia (baja temperatura corporal). La inhalación de gases calentados y humedecidos puede ayudar a regular la temperatura corporal, pero se necesitan más pruebas clínicas.
Área de la Ciencia:
- Medicina de cuidados intensivos
- Fisiología respiratoria
- Regulación térmica
Sus antecedentes:
- La hipotermia (temperatura corporal central ≤35°C) aumenta la morbilidad y la mortalidad en pacientes con ventilación mecánica.
- La intubación endotraqueal evita la humidificación natural de las vías respiratorias, lo que lleva a la pérdida de calor y humedad.
- Los dispositivos de humidificación de las vías respiratorias existentes tienen una eficacia controvertida para el recalentamiento de todo el cuerpo.
Objetivo del estudio:
- Evaluar la viabilidad y eficacia de la termorregulación basada en las vías respiratorias.
- Evaluar el potencial de los gases calentados y humedecidos inhalados para el tratamiento de la hipotermia en cuidados intensivos.
Principales métodos:
- Esta revisión narrativa sintetiza la literatura actual sobre la termorregulación basada en las vías respiratorias.
- Evalúa las tecnologías existentes y emergentes para calentar y humedecer los gases inhalados.
Principales resultados:
- El papel natural de las vías respiratorias superiores en el acondicionamiento del aire inspirado se evita con la intubación.
- Se produce una pérdida significativa de calor y humedad, lo que aumenta el riesgo de hipotermia.
- Se debate la efectividad de las estrategias actuales de calentamiento de las vías respiratorias para el recalentamiento.
Conclusiones:
- La termorregulación basada en las vías respiratorias a través de gases calentados y humedecidos es prometedora, especialmente para escenarios específicos como la atención de traumas.
- Es esencial una validación clínica más sólida para confirmar la eficacia y orientar la práctica clínica.
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