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Factores de riesgo y resultados respiratorios a corto plazo asociados con extubaciones no planificadas durante la
Irma Mannerstedt1, Laszlo Markasz1, Victoria Karlsson1
1Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Frontiers in pediatrics
|August 28, 2025
Resumen
Las tasas de extubación no planificada (UE) fueron más altas durante el cuidado piel a piel (SSC) para los bebés ventilados mecánicamente, pero disminuyeron con el tiempo. La mayoría de los lactantes no requirieron reintubación, aunque las necesidades de oxígeno aumentaron después de la UE.
Área de la Ciencia:
- Cuidados intensivos neonatales
- Medicina respiratoria en niños
- Seguridad del paciente
Sus antecedentes:
- La extubación no planificada (UE) es un evento adverso significativo en las unidades de cuidados intensivos neonatales.
- El cuidado piel a piel (SSC) es beneficioso para los recién nacidos, pero su implementación durante la ventilación mecánica (MV) presenta desafíos.
- No se ha informado previamente sobre el impacto de la SSC en la incidencia de la UE en lactantes intubados.
Objetivo del estudio:
- Investigar la incidencia de la extubación no planificada (UE) en los lactantes que reciben ventilación mecánica (MV).
- Analizar las características infantiles y los resultados respiratorios a corto plazo tras la UE.
- Evaluar las tasas de UE en una unidad donde la SSC es atención estándar, incluso durante la EM.
Principales métodos:
- Se realizó un estudio de cohorte retrospectivo en un solo centro entre 2021 y 2023.
- Se incluyeron los bebés que reciben MV en un centro de atención terciaria sueco.
- La incidencia de UE se calculó por cada 100 días de MV, diferenciando entre la atención convencional (CC) y la SSC, utilizando datos de registros médicos electrónicos.
Principales resultados:
- La incidencia global de la UE fue de 3,9 por cada 100 días MV (10,4 en SSC frente a 3,0 en CC, p < 0,001).
- La incidencia de UE durante la SSC mostró una tendencia a la baja (14,5 en 2021 a 7,7 en 2023, p=0,07).
- El 72% de los lactantes requirió reintubación dentro de los 120 minutos posteriores a la UE, con un aumento de los requerimientos de oxígeno observados.
Conclusiones:
- Si bien la incidencia de UE fue mayor durante la SSC, disminuyó durante el período de estudio.
- Más del 25% de las EU no requirieron reintubación, independientemente del tipo de atención.
- La implementación segura de SSC en los bebés ventilados mecánicamente requiere personal vigilante, conciencia de los padres y personal experimentado.
Palabras clave:
ventilación mecánicaCuidados intensivos neonatalesel recién nacidoNiño prematuroCuidado de la pielextubación no planificadaMás Videos Relacionados
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