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Terapia de oxígeno hiperbárico en pacientes con lesiones torácicas: ¿Es seguro?
Kübra Canarslan Demir1, Ahmet Uğur Avcı2, Münire Kübra Özgök Kangal1
1Department of Underwater and Hyperbaric Medicine, Gülhane Faculty of Medicine, University of Health Sciences, Ankara-Türkiye.
Resumen
La terapia de oxígeno hiperbárico (HBOT) es generalmente segura para pacientes con trauma torácico, pero puede causar complicaciones cardiopulmonares manejables, especialmente en aquellos con poca reserva clínica. La selección y el seguimiento cuidadosos son fundamentales para una administración segura.
Área de la Ciencia:
- Cuidados para traumas
- La medicina hiperbárica
- Pulmonología
Sus antecedentes:
- Evaluación de la seguridad de la oxigenoterapia hiperbárica en pacientes con trauma torácico contundente.
- Enfoque en las lesiones por aplastamiento de los terremotos de 2023 en Kahramanmaraş.
- Estudio de cohorte retrospectivo en un centro de atención terciaria.
Objetivo del estudio:
- Evaluar la seguridad de la HBOT y los eventos adversos en el trauma torácico contundente.
- Identificar los riesgos potenciales y las complicaciones asociadas con la TGO en esta población.
- Determinar la viabilidad de la HBOT para lesiones torácicas graves.
Principales métodos:
- Incluido 25 pacientes con trauma torácico documentado.
- Se administró HBOT a 2.4 ATA durante dos horas en una cámara múltiple.
- Se analizaron datos demográficos, clínicos, de resultados y de eventos adversos.
Principales resultados:
- Tres pacientes (12%) murieron debido a lesiones severas por aplastamiento, no relacionadas con la HBOT.
- Cinco pacientes (20%) presentaron síntomas cardiopulmonares manejables (disnea, dolor en el pecho, arritmia).
- Un paciente tuvo una convulsión debido a la toxicidad del oxígeno, sin secuelas permanentes; uno tenía pneumomediastinum, administrado conservadoramente.
Conclusiones:
- La HBOT es generalmente segura, pero puede causar complicaciones cardiopulmonares en pacientes con trauma torácico, particularmente aquellos con una reserva clínica deficiente.
- La mayoría de las complicaciones observadas fueron menores y manejables con un control cuidadoso.
- La evaluación de riesgos individualizada y el monitoreo multidisciplinario son cruciales para la seguridad de la TGO en pacientes seleccionados con trauma torácico.
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