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Relación entre la disnea y el impulso respiratorio en pacientes con ventilación mecánica: un estudio observacional
Chie Hatozaki1, Hideaki Sakuramoto2, Gen Aikawa3
1Intensive Care Unit, University of Tsukuba Hospital, Tsukuba, Japan.
Resumen
Los pacientes con ventilación mecánica (VM) con alto impulso respiratorio pueden sufrir lesiones pulmonares. Este estudio encontró correlaciones negativas débiles entre las escalas de disnea y el impulso respiratorio (P0.1) en pacientes con VM, particularmente aquellos con sedación profunda.
Área de la Ciencia:
- Medicina de Cuidados Críticos
- Fisiología Respiratoria
- Medición Clínica
Sus antecedentes:
- El alto impulso respiratorio durante la ventilación mecánica (VM) presenta un riesgo de lesión pulmonar inducida por el ventilador.
- La asociación entre el alto impulso respiratorio y la disnea en pacientes con VM no está bien definida.
Objetivo del estudio:
- Investigar la relación entre tres escalas de calificación de la disnea y el impulso respiratorio (P0.1) en pacientes que reciben VM.
- Aclarar la asociación entre la disnea subjetiva y las medidas objetivas del esfuerzo respiratorio.
Principales métodos:
- Estudio observacional prospectivo en una UCI (febrero de 2020 - marzo de 2022) que incluyó a adultos que requerían VM >24 horas.
- Se evaluó la disnea utilizando tres escalas validadas y se midió el impulso respiratorio a través de la presión de oclusión de las vías respiratorias (P0.1).
- Se utilizaron coeficientes de correlación de Pearson para analizar las relaciones entre las puntuaciones de disnea y el P0.1.
Principales resultados:
- Se observaron correlaciones negativas débiles entre las tres escalas de disnea y el P0.1 en la cohorte general (r = -0.293 a -0.240).
- El análisis estratificado reveló correlaciones negativas débiles más fuertes en el grupo de sedación profunda (r = -0.347 a -0.325).
- No se encontraron correlaciones significativas al estratificar por enfermedad o gravedad.
Conclusiones:
- Existen correlaciones negativas débiles entre las calificaciones subjetivas de disnea y el impulso respiratorio objetivo (P0.1) en pacientes con VM.
- El nivel de sedación puede influir en la relación entre la disnea percibida y el impulso respiratorio.
- Se necesita más investigación para comprender completamente esta compleja relación.
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