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Configuración del ventilador para broncoscopia con fibra óptica durante la ventilación mecánica: un ensayo controlado
Malcolm Lemyze1, Dominic C Marshall2, Maxime Granier3
1Department of Critical Care Medicine, Arras Hospital, Boulevard Besnier, 62000, Arras, France. malcolmlemyze@yahoo.fr.
Critical care (London, England)
|January 28, 2026
Resumen
La configuración optimizada del ventilador reduce significativamente los eventos adversos durante la broncoscopia flexible con fibra óptica. Esta estrategia previene la insuficiencia ventilatoria y garantiza un soporte adecuado en pacientes con ventilación mecánica.
Área de la Ciencia:
- Medicina de Cuidados Críticos; Terapia Respiratoria; Neumología
Sus antecedentes:
- La broncoscopia en pacientes con ventilación mecánica aumenta la resistencia de las vías respiratorias, la presión máxima de las vías respiratorias y reduce el volumen tidal.; La configuración actual del ventilador puede provocar eventos adversos graves durante la broncoscopia flexible con fibra óptica.
Objetivo del estudio:
- Determinar si la configuración específica del ventilador (controlada por volumen asistido con flujo inspiratorio y volumen tidal reducidos) disminuye los eventos adversos graves durante la broncoscopia flexible con fibra óptica en comparación con la configuración convencional.
Principales métodos:
- Ensayo controlado aleatorizado y ciego para el adjudicador en un solo centro en pacientes adultos intubados.; Los pacientes recibieron ajustes optimizados para broncoscopia o ajustes convencionales del ventilador.; El objetivo principal fue un compuesto de eventos adversos graves que requerían terminación prematura.
Principales resultados:
- Los ajustes optimizados resultaron en un 4% de eventos adversos graves frente al 96% con los ajustes convencionales (p < 0,001).; Los ajustes convencionales provocaron insuficiencia ventilatoria debido a la limitación de la alarma de presión.; Los ajustes optimizados redujeron la presión máxima de las vías respiratorias y restauraron una ventilación adecuada.
Conclusiones:
- Una estrategia de ventilación optimizada para broncoscopia reduce sustancialmente los eventos de ventilación limitada por alarma de presión.; Esta estrategia permite un soporte ventilatorio adecuado durante la broncoscopia flexible con fibra óptica.
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