RESUMEN
Available evidence strongly suggests that early weaning and extubation are desirable, but our ability to predict the point at which can be accomplished safely in extremely preterm remains limited.Extubation failure remains frequent and may carry significant short and long-term consequences.Improved tools for predicting successful extubation in this population are currently being explored with the hope of reducing extubation failure and the attendant risks of reintubation.This review summarized and analyzed the related problems in the peri-extubation period of extremely preterm, in order to provide reference for successful extubation and weaning of ventilatory as soon as possible.
RESUMEN
Mechanical ventilation plays a central role In the critical care setting; but its use is closely related with some life threatening complications as nosocomial pneumonia and low cardiac performance. One of the most severe complications is called ventilator-associated lung injury (VALI) and it includes: Barotrauma, volutrauma, atelectrauma, biotrauma and oxygen-mediated toxic effects and it is related with an inflammatory response secondary to the stretching and recruitment process of alveoli within mechanical ventilation. The use of some protective ventilatory strategies has lowered the mortality rate 10% approximately.
La importancia de la asistencia mecánica ventilatoria (AMV) en la Unidad de Cuidados Intensivos (UCI) es indiscutible; sin embargo, su uso está ligado con complicaciones como neumonía nosocomial y deterioro del rendimiento cardiaco, que en algunas ocasiones ponen en peligro la vida del enfermo. Una de las complicaciones más graves es el daño pulmonar asociado a la ventilación mecánica (DPVM). El DPVM se caracteriza por la presencia de edema pulmonar rico en proteínas. Se recomienda establecer cierto número de estrategias de protección pulmonar (EPP) para prevenir este tipo de lesión. Una vez instituidas, las EPP han demostrado una disminución de la mortalidad de aproximadamente 10%.