RESUMO
Objetivo: Analizar las complicaciones pulmonares de los recién nacidos que requirieron asistencia respiratoria mecánica (ARM) durante su internación en la Unidad de Cuidados Intensivos Neonatales (UCIN) en el Instituto de Previsión Social, Hospital Central (IPS-HC). Material y Método: Estudio descriptivo, retrospectivo, transversal, en la UCIN del HC- IPS, de Julio 2008 a Junio de 2009, con datos obtenidos de los Registros estadísticos de nacimientos de la Sala de RN y las Historias Clínicas de la Unidad de Terapia Intensiva Neonatal. Resultados: Ingresaron 156 prematuros, que representa el 3.46% del total de RN y 37 RN de termino que representa 0.82%. De estas cifras 135(86,5%) RN de pre termino y 33(89.1%) RN de término requirieron ARM. De los 193 RN ingresados en UCIN que corresponde al 4,2% del total de RN, 168(87%) pacientes recibieron procedimiento invasivo de ARM. De estos 73(43%) presentaron complicaciones pulmonares; el 22% correspondían a edades entre 25-28 semanas, 22% eran de 28,5-31 semanas, 21% fueron de 31,5-34 semanas, 21% de 34,5-36.5 semanas, 14% de 37,5-40 semanas. El sexo masculino predomino en un 67%. Se encontró que el 50% fueron RN con peso entre 1000-2000 gr, que junto con los de 2001 a 3000 gr fueron los que con mayor frecuencia presentaron complicaciones respiratorias, de ellos 76,3% fueron RN de pre término y 5,7% de termino en ambos grupos. Las complicaciones pulmonares fueron: neumotórax en un 26/73, atelectasia 26/73, neumonía asociada a respirador 33/73, displasia broncopulmonar 7/73, enfisema intersticial 7/73, hemorragia pulmonar 5/73, derrame pleural 3/73. La estancia hospitalaria fue en promedio de 11-20 días. Del total de RN que requirieron ventilación mecánica y presentaron complicaciones pulmonares se encontró que 75,3% de los RN egresaron vivos y 24,6% egresaron fallecidos. Las causales de muerte se presentaron en el siguiente orden: neumotórax, neumonía asociada a respirador y atelectasia...
Introduction: Mechanical ventilation is an invasive procedure with known risks that must be anticipated and when possible identified early in order to implement immediate treatment. Respiratory complications represent one of those risks. Objective: To analyze pulmonary complications in newborns (NB) that required mechanical ventilation (MAV) during hospitalization in the Neonatal Intensive Care Unit (NICU) at the central hospital of the Instituto de Previsión Social (IPS-HC).Method: A descriptive, retrospective, cross sectional study in the NICU of the HC-IPS from July 2008 to June 2009, with data obtained from delivery room statistical records and those of the Neonatal Intensive Care Unit. Results: 4500 births were recorded. Of the NB, 156 (3.46%) premature and 37 (0.82%) at-term infants were admitted. Of those admitted, 135 (86.5%) pre-term and 33 (89.1%) at-term NB required MAV. Of the 193 NB admitted to the NICU (4.2% of all newborns), 168 (87%) received invasive MAV procedures, with 73 (43%) of those showing pulmonary complications; 22% were aged 25 to 28 weeks, 22% were 28.5 to 31 weeks, 21% were 31.5 to 34 weeks, 21% were 34.5-36.5 weeks, and 14% were from 37.5 to 40 weeks of age. Males predominated, making up 67%.It was found that 50% of NB weighed between 1000g and 2000g, and these, together with those of 2001g-3000g, were those most commonly presenting respiratory complications. Of those, 76.3% were pre-term newborns and 5.7% at term in both groups. Pulmonary complications found were pneumothorax (26/73), atelectasis (26/73), ventilator-associated pneumonia (33/73), bronchopulmonary dysplasia (7/73) interstitial emphysema (7/73), pulmonary hemorrhage (5/73), and pleural effusion, (3/73).Average hospital stay was 11-20 days. Of the NB who required mechanical ventilation and in whom pulmonary complications were found, 75.3% were discharged alive and 24.6% died...