ABSTRACT
La CPAP (Presión Positiva Continua en Vía Aérea) es un método de ventilación no invasiva que proporciona una presión positiva continua en la vía aérea durante todo el ciclo respiratorio. Se aplica en pacientes con respiración espontánea. El sistema de CPAP Benveniste es un sistema de flujo variable en el que el nivel de presión se genera mediante cambios de flujo. Se necesita un flujo de 10-15 litros/min para conseguir una presión terapéutica. Este sistema es útil en prematuros y lactantes. La característica más relevante del sistema Benveniste es la adaptación y confort que proporciona por el hecho de ser un sistema de flujo variable, evitando así la necesidad de sedoanalgesia. Sus ventajas son la escasa complejidad tecnológica, la fácil fijación de la interfase, la escasez de fugas por boca, la buena tolerancia y que permite una buena manipulación y movilidad del niño. El buen manejo por parte de la enfermera de este sistema garantiza su éxito y para ello deben conocerse sus efectos fisiológicos así como su correcto funcionamiento (AU)
CPAP (Continuous Positive Airway Pressure) is a non-invasive ventilation method that provides continuous positive pressure in the airway during the entire respiratory cycle. It is applied in patients with spontaneous breathing. The Benviste CPAP system is a variable flow system in which the pressure level is generated by flow changes. A 10-15 litre/min flow is necessary to reach therapeutic pressure. This system is useful in premature and breastfeeding infants. The most relevant characteristic of the Benviste system is the adaptation and comfort that it provides by offering variable flow, thus avoiding the need for sedoanalgesia. Its advantages are its low technological complexity, the easy fastening of the interphase, the minimal leaks from the mouth, its good tolerance and that it enables good handling and mobility of the child. The nurses correct handling of this system ensures its success and to this end its physiological effects as well as its correct operation must be understood (AU)
Subject(s)
Humans , Infant, Newborn , Continuous Positive Airway Pressure/nursing , Noninvasive Ventilation/nursing , Asphyxia Neonatorum/therapy , Critical Illness/nursing , Intensive Care Units, Neonatal/organization & administrationABSTRACT
Children with ileostomy can develop short bowel syndrome (SBS), characterized by malabsorption of nutrients and consequent malnutrition. Continuous extracorporeal stool transport (CEST) consists of collecting and transporting the intestinal effluent drained from the proximal stoma to the portion of the distal intestine. Thus, intestinal flux can be maintained, while digestion and absorption approximate real physiology until defecation. We describe the case of a preterm newborn who suffered from necrotizing enterocolitis and who underwent resection of the small intestine and implantation of four stomas. CEST was applied, allowing early reduction of total enteral nutrition and its subsequent withdrawal. This in turn allowed the reduction of those complications associated to the continous use of this therapy (risk of infection and hepatobiliary alterations) and permited keeping the distal intestine in optimal conditions until reconstructive surgery could be performed. Our experience demonstrates that CEST is a safe and relatively simple technique with good results that allows restoration of intestinal homeostasis in neonates with SBS.
Subject(s)
Enterocolitis, Necrotizing/surgery , Ileostomy/methods , Infant, Premature, Diseases/surgery , Humans , Infant, Newborn , MaleABSTRACT
Los niños portadores de ileostomía pueden desarrollar el síndrome del intestino corto funcional (SICF), que se caracteriza por una malabsorción y la consecuente malnutrición. La técnica extracorpórea de recirculación enteral (TERE) consiste en recoger y transportar el efluente intestinal drenado desde el estoma proximal hasta la porción del intestino distal. Así se consigue mantener el tránsito intestinal con una digestión y absorción de mayor proximidad fisiológica, hasta llegar a la defecación. Se describe el caso de un neonato pretérmino intervenido quirúrgicamente de enterocolitis necrosante con resección de intestino delgado e implantación de 4 estomas. Se le aplicó la TERE, y se pudo reducir y retirar la nutrición parenteral precozmente, minimizando las complicaciones asociadas a su uso prolongado (el riesgo de infección y las alteraciones hepatobiliares) y manteniendo el intestino distal en condiciones óptimas hasta la cirugía reconstructiva. Nuestra experiencia demuestra que la TERE es una técnica poco compleja y con buenos resultados que permite restablecer una nutrición lo más fisiológica posible en neonatos con SICF
Children with ileostomy can develop short bowel syndrome (SBS), characterized by malabsorption of nutrients and consequent malnutrition. Continuous extracorporeal stool transport (CEST) consists of collecting and transporting the intestinal effluent drained from the proximal stoma to the portion of the distal intestine. Thus, intestinal flux can be maintained, while digestion and absorption approximate real physiology until defecation. We describe the case of a preterm newborn who suffered from necrotizing enterocolitis and who underwent resection of the small intestine and implantation of four stomas. CEST was applied, allowing early reduction of total enteral nutrition and its subsequent withdrawal. This in turn allowed the reduction of those complications associated to the continous use of this therapy (risk of infection and hepatobiliary alterations) and permited keeping the distal intestine in optimal conditions until reconstructive surgery could be performed. Our experience demonstrates that CEST is a safe and relatively simple technique with good results that allows restoration of intestinal homeostasis in neonates with SBS
