Relación entre traqueostomización y supervivencia en pacientes sometidos a ventilación mecánica con sintomatología respiratoria sugestiva de COVID-19 en Cartagena, Colombia

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dc.contributor.authorGómez Cardona, Efraín Antonio
dc.contributor.authorDíaz Hernández, Daniela
dc.contributor.authorBorré Naranjo, Diana Patricia
dc.contributor.authorDueñas Castell, Carmelo
dc.contributor.authorLozada Martínez, Iván David
dc.contributor.authorPicón Jaimes, Yelson Alejandro
dc.contributor.authorMuñoz Murillo, Katherine Lizeth
dc.date.accessioned2024-08-08T14:36:59Z
dc.date.available2024-08-08T14:36:59Z
dc.date.issued2022-02-28
dc.description.abstractLa COVID-19 ha sido una de las enfermedades que ha generado mayor carga de enfermedad en el siglo XXI. A la fecha, se estiman más de 280 millones de casos a nivel global. Aún se desconocen muchos aspectos de esta condición, lo que ocasiona controversias sobre el abordaje de pacientes críticamente enfermos. La traqueostomía es una intervención que ha demostrado ser beneficiosa en el manejo de enfermedades respiratorias, sin embargo, existe un vacío en la evidencia sobre la efectividad y seguridad de esta intervención en pacientes críticamente enfermos de COVID-19. Por lo anterior, el objetivo de este estudio consistió en relacionar el tiempo transcurrido desde el inicio del cuadro clínico, durante la intubación y los días de ventilación mecánica, hasta la realización de la traqueostomía, con la supervivencia de pacientes con síntomas sugestivos de COVID-19. Metodología. Estudio retrospectivo de corte transversal, realizado entre marzo del año 2020 y febrero del año 2021 en dos centros hospitalarios de cuarto nivel de la ciudad de Cartagena, Colombia. Incluyó pacientes mayores de 18 años que ingresaron a la unidad de cuidados intensivos por requerimiento de ventilación mecánica invasiva por sintomatología respiratoria viral. Se excluyeron aquellos con historias clínicas incompletas e internados por otras causas respiratorias. Resultados. Un total de 122 pacientes fueron incluidos en el estudio con una mediana de edad de 63 años (RIQ 22; 20-89), siendo el 66.4% (n=81) hombres. No se encontró una correlación significativa entre el número de días desde el inicio del cuadro clínico hasta realización de la traqueostomía (p=0.12), ni entre el tiempo transcurrido desde la intubación endotraqueal hasta la realización de la traqueostomía, con respecto a la supervivencia (p=0.53). Pero sí entre el número de días de ventilación mecánica invasiva y el desenlace final (p=0.02). Discusión. Aunque se ha reportado que la traqueostomía es uno de los procedimientos que acarrea mayores riesgos en el manejo del paciente con sintomatología respiratoria severa, durante la pandemia por COVID-19 la literatura describe que esta intervención aumenta la supervivencia, disminuye el tiempo de requerimiento de ventilación mecánica y reduce la estancia en unidad de cuidados intensivos. El número de complicaciones es muy bajo en comparación al beneficio que otorga y se observó que el comportamiento local es muy similar al reportado en la literatura. Conclusiones. El tiempo desde el inicio de los síntomas o de la intubación endotraqueal hasta la realización de traqueostomía no se correlaciona con la supervivencia de pacientes con sintomatología respiratoria sugestiva de COVID-19 que se encuentran bajo ventilación mecánica y traqueostomizados.spa
dc.description.abstractenglishCOVID-19 has generated one of the highest disease burdens in the 21st century. To date, there are more than 280 million estimated cases globally. Many aspects of this condition are still unknown, which causes controversy in how to approach critically ill patients. Tracheostomy is an intervention that has been shown to be beneficial in the management of respiratory disease, however, there is an evidence gap on the effectiveness and safety of this intervention in critically ill COVID-19 patients. Consequently, the aim of this study was to relate the time elapsed from the onset of the clinical condition, during intubation and days of mechanical ventilation, to performing the tracheostomy, with the survival of patients with symptoms suggestive of COVID-19. Methodology. Retrospective cross-sectional study, conducted between March 2020 and February 2021 in two fourth-level hospitals in the city of Cartagena, Colombia. It included patients older than 18 years who were admitted to the intensive care unit due to the need for invasive mechanical ventilation for viral respiratory symptoms. Those with incomplete medical records and hospitalized for other respiratory causes were excluded. Results. A total of 122 patients were included in the study with a median age of 63 years (IQR 22; 20-89), with 66.4% (n = 81) being male. No significant correlation was found between the number of days from the onset of the clinical condition to the performance of tracheostomy (p = 0.12), nor between the time elapsed from endotracheal intubation to the performance of tracheostomy, with respect to survival (p = 0.53). However, there was a relationship between the number of days of invasive mechanical ventilation and the final outcome (p = 0.02). Discussion. Although it has been reported that tracheostomy is one of the riskiest procedures in the management of patients with severe respiratory symptoms, during the COVID-19 pandemic the literature describes that this intervention increases survival, decreases the time required for mechanical ventilation and reduces the length of stay in the intensive care unit. The number of complications is very low in comparison to the benefit it confers, and it was observed that the local behavior is very similar to that reported in the literature. Conclusions. Time from symptom onset or endotracheal intubation to the performance of tracheostomy does not correlate with survival in patients with respiratory symptomatology suggestive of COVID-19 who are mechanically ventilated and tracheostomized.eng
dc.description.abstractotherA COVID-19 tem sido uma das doenças que gerou a maior carga de doenças no século XXI. Até o momento, mais de 280 milhões de casos são estimados globalmente. Muitos aspectos dessa condição ainda são desconhecidos, o que gera controvérsias sobre a abordagem de pacientes gravemente doentes. A traqueostomia é uma intervenção que tem se mostrado benéfica no manejo de doenças respiratórias, porém, há uma lacuna nas evidências sobre a eficácia e segurança dessa intervenção em pacientes críticos com COVID-19. Portanto, o objetivo deste estudo foi relacionar o tempo decorrido desde o início do quadro clínico, durante a intubação e os dias de ventilação mecânica, até a realização da traqueostomia, com a sobrevivência de pacientes com sintomas sugestivos de COVID-19. Metodologia. Estudo transversal retrospectivo, realizado entre março de 2020 e fevereiro de 2021 em dois hospitais de quarto nível na cidade de Cartagena, Colômbia. Foram incluídos pacientes maiores de 18 anos que foram admitidos na unidade de terapia intensiva por necessidade de ventilação mecânica invasiva devido a sintomas respiratórios virais. Foram excluídos aqueles com historial clínico incompleto e internados por outras causas respiratórias. Resultados. Um total de 122 pacientes foram incluídos no estudo com idade média de 63 anos (IQR 22; 20-89), sendo 66.4% (n=81) homens. Não foi encontrada correlação significativa entre o número de dias desde o início do quadro clínico até a traqueostomia (p=0.12), ou entre o tempo decorrido da intubação endotraqueal até a traqueostomia, com relação à sobrevivência (p=0.53). Mas sim entre o número de dias de ventilação mecânica invasiva e o desfecho final (p=0.02). Discussão. Embora tenha sido relatado que a traqueostomia é um dos procedimentos de maior risco no manejo de pacientes com sintomas respiratórios graves, durante a pandemia de COVID-19 a literatura descreve que essa intervenção aumenta a sobrevivência, diminui o tempo necessário para a ventilação mecânica e reduz a permanência na unidade de terapia intensiva. O número de complicações é muito baixo em relação ao benefício que proporciona e observou-se que o comportamento local é muito semelhante ao relatado na literatura. Conclusões. O tempo desde o início dos sintomas ou intubação endotraqueal até a realização de uma traqueostomia não se correlaciona com a sobrevivência de pacientes com sintomas respiratórios sugestivos de COVID-19 que estão sob ventilação mecânica e traqueostomizados.por
dc.format.mimetypeapplication/pdfspa
dc.identifier.doihttps://doi.org/10.29375/01237047.4227
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga UNABspa
dc.identifier.issni-ISSN 0123-7047spa
dc.identifier.issne-ISSN 2382-4603spa
dc.identifier.reponamereponame:Repositorio Institucional UNABspa
dc.identifier.repourlrepourl:https://repository.unab.edu.cospa
dc.identifier.urihttp://hdl.handle.net/20.500.12749/25942
dc.language.isospaspa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.relationhttps://revistas.unab.edu.co/index.php/medunab/article/view/4227/3583spa
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dc.relation.urihttps://revistas.unab.edu.co/index.php/medunab/issue/view/281spa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*
dc.rights.localAbierto (Texto Completo)spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.sourceVol. 25 Núm. 1 (2022): abril - julio 2022: Enfermedades Respiratorias, Telemedicina, Uso de Tabaco; 9-19spa
dc.subjectTraqueostomíaspa
dc.subjectRespiración Artificialspa
dc.subjectInfecciones por Coronavirusspa
dc.subjectEnfermedades Respiratoriasspa
dc.subjectColombiaspa
dc.subjectCOVID-19spa
dc.subject.keywordsMedical scienceseng
dc.subject.keywordsLife scienceseng
dc.subject.keywordsTracheostomyeng
dc.subject.keywordsRespiration Artificialeng
dc.subject.keywordsCoronavirus Infectionseng
dc.subject.keywordsRespiratory Tract Diseaseseng
dc.subject.keywordsColombiaeng
dc.subject.keywordsCOVID-19eng
dc.subject.keywordsHealth scienceseng
dc.subject.keywordsCiências médicaspor
dc.subject.keywordsCiências da vidapor
dc.subject.keywordsCiências da saúdepor
dc.subject.keywordsTraqueostomiapor
dc.subject.keywordsRespiração Artificialpor
dc.subject.keywordsInfecções por Coronaviruspor
dc.subject.keywordsDoenças Respiratóriaspor
dc.subject.keywordsColômbiapor
dc.subject.keywordsCOVID-19por
dc.subject.lembCiencias médicasspa
dc.subject.lembCiencias de la vidaspa
dc.subject.lembCiencias de la saludspa
dc.titleRelación entre traqueostomización y supervivencia en pacientes sometidos a ventilación mecánica con sintomatología respiratoria sugestiva de COVID-19 en Cartagena, Colombiaspa
dc.title.translatedRelationship Between Tracheostomization and Survival in Mechanically Ventilated Patients with Respiratory Symptoms Suggestive of COVID-19 in Cartagena, Colombiaeng
dc.title.translatedRelação entre traqueostomização e sobrevivência em pacientes submetidos à ventilação mecânica com sintomas respiratórios sugestivos de COVID-19 em Cartagena, Colômbiapor
dc.typeArticleeng
dc.type.coarhttp://purl.org/coar/resource_type/c_2df8fbb1
dc.type.coarversionhttp://purl.org/coar/version/c_ab4af688f83e57aaspa
dc.type.driverinfo:eu-repo/semantics/article
dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.type.localArtículospa
dc.type.redcolhttp://purl.org/redcol/resource_type/ART

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