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Presión de sellado del tubo endotraqueal y síntomas laringotraqueales postoperatorios, estudio de cohorte prospectiva
dc.contributor.advisor | Meléndez Flórez, Héctor Julio | spa |
dc.contributor.advisor | Ardila Gutiérrez, Carlos Eduardo | spa |
dc.contributor.author | Soler Galvis, Silvia Marcela | spa |
dc.date.accessioned | 2020-06-26T19:47:57Z | |
dc.date.available | 2020-06-26T19:47:57Z | |
dc.date.issued | 2017 | |
dc.identifier.uri | http://hdl.handle.net/20.500.12749/1628 | |
dc.description.abstract | La intubación orotraqueal es uno de los más frecuentes e importantes procedimientos para mantener la anestesia general y la ventilación mecánica; lo cual incluye el sellado del tubo endotraqueal posterior a la intubación; cuyo propósito es proteger la vía aérea, evitar fugas de aire, asegurando así el efecto de la ventilación y la reducción de la fuga de los anestésicos inhalados; sin embargo, este procedimiento no se encuentra exento de complicaciones; las cuales han sido asociadas con elevadas presiones de sellado del tubo endotraqueal. El objetivo principal de este trabajo fue determinar si la presión de sellado mayor a los valores recomendados es factor de riesgo para presencia de síntomas laringotraqueales post operatorios; adicionalmente describir posibles factores asociados. Se recolectaron 234 pacientes, los cuales fueron objeto de análisis. Se realizó un análisis bivariado para determinar la asociación de síntomas laringotraqueales con las diferentes presiones de sellado del tubo, encontrándose que todos los síntomas evaluados tuvieron una relación estadísticamente significativa con la presión de sellado por arriba de 30 Cms de H2O en el POP temprano; a las 24 horas todos los síntomas evaluados excepto la disfagia presentaron una asociación significativa con la presión de sellado por encima de 30 cm de H2O. Se realizó un análisis multivariado en donde se pudo documentar que la presencia de presiones por arriba de 30 cm de H2O se relacionó con una riesgo de 14,8 a 16,3 veces de presentar síntomas en el post operatorio temprano y a las 24 horas respectivamente, después de ajustar por variables como género, edad y antecedentes. En conclusión se determinó que las presiones elevadas de sellado del tubo endotraqueal se asocian con una mayor incidencia y riesgo de presentar síntomas en el post operatorio temprano y a las 24 horas. | spa |
dc.description.tableofcontents | RESUMEN ............................................................................................................... 8 1. DESCRIPCIÓN DEL PROYECTO .................................................................. 10 1.1 PLANTEAMIENTO DEL PROBLEMA ......................................................................... 10 1.2 PREGUNTA DE INVESTIGACIÓN ........................................................................... 111 1.3 HIPÓTESIS INVESTIGATIVA ................................................................................... 11 1.4 JUSTIFICACIÓN .................................................................................................... 11 2. MARCO TEÓRICO Y ESTADO DEL ARTE .................................................... 13 2.1 ANATOMÍA Y FISIOLOGÍA DE LA VIA AEREA ............................................................ 13 2.2 FISIOLOGÍA Y MECANISMOS DE LESIÓN TRAQUEAL ................................................ 15 2.3 TUBO ENDOTRAQUEAL CON MANGUITO ............................................................... 17 2.4 MÉTODOS DE MEDICIÓN DE LA PRESIÓN DE SELLADO DE TUBO ENDOTRAQUEAL ... 18 2.5 EPIDEMIOLOGÍA .................................................................................................. 19 2.6 SÍNTOMAS LARINGOTRAQUEALES POSTOPERATORIOS ........................................... 20 2.7 COMPLICACIONES ASOCIADAS A PRESION DE SELLADO DE TUBO ENDOTRAQUEAL 221 3. OBJETIVOS ....................................................................................................... 24 3.1 OBJETIVO GENERAL ............................................................................................. 24 3.2 OBJETIVOS ESPECÍFICOS ....................................................................................... 24 4. MATERIALES Y MÉTODOS .............................................................................. 25 5 4.1 TIPO DE ESTUDIO ................................................................................................ 25 4.2 POBLACIÓN A DE REFERENCIA Y MUESTRA ......................................................... 25 4.2.1 Población blanco .............................................................................................. 25 4.2.2 Población a estudio .......................................................................................... 25 4.3 CRITERIOS DE ELEGIBILIDAD .............................................................................. 25 4.3.1 Criterios de inclusión ........................................................................................ 25 4.3.2 Criterios de exclusión ........................................................................................ 26 4.4 MUESTREO ...................................................................................................... 26 4.4.1 Calculo de la muestra ........................................................................................ 26 4.4.2 Muestreo......................................................................................................... 26 4.5 OPERACIONALIZACION DE VARIABLES ................................................................ 26 4.5.1 Variable Resultado ........................................................................................... 26 4.5.2 Variable explicatoria presión de sellado .............................................................. 27 4.6 PROCESO DE RECOLECCIÓN DE LA INFORMACIÓN ................................................. 28 4.7 FLUJOGRAMA ..................................................................................................... 29 5. CONSIDERACIONES ÉTICAS .......................................................................... 30 6. ANÁLISIS ESTADÍSTICO .................................................................................. 32 7. RESULTADOS ................................................................................................... 33 8. DISCUSIÓN ....................................................................................................... 47 9. CONCLUSIONES .............................................................................................. 50 10. IMPACTO ESPERADO .................................................................................... 51 11. PRESUPUESTO .............................................................................................. 52 12. CRONOGRAMA .............................................................................................. 53 13. ANEXOS .......................................................................................................... 54 BIBLIOGRAFÍA ...................................................................................................... 66 | spa |
dc.format.mimetype | application/pdf | spa |
dc.language.iso | spa | spa |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/2.5/co/ | * |
dc.title | Presión de sellado del tubo endotraqueal y síntomas laringotraqueales postoperatorios, estudio de cohorte prospectiva | spa |
dc.title.translated | Endotracheal tube sealing pressure and postoperative laryngotracheal symptoms, prospective cohort study | eng |
dc.degree.name | Especialista en Anestesiología | spa |
dc.coverage | Floridablanca (Santander, Colombia) | spa |
dc.publisher.grantor | Universidad Autónoma de Bucaramanga UNAB | spa |
dc.rights.local | Abierto (Texto Completo) | spa |
dc.publisher.faculty | Facultad Ciencias de la Salud | spa |
dc.publisher.program | Especialización en Anestesiología | spa |
dc.description.degreelevel | Especialización | spa |
dc.type.driver | info:eu-repo/semantics/masterThesis | |
dc.type.local | Tesis | spa |
dc.type.coar | http://purl.org/coar/resource_type/c_bdcc | |
dc.subject.keywords | Endotracheal intubation | eng |
dc.subject.keywords | Endotracheal anesthesia | eng |
dc.subject.keywords | Medicine | eng |
dc.subject.keywords | Anesthesiology | eng |
dc.subject.keywords | Investigations | eng |
dc.subject.keywords | Analysis | eng |
dc.subject.keywords | Ventilation | eng |
dc.subject.keywords | Tracheal injuries | eng |
dc.subject.keywords | Air cap pressure | eng |
dc.identifier.instname | instname:Universidad Autónoma de Bucaramanga - UNAB | spa |
dc.identifier.reponame | reponame:Repositorio Institucional UNAB | spa |
dc.type.hasversion | info:eu-repo/semantics/acceptedVersion | |
dc.rights.accessrights | info:eu-repo/semantics/openAccess | spa |
dc.rights.accessrights | http://purl.org/coar/access_right/c_abf2 | spa |
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dc.contributor.cvlac | https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000320609 | * |
dc.contributor.cvlac | https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001624848 | * |
dc.subject.lemb | Intubación endotraqueal | spa |
dc.subject.lemb | Anestesia endotraqueal | spa |
dc.subject.lemb | Medicina | spa |
dc.subject.lemb | Anestesiología | spa |
dc.subject.lemb | Investigaciones | spa |
dc.subject.lemb | Análisis | spa |
dc.description.abstractenglish | Orotracheal intubation is one of the most frequent and important procedures to maintain general anesthesia and mechanical ventilation; which includes sealing the endotracheal tube after intubation; whose purpose is to protect the airway, prevent air leaks, thus ensuring the effect of ventilation and reducing the leakage of inhaled anesthetics; However, this procedure is not without complications; which have been associated with high sealing pressures of the endotracheal tube. The main objective of this work was to determine if sealing pressure greater than the recommended values is a risk factor for the presence of postoperative laryngotracheal symptoms; additionally describe possible associated factors. 234 patients were collected, which were analyzed. A bivariate analysis was carried out to determine the association of laryngotracheal symptoms with the different sealing pressures of the tube, finding that all the evaluated symptoms had a statistically significant relationship with the sealing pressure above 30 cm of H2O in early POP; At 24 hours, all the symptoms evaluated except dysphagia showed a significant association with the sealing pressure above 30 cm H2O. A multivariate analysis was carried out in which it was possible to document that the presence of pressures above 30 cm of H2O was related to a risk of 14.8 to 16.3 times of presenting symptoms in the early postoperative period and at 24 hours respectively. after adjusting for variables such as gender, age, and background. In conclusion, it was determined that high sealing pressures of the endotracheal tube are associated with a higher incidence and risk of presenting symptoms in the early postoperative period and at 24 hours. | eng |
dc.subject.proposal | Ventilación | |
dc.subject.proposal | Lesiones traqueales | |
dc.subject.proposal | Presión del neumotaponador | |
dc.type.redcol | http://purl.org/redcol/resource_type/TM | spa |
dc.rights.creativecommons | Atribución-NoComercial-SinDerivadas 2.5 Colombia | * |
dc.coverage.campus | UNAB Campus Bucaramanga | spa |
dc.description.learningmodality | Modalidad Presencial | spa |