Cornejo Rodrigo, Romero Carlos, Goñi Daniela, Luengas Rafael, Llanos Osvaldo, Gálvez Ricardo, Castro José
Unidad de Pacientes Críticos, Hospital Clínico, Universidad de Chile, Santiago de Chile.
Rev Med Chil. 2009 Oct;137(10):1351-6.
Management of patients with severe respiratory failure is mainly supportive, and protective mechanical ventilation is the pivotal treatment. When conventional therapy is insufficient to improve oxygenation without deleterious effects, other strategies should be considered. We report a 53 year-old male who presented a severe respiratory failure refractory to conventional management after pneumonectomy. Prone position ventilation was used for 36 hours. Respiratory variables improved and he did not show hemodynamic instability. He was returned to the supine position without worsening of oxygenation parameters. Extended prone position ventilation could be considered in patients presenting with unresponsive severe respiratory failure after pulmonary resection.
重度呼吸衰竭患者的管理主要是支持性的,保护性机械通气是关键治疗方法。当常规治疗不足以改善氧合且无有害影响时,应考虑其他策略。我们报告一名53岁男性,肺切除术后出现对常规治疗难治的重度呼吸衰竭。采用俯卧位通气36小时。呼吸变量改善,且未出现血流动力学不稳定。他恢复到仰卧位时氧合参数未恶化。对于肺切除术后出现难治性重度呼吸衰竭的患者,可考虑延长俯卧位通气。