¿Disminuyen las complicaciones respiratorias postoperatorias en pacientes con enfermedad pulmonar obstructiva crónica con el uso de ventilación controlada por presión en anestesia?
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Antecedentes: La ventilación mecánica en una de las principales medidas terapéuticas en anestesiología por lo que se requiere mejorar su conocimiento buscando nuevos modos ventilatorios que permitan tener mejores desenlaces en los pacientes que requieren soporte ventilatorio invasivo durante cirugías realizadas bajo anestesia general. El uso de la ventilación controlada por presión trae ventajas fisiológicas para los pacientes que requieren soporte con ventilación mecánica invasiva, el objetivo de este trabajo es establecer si el uso de este modo ventilatorio se traduce en desenlaces clínicamente importantes para recomendarlo sobre el uso de la ventilación controlada por volumen Métodos: revisión sistemática de la literatura. Se consultó el periodo entre enero de 1980 a enero de 2013 en las bases de datos MEDLINE , EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) los términos: “COPD AND pressure ventilation AND anesthesia AND postoperative pulmonary complications”,”pressure controlled ventilation AND COPD AND (surgery or anesthesia)”,” pressure controlled ventilation AND (surgery or anesthesia)”,”COPD AND (surgery OR anesthesia)”, COPD AND pulmonary complications AND ventilation” y “volume controlled ventilation AND pressure controlled ventilation AND (anesthesia OR surgery)”. Los criterios de selección considerados fueron: estudios controlados aleatorios realizados en pacientes con diagnóstico de enfermedad pulmonar obstructiva crónica llevados a cirugía bajo anestesia general que compararan ventilación controlada por presión contra ventilación controlada por volumen. Se planeó evaluar como desenlaces complicaciones respiratorias postquirúrgicas. Resultados: No se encontró ningún artículo que comparara la ventilación controlada por presión y la ventilación controlada por volumen en pacientes con enfermedad pulmonar obstructiva crónica sometidos a anestesia general. Conclusión: No se cuenta con evidencia que recomiende el uso de la ventilación controlada por presión por encima de la ventilación controlada por volumen en anestesia para pacientes con enfermedad pulmonar obstructiva crónica.
Abstract. Background: Mechanical ventilation in a major therapeutic measures in anesthesiology by what is required to improve their knowledge seeking new ventilation modes that yield better outcomes in patients requiring invasive ventilatory support during surgeries performed under general anesthesia. The use of pressure controlled ventilation brings physiological advantages for patients requiring mechanical ventilation support with, the aim of this study is to establish if the use of this ventilatory mode result in clinically relevant endpoints Methods: A systematic review of the literature. We consulted the period from January 1980 to January 2013 in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), the terms "COPD and Pressure Ventilation and Anesthesia and postoperative pulmonary complications", "pressure controlled ventilation AND COPD AND (surgery or anesthesia) "," pressure controlled ventilation AND (surgery or anesthesia) "," COPD AND (OR anesthesia surgery) "AND Pulmonary Complications COPD and Ventilation" and "volume controlled ventilation controlled ventilation pressure AND AND ( OR anesthesia surgery)". The selection criteria were randomized controlled studies conducted in patients with chronic obstructive pulmonary disease undergo surgery under general anesthesia comparing pressure-controlled ventilation against volume-controlled ventilation. We planned to evaluate like outcomes the postoperative respiratory complications. Results: We found no article that compared the pressure-controlled ventilation and volume-controlled ventilation in patients with chronic obstructive pulmonary disease undergoing general anesthesia. Conclusión: No evidence has recommended the use of pressure-controlled ventilation over volume-controlled ventilation in anesthesia for patients with chronic obstructive pulmonary disease.
Abstract. Background: Mechanical ventilation in a major therapeutic measures in anesthesiology by what is required to improve their knowledge seeking new ventilation modes that yield better outcomes in patients requiring invasive ventilatory support during surgeries performed under general anesthesia. The use of pressure controlled ventilation brings physiological advantages for patients requiring mechanical ventilation support with, the aim of this study is to establish if the use of this ventilatory mode result in clinically relevant endpoints Methods: A systematic review of the literature. We consulted the period from January 1980 to January 2013 in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), the terms "COPD and Pressure Ventilation and Anesthesia and postoperative pulmonary complications", "pressure controlled ventilation AND COPD AND (surgery or anesthesia) "," pressure controlled ventilation AND (surgery or anesthesia) "," COPD AND (OR anesthesia surgery) "AND Pulmonary Complications COPD and Ventilation" and "volume controlled ventilation controlled ventilation pressure AND AND ( OR anesthesia surgery)". The selection criteria were randomized controlled studies conducted in patients with chronic obstructive pulmonary disease undergo surgery under general anesthesia comparing pressure-controlled ventilation against volume-controlled ventilation. We planned to evaluate like outcomes the postoperative respiratory complications. Results: We found no article that compared the pressure-controlled ventilation and volume-controlled ventilation in patients with chronic obstructive pulmonary disease undergoing general anesthesia. Conclusión: No evidence has recommended the use of pressure-controlled ventilation over volume-controlled ventilation in anesthesia for patients with chronic obstructive pulmonary disease.