Validez diagnóstica de un protocolo de destete de ventilación mecánica
DOI:
https://doi.org/10.20453/rmh.v37i2.6830Palavras-chave:
destete, extubación traqueal, ventilación mecánica, unidad de cuidados intensivosResumo
Objetivo: Determinar la validez diagnóstica de un protocolo para predecir el destete exitoso de ventilación mecánica (VM). Material y métodos: Estudio observacional de validación de instrumento realizado en una cohorte de 92 pacientes con VM por más de 24 horas. El protocolo comprendió 15 criterios: resolución de la causa de ingreso a VM, presión positiva teleespiratoria (PEEP) £ 8 cm de agua, PaO2/FiO2 ≥150 mm Hg, FiO2 £ 40 %, estabilidad hemodinámica, potasio y fósforo sérico normal, prueba de respiración espontánea exitosa, prueba de fuga de cuff negativa, nivel de conciencia, tos y deglución adecuados, escasas secreciones traqueales y uso de ventilación no invasiva o cánula nasal de alto flujo postextubación. Resultados: La sensibilidad del protocolo fue de 10,8 %, especificidad de 100 %, valor predictivo positivo de 100 %, valor predictivo negativo de 10,8 % y área bajo la curva ROC de 0,86. Conclusión: El protocolo mostró baja sensibilidad y alta especificidad para predecir el destete exitoso, por lo que fue más útil para confirmar el éxito del destete que para identificar a todos los pacientes potencialmente aptos.
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Copyright (c) 2026 Diana Fernandez Merjildo, Willy Porras García
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