CURSO-TALLER
 VENTILACIÓN MECÁNICA
PARA AREAS CRÍTICAS

Lectura de apoyo previo al curso

 

 
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Índice Pag.

Bienvenido al curso taller AVENTHO #

Indicaciones para iniciar la ventilación mecánica $

Programación en ventilación mecánica %

Monitoreo durante la ventilación mecánica invasiva "&

Referencias y literatura recomendada $'

 VENTILACIÓN MECÁNICA AVENTHO "

 

 
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BIENVENIDOS AL CURSO TALLER

 VENTILACIÓN MECÁNICA
MECÁNICA AVENTHO
)* "#$%&'()&*$ +#),$&)(  +, -. /.0+.01 2+ ,/3-4*5/6. 2+ 4*
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2+ */>+ @+, 2+5/>: 1AB9+.1: ./0>69+.1 C 10>1, 9*,+,D C ,+
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E*5/* 41, *47=141,: -.* ,+F*4 2+ 0+>3/.*5/6. 8/.*43+.0+ E*5+
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8/.*43+.0+ +4 */>+ 2+ 41, *47=141, <*,* 2+ 3*.+>* <*,/7* 2+
>+9>+,1 * 4*, 7B*, >+,</>*01>/*, <>/.5/<*4+,G

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*50-*4/?*2*G

(  VENTILACIÓN MECÁNICA AVENTHO

 

 
#

INDICACIONES PARA INICIAR LA

 VENTILACIÓN MECÁNICA
MECÁNICA
)* 7+.0/4*5/6. 3+5J./5* <-+2+ ,-,0/0-/> 010*4 1
<*>5/*43+.0+ 4* >+,</>*5/6. +,<1.0J.+*G K,0J /.2/5*2*
<*>* 4* 1A/9+.*5/6. /.,-8/5/+.0+: /.,-8/5/+.0+
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,/0-*5/1.+, 54B./5*, ;-+ /.2/5*. 4* .+5+,/2*2 2+
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4*, ,/9-/+.0+,M

Insuficiencia respiratoria
-&./ 01 2&./34+&)(
! N>+,/6. *>0+>/*4 <*>5/*4 2+ 1AB9+.1 O%P 33Q9 @<>+7/1 R(
,-<4+3+.0*>/1D
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,-<4+3+.0*>/1D
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+2+3* *9-21 <-431.*> 5*>2/19=./51: *,</>*5/6.: ,B.2>13+,
<4+->1U<-431.*>+,: +05G

-&./ 51 2&.#6),.$&)(72&./"#$%&'()&*$
! N>+,/6. 2+ 2/6A/21 2+ 5*>I1.1 @VR(D *-3+.0*2* 51.
*5/21,/, >+,</>*01>/*M
o  <VR( WXP 33Q9 51. <Q O&G#( @E*I/0-*43+.0+
,/.013J0/5*D

 VENTILACIÓN MECÁNICA AVENTHO #

 

 
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o  NVR( .1>3*4M #XU$X * ./7+4 2+4 3*>G Y2*<0*> ,1I>+

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]1194+D
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+A*5+>I*2*: 5>/,/, *,3J0/5*: ,B.2>13+ 513<*>0/3+.0*4
*I213/.*4: ,B.2>13+, <4+->1U<-431.*>+,: 0>*,01>.1,
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3/*,0=./5*: 2+81>3*5/1.+, 2+ 4* <*>+2 01>J5/5*:
+.8+>3+2*2+, 2+,3/+4/./?*.0+,: +05G

Indicaciones neurológicas
! N-.0*L+2+ 4* +,5*4* 2+ 513* 2+ ]4*,91_ ` ' <-.01,
! Z/,3/.-5/6. 2+ ( <-.01, 2+4 <-.0*L+ /./5/*4 @/.2/5* -.
<>15+,1 .+->1469/51 <*01469/51 <>19>+,/71D

K. <*5/+.0+, .+->15>B0/51, .1 ,141 /3<1>0* <>10+9+> 4* 7B*

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+2+3* 5+>+I>*4 @E/<+>5*<./*: E/<1A+3/*D 1 .+5>1U*<1<01,/,
@E/<+>1A+3/*DG

Otras indicaciones:
! Y5/21,/, >+,</>*01>/* ;-+ .1 >+,<1.2+ *4 0>*0*3/+.01
/./5/*4 @I>1.512/4*0*21>+,: +,0+>1/2+ ab: +05GD:
E*I/0-*43+.0+ ,/.013*0/5* 51. <VR( WXP 33Q9 C <Q
O&G#(

$  VENTILACIÓN MECÁNICA AVENTHO

 

 
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! Y<.+*
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E/<17+.0/4*5/6.

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51+A/,0/> +. +4 3/,31 <*5/+.0+ 8>+5-+.0+3+.0+G

En tu curso AV ENTHO tendrem os sesiones teorico-practicas

teorico-practicas para un m ejor aprendizaje.

 VENTILACIÓN MECÁNICA AVENTHO X

 

 
%

PROGRAMACIÓN EN VENTILACIÓN
MECÁNICA   

 VENTILACIÓN
 VENTILACI ÓN MECÁNICA
MECÁNIC A ASISTIDA-CONTROLA
ASISTID A-CONTROLADA
DA
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,+ 2+,5>/I/>J. * 51.0/.-*5/6.: ,/+.21 +4 3121 YfV <1>
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Pogramación de la ventilación asistida-

controlada por volumen (ACV)
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%  VENTILACIÓN MECÁNICA AVENTHO
 

 
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Curva de Presión/Tiempo
Presión/Tiempo en Ventilación
Ventilación Controlada por Volumen sin Presión Positiva
Positiva al Final
de la espiración ni pausa inspiratoria)

 VENTILACIÓN MECÁNICA AVENTHO &

 

 
'

Programación inicial de ACV:

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<>+,/6. *>0+>/*4 2+ 1AB9+.1 @<*R(D +.0>+ %P C "PP 33Q9G

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/.,</>*01>/*G

Curva P/T en Modo Controlado por Volumen. La inspiraci

inspiración
ón es desencadenada de acuerdo a la
Frecuencia Respiratoria
Respiratoria Program ada
'  VENTILACIÓN MECÁNICA AVENTHO
 

 
h

Curva P/T en Modo A sistido

sistido por Volumen
La inspiraci
inspiración
ón es desencadenad a por el esfuerzo inspiratori
inspiratorioo del paciente deflexión
deflexión negativa al
inicio de la curva)  

Bucle de Presión/Volumen
Presión/Volumen en M odo Controlado por Volumen
El cic
ciclo
lo parte de cero
cero intersección
intersección entre ambos ejes) y sigue
sigue un orden inverso a las manecill
manecillas
as
del reloj.

 VENTILACIÓN MECÁNICA AVENTHO h

 

 
"P

Bucle de Presión/Volumen
Presión/Volumen en M odo Asistido
Asistido por Volumen
El ci
ciclo
clo parte
parte de cero intersección
intersección entre
entre ambos ejes) se genera presión
presión negativa a la

izquierda) que activa

activa la inspiración
inspiración por el ventilador
ventilador derecha y arriba) siguiendo
siguiendo un o rden
inverso a las manecillas del reloj.  

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jc*44* @53D k "X(G$D A PGh"l m XP @E13I>+D
jc*44* @53D k "X(G$D A PGh"l m $X @3-L+>D

"P  VENTILACIÓN MECÁNICA AVENTHO

 

 
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 VENTILACIÓN MECÁNICA AVENTHO ""

 

 
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)* <>+,/6. <1,/0/7* *4 8/.*4 2+ 4* +,</>*5/6. +, -0/4/?*2* <*>*

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Curva de Presión/Tiempo
Presión/Tiempo en Mo do Controlado por Volumen con PEE P
Nótese el inicio
inicio de la inspiración
inspiración a partir
partir de un nivel de presión superior a cero línea
punteada). La ventilaci
ventilación
ón inicia por la
la frecuencia respiratori
respiratoriaa programad a no esfuerzo del
paciente)

Bucle de de Presión/Volumen en Modo Con trolado por Volumen

Nótese que el ciclo

ciclo inicia
inicia en una p resión superior a cero lílínea
nea inferior)
inferior)

"(  VENTILACIÓN MECÁNICA AVENTHO

 

 
"#

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/.,</>*5/6. C 3+.1> 0/+3<1 2+ +,</>*5/6.G

Curva de P/T en Modo ACV con Pausa Inspiratori

Inspiratoriaa se observa una meseta al final de la
inspiración)

Curva de Presión/Tiempo
Presión/Tiempo en Modo Asistido por Volumen con PEEP y Pausa IInspiratori
nspiratoriaa Nótese
la deflexión negativa al inicio de la curva, dada por el esfuerzo inspiratorio del paciente)

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 VENTILACIÓN MECÁNICA AVENTHO "#
 

 
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•   <'F9/ &$:.&6(%/6&/1
K, 4* 7+415/2*2 51. 4* ;-+ ,+>J 101>9*21 +4 714-3+. 51>>/+.0+
* 0>*7=, 2+ 4* >+,/,0+.5/* +L+>5/2* <1> 4* 7B* *=>+* 2+
51.2-55/6.: <1> 0*.01: 2+I+ 013*>,+ +. 5-+.0* ;-+: * 3*C1>
84-L1: 3*C1> <>+,/6. ,+>J +L+>5/2* +. +4 ,/,0+3* >+,</>*01>/1 C

,+>J +7/2+.5/*21 +. +4 *-3+.01 2+ 4* <>+,/6. 3JA/3* 2+ 4*

7B* *=>+*G

Z+ 3*.+>* 51.7+.5/1.*4 ,+ >+513/+.2* *L-,0*> +4 84-L1 +.

5/8>*, 2+ #P * %P )f3/.: <>+8+>+.0+3+.0+ +. +4 ./7+4 ;-+
9+.+>+ 3+.1, *-3+.01 2+ <>+,/6. +. 4* 7B* *=>+*: <+>1
<+>3/0/+.21 -.* >+4*5/6. /.,</>*5/6.M +,</>*5/6. *2+5-*2*:
+.0>+ "M( * "M#: ,/+3<>+ 013*.21 +. 5-+.0* ;-+ 4*

8>+5-+.5/* >+,</>*01>/* 2+4 <*5/+.0+ 0*3I/=. 9+.+>* 5*3I/1,

"$  VENTILACIÓN MECÁNICA AVENTHO
 

 
"X

+. 2/5E* >+4*5/6.: *4 /9-*4 ;-+ ,/ ,+ <>19>*3* <*-,*

/.,</>*01>/*G K. 5*,1 2+ *0>*<*3/+.01 *=>+1 /3<1>0*.0+: +4
84-L1 <-+2+ ,+> <>19>*3*21 E*,0* 'P * "PP )f3/.G

Curva de Flujo / Tiempo en M odo ACV

Se observa un flujo
flujo inspiratorio cuadrático desn ivel positivo) y flujo espiratorio desnivel
negativo)

En el curso tendras la oportunidad de realizar la programación en el ventilador

mecanico con diversos casos clinicos.

 VENTILACIÓN MECÁNICA AVENTHO "X

 

 
"%

M/%( &+./6%($%#1 H+ 2+I+ 0+.+> +. 5-+.0* ;-+ -. 5*3I/1 +.

4* <>19>*3*5/6. 7* * 9+.+>*> 312/8/5*5/1.+, +. -.1 1 7*>/1,
<*>J3+0>1,: +L+3<41: *-3+.0*> +4 714-3+. 51>>/+.0+
9+.+>*>J -. *-3+.01 2+ 4* <>+,/6. 3+,+0* C 2+ 4* <>+,/6.
3JA/3* 2+ 4* 7B* *=>+*: *-3+.0*> 84-L1 9+.+>*>J -. *-3+.01
2+ 4* <>+,/6. 3JA/3* 2+ 4* 7B* *=>+* C -.* 2/,3/.-5/6. 2+4
0/+3<1 /.,</>*01>/1: <>141.9*.21 4* >+4*5/6. /.,</>*5/6. M
+,</>*5/6.: <1> 41 ;-+ *4 312/8/5*> 5*2* <*>J3+0>1: ,+ 2+I+
7/9/4*> .-+7*3+.0+ 012* 4* 3+5J./5* 7+.0/4*01>/*G

 VENTILACIÓN POR SOPORTE DE PRESIÓN.

PRESIÓN. 
[121 b+.0/4*01>/1 44*3*21 p+,<1.0J.+1q: +. +4 5-*4 +4
7+.0/4*21> 101>9* -.* <>+,/6. 2+ ,1<1>0+ *9>+9*2* * 4*
<>+,/6. .+9*0/7* ;-+ +,0+ +L+>?* 2->*.0+ 4* 7+.0/4*5/6.
+,<1.0J.+*: +4 7+.0/4*21> <>1<1>5/1.* 4* <>+,/6. 2+
*55/1.*3/+.01 <*>* 5*2* >+,</>*5/6.: ;-+ 2+0+>3/.* 4* 0*,*
2+ 84-L1 2+ */>+ 3JA/31G )* /.,</>*5/6. ,+ 0+>3/.* -.* 7+?
;-+ +4 84-L1 2+ /.,</>*5/6. ,+ E* >+2-5/21 * -. <1>5+.0*L+
<>+2+0+>3/.*21 2+ ,- 7*41> 3JA/31G N>+,/6. 2+ ,1<1>0+ +,

-. 3121 2+ 7+.0/4*5/6. 3+5J./5* .1 51.0>14*21: +, <*>*

<*5/+.0+, 51. 8-+>?* /.,</>*01>/*: ;-+ 0+.9*. 3B./31 1 .-41
+8+501 ,+2*.0+: +, -. 3121 -0/4/?*21 +. +4 <>15+,1 2+4 >+0/>1
2+ 4* 7+.0/4*5/6. 3+5J./5*: ,+ 4+ <-+2+ *9>+9*> -.* <>+,/6.
51.0/.-* +. 4* 7B* *=>+* * +,0+ 3121: +.01.5+, 44*3*21
VNYNUNHG

"%  VENTILACIÓN MECÁNICA AVENTHO

 

 
"&

MONITOREO DURANTE LA
MECÁNICA INVASIVA  
 VENTILACIÓN MECÁNICA
c121 <*5/+.0+ I*L1 b[ ,+ 2+I+ 31./01>/?*> 2+ 5+>5*: C* ;-+
+,0J. +A<-+,01, * 513<4/5*5/1.+,: C* ;-+ 4* 7+.0/4*5/6.
3+5J./5* <>12-5+ 4+,/6.  /') $78 /1> 41 0*.01: ,+ 2+I+.
3/./3/?*> 41, >/+,91,: *4 <*5/+.0+ ,+ 4+ 2+I+ 7/9/4*>M

Mecánica del sistema respiratorio (distensibilidad y

resistencia)
•   G6#:&*$ +,3&+( =# '( ">( (46#( @.6#:&*$ .&)/C .6#:&*$
=&$,+&)(C G(NB1
K, 4* <>+,/6. 3JA/3* 9+.+>*2* +. 4* 7B* *=>+*i ,+ 3/2+ *4
8/.*4 2+ -.* /.,</>*5/6. C 2+<+.2+ 2+4 b0C 2+4 84-L1
/.,</>*01>/1: <-+2+ 312/8/5*>,+ <1> 4* /3<+2*.5/* 01>J5/5*: 4*
>+,/,0+.5/* 2+4 0-I1 +.210>*;-+*4 C +4 +,8-+>?1 3-,5-4*> 2+4
<*5/+.0+G K4 *-3+.01 2+ 4* >+,/,0+.5/* 2+ 4* 7B* *=>+* @o*_D
<-+2+ *-3+.0*>4*: 4*, 8-9*, <-+2+. 2/,3/.-/>4*G
L#%(1 G(N O PQ )+25A

•   G6#:&*$ +#:#%( @.6#:&*$ .'(%#(FB1 

K, 9+.+>*2* <1> 4* 2/,0>/I-5/6. 2+4 */>+ 2+.0>1 2+4 <-436.:
51. 8/. 2+ 7+.5+> +4 >+0>15+,1 +4J,0/51 <-431.*>: +, -.
/.0+.01 2+ 3+2/5/6. 2+ 4* <>+,/6. *47+14*>G H+ 3/2+ *4 8/.*4
2+ -.* <*-,* /.,</>*01>/* 2+ -.1, PG( * # ,+9-.21, 2+
2->*5/6.: 2->*.0+ 4* 5-*4 +4 84-L1 2+ */>+ +, PG K4 <>/3+> <-.01
2+ 84-L1 P 51>>+,<1.2+ *4 <-.01 2+ <>+,/6. 2/.J3/51U+,0J0/5*:
2+,<-=, 4* <>+,/6. 2+5*+ E*,0* *45*.?*> -. 7*41> 2+
 VENTILACIÓN MECÁNICA AVENTHO "&
 

 
"'

+;-/4/I>/1 @3+,+0*DG )* 7+415/2*2 51. 4* ;-+ ,+ *45*.?* +,0+

+;-/4/I>/1 2+<+.2+ 2+ 4* E1319+.+/2*2 2+4 <*>=.;-/3*
<-431.*>G H- 7*41> ,+ 312/8/5* *.0+ 5*3I/1, +. 4*
2/,0+.,/I/4/2*2 <-431.*> 1 01>J5/5* C +. 5*<*5/2*2 >+,/2-*4
8-.5/1.*4G
L#%(1 G6#:&*$ +#:#%( R5S )+25A 
@,+ *,15/* * 3*C1> ,-<+>7/7+.5/*DG

Curva de P/T en modo Controlado por Volumen

T#:&:%#$)&( =# '( ">( (46#( @T(NB1

K, 4* >+4*5/6. +.0>+ 2/8+>+.5/* 2+ <>+,/6. C -. 84-L1
2+0+>3/.*21: ;-+ ,+ +A<>+,* +. 53Q(Rf)f,: ,+ 5*45-4*
5131M @<>+,/6. 3JA/3* 2+ 4* 7B* *=>+* k <>+,/6. 3+,+0*D f
84-L1G )* >+,/,0+.5/* 3JA/3* @o3JAD /.54-C+ 4* >+,/,0+.5/* 2+
4*, 7B*, *=>+*, <>1</*3+.0+ 2/5E*,: 4* >+,/,0+.5/* 2+4 0-I1
+.210>*;-+*4: 41, +;-/<1, 2+ 3+2/5/6.: 4* >+,/,0+.5/* 2+4
0+L/21 <-431.*> C 2+ 4* 5*L* 01>J5/5*G )* >+,/,0+.5/* 3B./3*

"'  VENTILACIÓN MECÁNICA AVENTHO

 

 
"h

@o3B.D >+84+L* 4* o*_ 3J, 4* >+,/,0+.5/* 2+4 0-I1

+.210>*;-+*4 C 41, +;-/<1, 2+ 3+2/5/6.G

)* 2/8+>+.5/* +.0>+ o3JA C o3B.: 44*3*2* roH: +A<>+,* 4*,

2+,/9-*42*2+, 1 4* 8*40* 2+ E1319+.+/2*2

2+ 0/+3<1 /.0>*<-431.*>+, 2+ 4*, @<+.2+4-80D
C 2+ 4* <*>+2 01>J5/5* 51.,0*.0+,
C 4*, <>1</+2*2+, 7/,51+4J,0/5*, 1 <4*,01+4J,0/5*, 2+4
<*>=.;-/3* <-431.*>: +, 2+5/>: 4* >+,/,0+.5/* 2+4 0+L/21
<-431.*>G

T#:&:%#$)&( +>$&+( =# '( ">( (46#( / .6#:&*$ %6($:(46#(1

@G6#:&*$ +,3&+(UG6#:&*$ +#:#%(B
M/6+(' R5VQ ( P )+25A7W7:

H/0-*5/1.+, 8>+5-+.0+, ;-+ *-3+.0*. 4* >+,/,0+.5/* 2+ 4*,

7B*, *=>+*,M
! K,<*,31 I>1.;-/*4
! RI,0>-55/6. 2+ 4* 7B* *=>+* @,+5>+5/1.+,: *9-*: +05GD
! ^>1.;-/0/, 5>6./5*
! T+-31<*0B* 1I,0>-50/7*
! V*4/I>+ 2/,3/.-/21 2+ 4* 5J.-4* +.210>*;-+*4

! K2+3* <-431.*>

)*, ,/0-*5/1.+, *.0+, 2+,5>/0*,: *-3+.0*>J. 4* <>+,/6.

3JA/3* 2+ 4* 7B* *=>+* C 4* <>+,/6. 0>*.,*=>+*: ;-+ +, 4*
2/8+>+.5/* 2+ 4* <>+,/6. </51 3+.1, 4* <>+,/6. 3+,+0*: *
3*C1> *-3+.01 2+ >+,/,0+.5/*: 3*C1> <>+,/6. </51 C <>+,/6.
0>*.,*=>+*G

 VENTILACIÓN MECÁNICA AVENTHO "h

 

 
(P

Curva de P/T en mod o Control

Controlado
ado por Volumen
Aumento de Resist
Resistencia
encia de la vía aérea, nót
nótese
ese el aumento de la Pmáx y de la
Presión Transaérea

Bucle de Presión/Volumen en mo do Controlado por Volumen

Aum ento de la Resistencia de llaa vía
vía aérea línea punteada ) y atrapamiento aéreo,
el volumen exhalado no regresa a cero.

(P  VENTILACIÓN MECÁNICA AVENTHO

 

 
("

;&:%#$:&E&'&=(= =#' :&:%#+( 6#:.&6(%/6&/ @X6:C

)/+.'&($)#B1
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/.0>*<-431.*> C +4 *-3+.01 2+ <>+,/6. @rN: 2/8+>+.5/* 2+
<>+,/1.+,D .+5+,*>/1 <*>* <>12-5/> +,0+ 5*3I/1 2+ 714-3+.
@rb: 2/8+>+.5/* 2+ 714-3+.D: Z/,0+.,/I/4/2*2 @34f53Q(RD s
rbfrG

J'(:%($)&( =#' :&:%#+( 6#:.&6(%/6&/1 K, 4* /.7+>,* 3*0+3J0/5*

* 4* 2/,0+.,/I/4/2*2: +, 2+5/>: +4 5*3I/1 2+ <>+,/6. >+;-+>/21
<*>* 5*3I/*> +4 714-3+. <-431.*>G

N*>* 4* 3+2/5/6. 2+ 4* 2/,0+.,/I/4/2*2 01>*51U<-431.*> +.

<*5/+.0+, /.0-I*21, C 7+.0/4*21, 3+5J./5*3+.0+ ,+ >+*4/?* *
<*>0/> 2+4 515/+.0+ +.0>+ +4 714-3+. 5/>5-4*.0+ *23/./,0>*21
<1> +4 7+.0/4*21> @b0D C 4* 2/8+>+.5/* 2+ <>+,/6. +.0>+ +4 8/.*4
2+ 4* <*-,* /.,</>*01>/* @N 3+,+0*D C +4 8/.*4 2+ 4* +,</>*5/6.
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51415*2*, +. ,+>/+: +4 <-436. C 4* 5*L* 01>J5/5*: <1> 41 ;-+ 4*,
7*>/*5/1.+, 2+ -.1 - 10>1 513<1.+.0+ <>12-5+. 5*3I/1, 2+
4* 2/,0+.,/I/4/2*2 010*4 2+4 ,/,0+3*G

)* 2/,0+.,/I/4/2*2 2+ 0121 +4 ,/,0+3* >+,</>*01>/1

@=&:%#$:&E&'&=(= =&$,+&)(B  +,0*>J 2*2* <1> 4* >+4*5/6. +.0>+
 VENTILACIÓN MECÁNICA AVENTHO ("
 

 
((

+4 /.5>+3+.01 2+ 714-3+. C +4 5*3I/1 2+ <>+,/6. +. 4*, 7B*,

*=>+*,: 4* 2/,0+.,/I/4/2*2 <-431.*> C 4* 2/,0+.,/I/4/2*2 2+ 4*
<*>+2 01>J5/5*G

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8-7G.&)/ I GJJG

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3-5E1, >+,</>*21>+,G )* 2/,0+.,/I/4/2*2 +,0J0/5* .1>3*4 +,
*4>+2+21> 2+ &P * "PP 34f53Q(RG

;&:%#$:&E&'&(= #:%,%&)( =#' :&:%#+( 6#:.&6(%/6&/ @X:%B H

Y8% 7 @G +#:#%( I GJJG %/%('B

;&:%#$:&E&'&=(= #:.#)>K&)(1  K, 4* ;-+>+4*5/1.* 4*

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<>+8+>/I4+ <*>* <12+> 513<*>*> <*5/+.0+, 7+.0/4*21, 51.
714g3+.+, 2/8+>+.0+,G

;&:%#$:&E&'&=(= #:.#)>K&)( =#' :&:%#+( 6#:.&6(%/6&/ @X #:.B

H ;&:%#$:&E&'&=(= 7 X(.()&=(= 6#:&=F(' KF$)&/$('

Z+I+ 013*>,+ +. 5-+.0* ;-+ 4* 3+2/5/6. 2+ 4* 2/,0+.,/I/4/2*2

<-+2+ 7+>,+ *8+50*2* <1> 4* 3*9./0-2 2+4 714-3+.
5/>5-4*.0+: 4* 2->*5/6. 2+ 4* <*-,* /.,</>*01>/*: 4* 3*9./0-2
2+ 4* NKKN +A0+>.* +3<4+*2* C 4* NKKN /.0>B.,+5*G

((  VENTILACIÓN MECÁNICA AVENTHO

 

 
(#

Situaciones restrictivas que disminuyen la

distensibilidad pulmonar:
GF'+/$(6#:1
• 
Y-3+.01
3+3I>*.* 2+ 4* 0+.,/6. ,-<+>8/5/*4M K.8+>3+2*2 2+
E/*4/.*
•   R5-<*5/6. *47+14*>M K2+3* <-431.*>: .+-31.B*
•   Y40+>*5/6. +,0>-50->*4M K2+3* /.0+>,0/5/*4: .+-31./0/,:
8/I>1,/,
•   Z/,3/.-5/6. 2+4 714-3+. 2/,<1./I4+ <*>* 4* 7+.0/4*5/6.M
Y0+4+50*,/*,: Z+>>*3+ <4+->*4: T+-3106>*A
•   [+?54* 2+ 41, *.0+>/1>+,M HB.2>13+ 2+ 2/,0>=, >+,</>*01>/1
*9-21
-/6,)&)(:1
•  Z/,0+.,/6. *I213/.*4 [*481>3*5/1.+, K.8+>3+2*2+,
.+->13-,5-4*>+,

Curva de P/T en modo Controlado por Volumen

Disminución de la Distensibilidad pulmonar, nótese el aumento de la Presión
meseta y la Presión de distensión

K. 4*, <*01419B*, <>+7/*3+.0+ 2+,5>/0*,: E*I/0-*43+.0+ ,+

>+;-/+>+ 3*C1> <>+,/6. <*>* 3*.0+.+> -. *2+5-*21
 VENTILACIÓN MECÁNICA AVENTHO (#
 

 
($

/.0+>5*3I/1 9*,+1,1: <1> 41 ;-+ *-3+.0*>J 4* >+4*5/6. +.0>+

4* <>+,/6. 3+,+0* C 4* <>+,/6. *4 8/.*4 2+ 4* +,</>*5/6.:
44*3*2* <>+,/6. 2+ 2/,0+.,/6. @2>/7/.9 <>+,,->+M < 3+,+0* k
NKKND: 5-C1, ./7+4+, +4+7*21, @W"# 53Q(RD +,0J.
>+4*5/1.*21, 51. 3*C1> 31>0*4/2*2G
L#%(1 G6#:&*$ =# =&:%#$:&*$ R0P )+25A

Bucle de Presión/Volumen en Modo Controlado por Volumen

Disminución de la distensibili
distensibilidad
dad p ulmonar, se ob serva una h orizontalizaci
orizontalización
ón d el bucle que
corresponde a un aumento de presión desproporcionado con mínima ganancia de volumen.

Parámetros num éricos de monitoreo en el ventilador

ventilador mecánico

($  VENTILACIÓN MECÁNICA AVENTHO

 

 
(X

 Auto-Presión espiratoria al final de la espiración

(AutoPEEP) o presión espiratoria al final de la
espiración intrínseca (PEEPi).

K,0/3*
313+.01 4* 2+
<>+,/6. *47+14*>
5+>1 84-L1 +. 4* *4
7B*8/.*4 2+ 4* +,</>*5/6. +. -.
>+,</>*01>/*G
H+ 3/2+ >+*4/?*.21 -.* 154-,/6. ,1I>+ 4* 7J47-4* +,</>*01>/*
2+4 5/>5-/01 /.3+2/*0*3+.0+ *.0+, 2+4 513/+.?1 2+ -. .-+71
5/541 >+,</>*01>/1 @<*-,* +,</>*01>/*DG

V-*.21 <+>,/,0+ 84-L1 +,</>*01>/1 +. +,0+ 313+.01: /.2/5*

;-+ 4* <>+,/6. *47+14*> .1 E* 44+9*21 * P 53Q(R 1 *4 ./7+4 2+

NKKN +A0>B.,+5*
+,</>*01>/1 <>+8/L*21:
2+3*,/*21 51>01<-+2+ ,+> <>+51?
1 *4 5/+>>+ 2+I/212+
* 4*-.7B*0/+3<1
*=>+*
@<1> 8+.63+.1, 2+ 514*<,1 2/.J3/51DG )1 *.0+>/1> ,/9./8/5*
;-+ +4 0/+3<1 +,</>*01>/1 .1 +, ,-8/5/+.0+ <*>* ;-+ 4*
+AE*4*5/6. ,+* 513<4+0* 1 ;-+ +A/,0+ -. *0>*<*3/+.01 2+
*/>+ 2+.0>1 2+4 <-436.: ;-+ ,/ <+>,/,0+ C *-3+.0*
@E/<+>/.,-84*5/6. 2/.J3/5*D: 9+.+>*>J -.* <>+,/6. ;-+ <-+2+
,+> 2+4+0=>+* <*>* +4 <*5/+.0+G

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>+,</>*01>/1: E/<10+.,/6. <1> *-3+.01 2+ 4* <1,5*>9* 2+4
7+.0>B5-41 2+>+5E1: I*>10>*-3* + /.0+><>+0*5/6. +>>6.+* 2+
<*>J3+0>1, E+312/.J3/51,G

N-+2+ <>+,+.0*,+ 2+ 0>+, 81>3*,M

 VENTILACIÓN MECÁNICA AVENTHO (X

 

 
(%

0V D&$ :/E6#=&:%#$:&*$ .F'+/$(61

K4 714-3+. <-431.*> <-+2+ ,+> .1>3*4 1 +,0*>
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,1I>+ 4* <>+,/6. *47+14*> *4 8/.*4 2+ 4* +,</>*5/6. C
9+.+>* -. 9>*2/+.0+ +.0>+ 41, *47=141, C 4* <>+,/6.
*031,8=>/5* ,/. ,1I>+2/,0+.,/6. <-431.*>

5V 2&.#6&$:FK'()&*$ =&$,+&)( :&$ '&+&%()&*$ =#' K'F9/

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<>1</+2*2+, 2+4 ,/,0+3* >+,</>*01>/1 @>+,/,0+.5/*
*-3+.0*2* Cf1 2/,0+.,/I/4/2*2 *-3+.0*2*
E*I/0-*43+.0+DG

PV 2&.#6&$:FK'()&*$ )/$ '&+&%()&*$ =#' K'F9/ (46#/V

K, 2+,+.5*2+.*2* <1> 1I,0>-55/6. *4 84-L1 *=>+1: 15->>+
2->*.0+ -.* 2+84*5/6. <*,/7* ,/ 4* <>+,/6. <4+->*4 ,+
7-+47+ 3J, <1,/0/7* ;-+ 4* <>+,/6. +. 4* 7B* *=>+*
<+;-+F* @514*<,1 2/.J3/51DG

(%  VENTILACIÓN MECÁNICA AVENTHO

 

 
(&

Curva de Flujo / Tiempo en m odo Controlado por Volum en

Nótese com o el flujo espiratorio
espiratorio se prolonga po r obstrucción de la vía respiratoria
respiratoria y no
llega a cero.

Bucle de Presión / Volumen con Atrapamiento aéreo

Nótese como el volumen no retorna a cero.
Nota: La misma imagen se observa cuando existe fuga de volumen.

X/$:%($%# =# %&#+./1K, +4 <>12-501 2+ 4* 2/,0+.,/I/4/2*2 <1>

4* >+,/,0+.5/* 2+4 ,/,0+3* >+,</>*01>/1: 3/2+ +4 0/+3<1 2+
44+.*21 1 7*5/*3/+.01 <-431.*>G H/ 5*+ <1> 2+I*L1 2+ 5/+>01,
4B3/0+, <>+2/,+F*21,: +4 44+.*21 1 7*5/*3/+.01 <-431.*> .1
,+>J 513<4+01G H+ >+;-/+>+ 2+ X 51.,0*.0+, 2+ 0/+3<1 <*>*
 VENTILACIÓN MECÁNICA AVENTHO (&
 

 
('

7*5/*> 1 44+.*> *<>1A/3*2*3+.0+ +4 hhS 2+ 41, <-431.+,: $

51.,0*.0+, <*>* +4 h'S: # 51.,0*.0+, <*>* -. hXS: (
51.,0*.0+, <*>* -. '%S C " 51.,0*.0+ <*>* +4 %#S
g./5*3+.0+G H+ 2+I+>J +,0*I4+5+> -.* >+4*5/6. /.,</>*5/6.U
+,</>*5/6. 51. -. 0/+3<1 +,</>*01>/1 ,-8/5/+.0+ <*>* <12+>
7*5/*> *2+5-*2*3+.0+ 41, <-431.+, +. I*,+ * +,01G

Sobredistensión pulmonar.
K, 5-*.21 ,+ <>12-5+ -. *-3+.01 +. 4* 0+.,/6. 2+ 4*,
<*>+2+, 2+4 ,/,0+3* >+,</>*01>/1 @<>/.5/<*43+.0+ *47+141,D
5*-,*21 <1> -. *-3+.01 2+ <>+,/6. ;-+ .1 51>>+,<1.2+>J
51. -. *-3+.01 2+ 714-3+. <>1<1>5/1.*4: +, 2+5/>: *-3+.0*
4* <>+,/6. ,/. *<1>0*> -. 714-3+. *2+5-*21: 5*-,*.21 2*F1
/.2-5/21 <1> +,0>=, C 0+.,/6. 2/.J3/51, * ./7+4 2+ 4* <*>+2
*47+14*>G

Bucle de Presión
Presión / Volumen en Mod o Controlado por Volumen
Se observa un incremento de la presión al final de la inspiración
inspiración pico inspiratorio)
inspiratorio) que no
genera un aumento p roporcional de volumen como al inicio
inicio de la fase inspiratoria.
inspiratoria.

('  VENTILACIÓN MECÁNICA AVENTHO

 

 
(h

Movimiento y trabajo respirator

respiratorio
io (TR)
)* 7+.0/4*5/6. 51.7+.5/1.*4 C 4* 7+.0/4*5/6. 3+5J./5* +,
I*,*2* +. <*>J3+0>1, I/18B,/51, C 3+5J./51, *<4/5*21, * 4*
>+,</>*5/6.: +4 0>*I*L1 +, 4* 8-+>?* .+5+,*>/* <*>* 317+> *491
2+ -. 4*21 * 10>1: +. +,0+ 5*,1: 4* <>+,/6. 010*4 2+4 ,/,0+3*
>+,</>*01>/1 <*>* /.9>+,*> C +9>+,*> +4 */>+ 2+4 *3I/+.0+ E*5/*
+4 <-436. C 7/5+7+>,*G

K4 0>*I*L1 >+,</>*01>/1 .1>3*4 2+4 <*5/+.0+ +. 7+.0/4*5/6.

3+5J./5* +, 2+ PG# * PG& t1-4+, @ZD C +4 0>*I*L1 010*4 2+4
7+.0/4*21> 3+5*./51 ,-3*21 *4 <*5/+.0+ .1 2+I+ ,1I>+<*,*>
"ZG

Monitoreo de gases
K, /3<1>0*.0+ 31./01>/?*> 41, 9*,+, 2+4 <*5/+.0+ 2+ 81>3* .1
/.7*,/7* @<-4,/1A/3+0>B*: 2/6A/21 2+ 5*>I1.1 +AE*4*21D 1
/.7*,/7* @9*,13+0>B* *>0+>/*4D ,/ ,+ 5>++ <+>0/.+.0+: 1 ,/ ,+
<>+,+.0* -. 5*3I/1 *I>-<01 +. 4* 54B./5* 2+4 <*5/+.0+G )*,
3+0*, * <+>,+9-/> ,1. 4*, ,/9-/+.0+,M

•   .(A51 [\ I 0\\ ++2?

d-+>* 2+4 >*.91 s [*C1> 31>0*4/2*2

•   .(XA51 M/6+/)(.$&(1 PQ I SQ ++2? 

@* ./7+4 2+4 3*>: *L-,0*> * ,- *40->* E*I/0-*4D

[+0* 2+ H*0->*5/6. 2+ 1AB9+.1M h$ * h%S +. <*5/+.0+ ,/.

HZoY: ''S * h$S +. <*5/+.0+ 51. HZoYG H+ E* 2+31,0>*21
 VENTILACIÓN MECÁNICA AVENTHO (h
 

 
#P

;-+ 7*41>+, 3+.1>+, 1 3*C1>+, * +,01, >*.91, ,+ *,15/*. *

513<4/5*5/1.+, C 3+.1> ,-<+>7/7+.5/*G

a.0+>>19*01>/1 C +A<41>*5/6. 8B,/5* 2+4 <*5/+.0+ @HB.013*, C

,/9.1,D

K4 <*5/+.0+ +. 7+.0/4*5/6. 3+5J./5* <-+2+ >+8+>/> :>$%/+(: ,/

.1 +,0J 513<4+0*3+.0+ ,+2*21: <-+2+ 513-./5*>,+ 51.
,+F*, 1 +,5>/I/>: ,/ 4+ +, 8*50/I4+: +, .-+,0>* 1I4/9*5/6. +,0*> *4
<+.2/+.0+ 2+ 41, 3/,31,: <>/.5/<*43+.0+ <12+31,
2+0+>3/.*> ,/ <>+,+.0* *49-.* 2+ 4*, #ZM 2/,.+*: 2141> 1
2/,51.81>0: <*>* 41 5-*4 +, .+5+,*>/1 +,0*I4+5+> -.* 3+0* 2+
*.*49+,/* C ,+2*5/6. 9-/*2* <1> +,5*4*, 54B./5*, - 10>1 0/<1 2+
31./01>+1G

K. 5*,1 2+ <>+,+.0*> *49-.* *40+>*5/6.: ,+ 2+I+>J /2+.0/8/5*>

C >+,147+> * 4* I>+7+2*2G

K. 5-*.01 * 41, :&?$/: ;-+ <12+31, +.51.0>*> +,0J.M *4+0+1

.*,*4: 5/*.1,/, <+>/I-5*4: -.9-+*4 1 9+.+>*4/?*2*: 0/>*L+
5+>7/5*4: ,-<>*+,0+>.*4: /.0+>51,0*4: 2/,15/*5/6. 01>*51U
*I213/.*4: 2/*81>+,/,G Y,B 5131 <12+31, +.51.0>*>
,B.2>13+, <4+->1<-431.*>+, 3+2/*.0+ 4* /.,<+55/6.:
<*4<*5/6.: *-,5-40*5/6. C <+>5-,/6.G K, 2+ 7/0*4 /3<1>0*.5/*
4* 7/9/4*.5/* .+->1469/5*: C* ;-+ <12+31, +.51.0>*>M
2+0+>/1>1 2+4 +,0*21 2+ 51.5/+.5/*: *9/0*5/6.: 2+4/>/1 1
>+,</>*5/1.+, *.1>3*4+,G

#P  VENTILACIÓN MECÁNICA AVENTHO

 

 
#"

En tu curso tendras interacción continua con los p rofesores para realizar resol
resolución
ución de caso s
clinicos,
clinicos, realizando
realizando programación d el ventilador
ventilador m ecánico y m onitoreo pulmonar.  

Monitoreo básico
H+ 2+I+ 31./01>/?*> 51.0/.-*3+.0+M
•  d>+5-+.5/* V*>2/*5*
•  d>+5-+.5/* o+,</>*01>/*
•  c+.,/6. Y>0+>/*4: c+.,/6. Y>0+>/*4 [+2/*
•  c+3<+>*0->*
•  RA/3+0>B* 2+ <-4,1
•  V*<.19>*8B*
•  u>+,/,
)* 7/9/4*.5/*51.0/.-* 2+ 41, 5*3I/1, +. +,01, <*>J3+0>1, +,
2+ 7/0*4 /3<1>0*.5/* <*>* 2+0+>3/.*> +4 +,0*21 2+ 9>*7+2*2 C

 VENTILACIÓN MECÁNICA AVENTHO #"

 

 
#(

* 26.2+ 7* 4* +714-5/6. 2+ .-+,0>1 <*5/+.0+ C ,-, 8-.5/1.+,

1>9J./5*,G

 Via aérea y entorno del paciente

pacien te
c-I1 +.210>*;-+*4 I/+. 51415*21: 2+ 0*4 81>3* ;-+ +,0=
*,+9->*21 +4 0-I1 C +4 941I1 /.84*21 2+.0>1 2+ 4* 0>J;-+* <1>
2+I*L1 2+ 4*, 5-+>2*, 715*4+, C ;-+ *3I1, <-431.+, ,+
+.5-+.0>+. 7+.0/4*21,: 2+,5*>0*> /.0-I*5/6. ,+4+50/7* *
5-*4;-/+>* 2+ 41, I>1.;-/1, <>/.5/<*4+, @8>+5-+.0+3+.0+ +4
2+>+5E1D: C* ;-+ <-+2+ 5*,*> *0+4+50*,/*,G

H+ >+513/+.2* -. .+-310*<1.*3/+.01 *2+5-*21 <*>*

+7/0*> *,</>*5/6. 2+ 4*, ,+5>+5/1.+, 1>18*>B.9+*, C 0>*;-+*4+,
+. 4* 7B* *=>+*: <-+2+ ,+> 51. 941I1 5/>5-4*> 1 </>*3/2*4: ,+
>+513/+.2* 3*.0+.+>41 /.84*21 * -.* <>+,/6. +.0>+ (P C #P
33Q9: 2*21 ;-+ -.* <>+,/6. 2/,3/.-/2* <-+2+ 8*71>+5+>
3/5>1*,</>*5/1.+, C -.* <>+,/6. 3-C *40* <-+2+ 8*71>+5+>
/,;-+3/* 2+ 4* 3-51,* 0>*;-+*4G

H+ >+513/+.2* +4 -,1 2+ 5/>5-/01 5+>>*21 2+ *,</>*5/6.: ,+

>+513/+.2* .1 *,</>*> *4 <*5/+.0+ <1> E1>*>/1 ./ 2+ 3*.+>*
>-0/.*>/*G H+ >+513/+.2* *,</>*> 5-*.21 ,+ 0+.9* ,1,<+5E*
2+ 1I,0>-55/6. 3-51,* 1 *5-1,* +. 4* 7B* *=>+*: +,01 <-+2+
,1,<+5E*>,+ *4 <>+,+.0*> *49-.1 2+ 41, ,/9-/+.0+, ,/9.1,M

•   c1,
•   H+5>+5/1.+, 7/,/I4+,
•   H+5>+5/1.+, *-2/I4+,
•
  Y-3+.01 2+ 4* <>+,/6. 3JA/3* 2+ 4* 7B* *=>+*
#(  VENTILACIÓN MECÁNICA AVENTHO
 

 
##

•   Z/,3/.-5/6. 2+4 714-3+. 51>>/+.0+ ,/9./8/5*0/7* *4

<>19>*3*21
•   Y-3+.01 2+4 0>*I*L1 >+,</>*01>/1
•   K,8-+>?1 +7/2+.0+ 2+ 41, 3g,5-41, +,</>*01>/1,
•
  Y0>*<*3/+.01 *=>+1 7/,/I4+ +. 5->7*, C I-54+,

Curva de Volumen / Tiempo en m odo Controlado por Volum en donde se ob serva Fuga de Aire.
El volumen de aire no llega a cero lílínea
nea roja)

Curva de Presión / Tiempo

Tiempo en modo Controlado por Volumen do nde se observan Secreciones.
Se observan cambios abruptos en la presión en la fase espiratoria
espiratoria

 VENTILACIÓN MECÁNICA AVENTHO ##

 

 
#$

Curva de Flujo / Tiempo en m odo Controlado por Volum en donde se ob servan Secreciones
Secreciones o
Agua en el circuito
circuito del ventilador. Se observan cambios abrup tos de flujo en la fase espiratoria

)* <1,/5/6. 2+4 <*5/+.0+ ,+ >+513/+.2* +.0>+ #P C $Xv 2+

+4+7*5/6. 2+ 5*I+5+>* <*>* 2/,3/.-/> +4 >/+,91 2+ .+-31.B*
*,15/*2* * 7+.0/4*5/6. 3+5J./5*G
H+ 2+I+ >+*4/?*> E/9/+.+ *2+5-*2* 2+ 3*.1, C -,1 2+
2/,<1,/0/71, 2+ I*>>+>* C */,4*3/+.01 ,/ +,0J. /.2/5*21,: <*>*
2/,3/.-/> +4 >/+,91 2+ .+-31.B* *,15/*2* * 7+.0/4*5/6.
3+5J./5*G

Sedoanalgesia
K4 <*5/+.0+ +. 7+.0/4*5/6. 3+5J./5* >+;-/+>+ -.* *2+5-*2*
*.*49+,/*: <+>1 .1 81>?1,*3+.0+ ,+2*5/6.: 4* *.*49+,/*
1</1/2+ +, 4* 3*C1>3+.0+ >+513+.2*2*: <-+2+ -,*>,+
2+,2+ 1</1/2+ 2+ <10+.5/* 4+7+ E*,0* *40*: +. >*.91, 2+ 21,/,
2+ ,+9->/2*2: +4 -,1 2+ N*>*5+0*314 @7/* +.0+>*4 1
/.0>*7+.1,*D 2+ .1 0+.+> 51.0>*/.2/5*5/1.+,: 2/,3/.-C+ 41,

>+;-+>/3/+.01, 2+ 1</1/2+G K. 5*,1 2+ >+;-+>/> ,+2*5/6.: ,+

#$  VENTILACIÓN MECÁNICA AVENTHO
 

 
#X

>+513/+.2* +4 -,1 2+ Z+A3+2+013/2/.*: ,+ 2+I+ +7/0*> +. 4*

3+2/2* 2+ 41 <1,/I4+ +4 +3<4+1 2+ I+.?12/*5+</.*, <*>*
3*.0+.+> ,+2*5/6.: <-+2+ 51.,/2+>*>,+ +4 -,1 2+ N>1<1814i
012* ,+2*5/6. 101>9*2* 2+I+ 31./01>/?*>,+ 2+ 81>3*
1IL+0/7*: C* ,+* <1> +,5*4*, 7*4/2*2*, 5131 oYHH C o*3,*C: 1
<1> ,/,0+3*, 2+ 31./01>+1 2+ *50/7/2*2 +4=50>/5* 5+>+I>*4G

K, /3<1>0*.0+ >+5*45*> ;-+ 0121 <*5/+.0+ E1,</0*4/?*21:

+,<+5/*43+.0+ +. 7+.0/4*5/6. 3+5J./5*: .1 2+I+ <>+,+.0*>
2141> ./ 2/,51.81>0: 4* ,+2*5/6. .1 *4/7/* ./.9-.* 2+ 4*, 21,
51,*,: <1> 41 ;-+ ,+ 2+I+ /.0+>>19*> C +A<41>*> *4 <*5/+.0+ C
,- +.01>.1 <*>* I-,5*> +,0>*0+9/*, <*>* ,- 51>>+55/6.G

Y49-.1, <*5/+.0+, 51. .+-31<*0B*, *9-2*, 9>*7+, @+LG

,B.2>13+ 2+ 2/,0>=, >+,</>*01>/1 *9-21 ,+7+>1D >+;-+>/>J.
3*C1> ./7+4 2+ ,+2*5/6. + /.54-,/7+ <12>B*. >+;-+>/> I41;-+1
.+->13-,5-4*>: ,/. +3I*>91: +,0*2B,0/5*3+.0+ ,1. 41,
3+.1, 2+ 41, 5*,1, +. -. E1,</0*4G

“Lo que no se monitoriza es imposible de detectar, y

 vigilar al paciente en ventilación mecánica es

responsabilidad profesional de salud implicado en su
tratamiento, ya sea enfermería, terapistas respiratorios,
médicos en formación y médicos responsables, si alguno detectase
alguna anomalía debe estar entrenado para resolverla,
independientemente su área de especialidad”. 
especialidad”. 

 VENTILACIÓN MECÁNICA AVENTHO #X

 

 
#%

 Volemia y balance hídrico

H+ >+513/+.2* +7*4-*> 8>+5-+.0+3+.0+ 4* >+,<-+,0* *
714-3+. 2+4 <*5/+.0+ C +7/0*> /.8-.2/> 3J, 4B;-/21, 2+ 41
.+5+,*>/1 +. <*5/+.0+, ;-+ C* .1 0+.9*. 5*<*5/2*2 2+
>+,<-+,0* * 714-3+. 1 ;-+ 0+.9*. /.014+>*.5/* *4 714-3+.
@dKba 2/,3/.-/2*: HZoY: H+<,/,: +05D: +7/0*> I*4*.5+ EB2>/51
<1,/0/71 +, -.* 3+2/2* ;-+ 2+3-+,0>* 3+L1>B* +. 4*
,-<+>7/7+.5/* 2+ 41, <*5/+.0+,: C* ;-+ 4* ,1I>+>>+*./3*5/6.
1 ,1I>+5*>9* EB2>/5* 9+.+>* *40+>*5/1.+, +. 4* 2/8-,/6. 2+
1AB9+.1 +. 4* 3+3I>*.* *47+1415*</4*> C 3/5>17*,5-4*0->*:
,+ >+513/+.2* 3*.0+.+> I*4*.5+ EB2>/51 .+-0>1 *
4/9+>*3+.0+ .+9*0/71 +. <*5/+.0+, ;-+ C* .1 >+;-/+>*.
>+,-5/0*5/6. 51. 84-/21,G

Estado nutricional y aporte dietético

H+ 2+I+ 7*41>*> +4 /./5/1 2+ 4* .-0>/5/6. +. +4 <*5/+.0+ I*L1
7+.0/4*5/6. 3+5J./5*: +, <>+8+>/I4+ 1<0*> <1> 4* .-0>/5/6.
+.0+>*4 2+ .1 0+.+> 51.0>*/.2/5*5/1.+,: 2+ <>+,+.0*>
/.014+>*.5/* * 4* 2/+0* <1> 7B* +.0+>*4 ,+ <-+2+ 51.,/2+>*> +4

+3<4+1 g./51 1 +. 51.L-.01 2+ <>15/.=0/51, 5131 4*

[+01541<>*3/2* 1 K>/0>13/5/.*G )* <1,/5/6. <>1.* .1 +,
51.0>*/.2/5*5/6. <*>* /./5/*> 4* .-0>/5/6. <1> 7B* +.0+>*4G H+
>+513/+.2* 9-/*>,+ <1> 3+0*, .-0>/5/1.*4+, +,0*.2*>/?*2*, *
./7+4 /.0+>.*5/1.*4G

Intercambio gaseoso
T1 ,+ >+513/+.2* 4* 013* >-0/.*>/* 2+ +,0-2/1,
9*,13=0>/51,: ,1I>+ 0121 ,/ ,+ 5-+.0* 51. 1A/3+0>B* 2+ <-4,1
#%  VENTILACIÓN MECÁNICA AVENTHO
 

 
#&

C 5*<.19>*8B* 51.0/.-*,G H+ >+513/+.2* 4* 013* 2+

9*,13+0>B* *>0+>/*4 +. 5*,1 2+ <>+,+.0*> 0>*,01>.1,
7+.0/4*01>/1, ,/9./8/5*0/71, 2+ E/<1A+3/* 1 E/<+>5*<./* <*>*
+7*4-*> 4* >+4*5/6. N*R(fd/R(: 4* N*VR( C 4* N*R(: +. 5*,1 2+
,1,<+5E* 2+ *40+>*5/6. 2+4 +;-/4/I>/1 J5/21UI*,+ ,+
>+513/+.2* 4* 013* 2+ 9*,13+0>B* 7+.1,*

K. *,<+501, 2+ >+*./3*5/6. +, 51.0>17+>,/*4 4* 013* 2+

9*,13+0>B* 7+.1,* 5+.0>*4 1 2+ ,*.9>+ 7+.1,* 3/A0* <*>*
2+0+>3/.*> 4* H75R( 1 4* 013* 2+ 9*,13+0>B* *>0+>/*4 C
7+.1,* <*>* +7*4-*> +4 Z+40* 2+ <VR( 1 +4 ZVR(fZ*7R(G

Imágenes pulmonares
T1 ,+ >+513/+.2* 4* 013* >-0/.*>/* 2+ >*2/19>*8B*, 01>J5/5*,:
,+ 2+I+ 51.,/2+>*> <*>* +7*4-*> -.* *2+5-*2* 51415*5/6. 2+4
0-I1 +.210>*;-+*4: 2/*9.1,0/5*> 1 2+,5*>0*> ,B.2>13+,
<4+->1<-431.*>+, @*0+4+50*,/*: 2+>>*3+ <4+->*4:
.+-3106>*A: +05D: <1,0+>/1> * 4* 51415*5/6. 2+ -. 2/,<1,/0/71
5131 ,1.2* /.0>*01>J5/5* 1 *.0+ 4* ,1,<+5E* 2+ -.*
.+-31.B* *,15/*2* * 4* 7+.0/4*5/6. 3+5J./5*G

)* -40>*,1.19>*8B* <-431.*> +, -. 3=0121 <*>* +7*4-*> 41,

5*3<1, <-431.*>+, 2+ 81>3* .1 /.7*,/7*: 3+.1, 51,01,*:
3J, >J</2* C * 4* 5*I+5+>* 2+4 <*5/+.0+: 51. 4* 5-*4 ,+
<-+2+. 2+0+50*> ,B.2>13+, <4+->1<-431.*>+, 2+ 3*.+>*
51.8/*I4+: *,B 5131 +7*4-*> 4* 317/4/2*2 2/*8>*93J0/5* C 8-9*
2+ 714-3+.: +.0>+ 10>*, 51,*,G

 VENTILACIÓN MECÁNICA AVENTHO #&

 

 
#'

T1 ,+ >+513/+.2* 4* 013* >-0/.*>/* 2+ +,0-2/1, 01319>J8/51,

2+ 06>*A: ,+ >+513/+.2* +. 5*,1 2+ 2-2* >*2/19>J8/5* 1
-40>*,1.19>J8/5* 2/*9.6,0/5*: C* ;-+ 4* 317/4/?*5/6. 2+4
<*5/+.0+ <12>B* 9+.+>*> >/+,91 2+ 513<4/5*5/1.+, +. 5/+>01,
5*,1,: +4 5-*4;-/+> 5*,1 ,+ 2+I+ /.2/7/2-*4/?*> C 2+0+>3/.*> +4
3+L1> +,0-2/1 /3*9+.1469/51 <*>* 4* <*01419B* 2+4 <*5/+.0+G

 A  B
 

C
Imágenes pulmonares de
utilidad. A. Rx. de Tórax,
B. TAC Tórax, C. USG
pulmonar.

Rehabilitación y fisioterapia
Z+I+ 51.,/2+>*>,+ 4* >+E*I/4/0*5/6. 51><1>*4 C 8/,/10+>*</*
<-431.*> 0+3<>*.* +. 41, <*5/+.0+, I*L1 7+.0/4*5/6.
3+5J./5*: 2+ .1 <>+,+.0*> 51.0>*/.2/5*5/6. <*>* 4* 3/,3*:
2*21 ;-+ 4* /.317/4/2*2 ,+ *,15/* * 2+I/4/2*2 2+4 3-,5-41
+,;-+4=0/51 2+4 <*5/+.0+ +. +,0*21 5>B0/51 <1> .+->1<*0B* 1

3/1<*0B* *9-2*: ;-+ <-+2+ 2/,3/.-/> 51. +,0*, +,0>*0+9/*,G

#'  VENTILACIÓN MECÁNICA AVENTHO
 

 
#h

)* 8/,/10+>*</* <-431.*> 0*3I/=. <-+2+ 81>0*4+5+> 41,

3g,5-41, >+,</>*01>/1,: 3+L1>*> +4 +,8-+>?1 /.,</>*01>/1 C
+,</>*01>/1: >+,147+> *0+450*,/*,: +05G

En tu curso se manejan conceptos innovadores en rehabili

rehabilitaci
tación
ón pulmonar

oportuna de l paciente crít

crítico
ico con ventilación mecán ica. 

Control glucémico
)1, <*5/+.0+, 9>*7+, E*I/0-*43+.0+ >+;-/+>+. 31./01>+1 2+
4* 94-51,* <*>* +7/0*> ./7+4+, 2/,3/.-/21, 1 +4+7*21, 2+ 4*
3/,3*: E*I/0-*43+.0+ ,+ <>+8/+>+. +. 5/8>*, 5+>5*.*, * ""P *
"'P 39f24 +. -. ,/0/1 51. *2+5-*2* 7/9/4*.5/*G

H+ 2+I+. I-,5*> +,0>*0+9/*, 2/+0=0/5*, C 8*>3*51469/5*, <*>*

3*.0+.+> 4* 94-51,* ,=>/5* +. >*.91, 2+ ,+9->/2*2G
 VENTILACIÓN MECÁNICA AVENTHO #h
 

 
$P

Pulsioximetría y monitoreo no invasivo de la

oxigenación.
)* <-4,/1A/3+0>B* +, -. 3=0121 .1 /.7*,/71 ;-+ <+>3/0+ 4*
>J</2* 3+2/5/6. 2+ 4* ,*0->*5/6. 2+ 1AB9+.1 2+ 4*
E+31941I/.* +. ,*.9>+ *>0+>/*4G 

Interpretación clínica.
)* <-4,/1A/3+0>B* 3/2+ 4* ,*0->*5/6. 2+ 1AB9+.1 +. 4* ,*.9>+:
<+>1 .1 3/2+ 4* <>+,/6. 2+ 1AB9+.1 @N*R(D: 4* <>+,/6. 2+
2/6A/21 2+ 5*>I1.1 @N*VR(D 1 +4 <QG N1> 0*.01: .1 ,-,0/0-C+ *
4* 9*,13+0>B* +. 4* 7*41>*5/6. 513<4+0* 2+ 41, +.8+>31,
5>B0/51,G H/. +3I*>91: ,-<+>* * 4* 9*,13+0>B* +. >*</2+? C +.
4* 31./01>/?*5/6. 2+ +,01, +.8+>31,G )1, *<*>*01,
2/,<1./I4+, +. 4* *50-*4/2*2 ,1. 3-C 8/*I4+, <*>* 7*41>+,
+.0>+ +4 'P C +4 "PPS: <+>1 ,- 8/*I/4/2*2 2/,3/.-C+ <1>
2+I*L1 2+ +,0*, 5/8>*,G

H*0->*5/6. 2+ R( N*R( +. 33Q9

"PPS %&&
h'S "PP
hXS 'P
hPS %P
'PS $'
&#S $P
%PS #P
relación entre SpO2 y PaO2.  
Tabla de relación

$P  VENTILACIÓN MECÁNICA AVENTHO

 

 
$"

KA/,0+ -. 7*41> 5>B0/51M N*R( %P 33 2+ Q9 ;-+ ,+

51>>+,<1.2+ 51. -.* ,*0->*5/6. 2+4 hPS: <1> 2+I*L1 2+ 4*
5-*4: <+;-+F*, 2/,3/.-5/1.+, 2+ 4* N*R( 15*,/1.*.
2+,*0->*5/1.+, /3<1>0*.0+,G N1> +4 51.0>*>/1: <1> +.5/3* 2+4
hXS: 9>*.2+, *-3+.01, 2+ 4* N*R( .1 ,-<1.+. /.5>+3+.01,
,/9./8/5*0/71, 2+ 4* ,*0->*5/6. 2+ 1AB9+.1G K4 <-.01 5>B0/51 ;-+
2+I+ 2*> 4* ,+F*4 2+ *4*>3* +, +4 2+ ,*0->*5/1.+, /.8+>/1>+, *4
hXS @/.8+>/1>+, *4 hP 6 h(S 5-*.21 +A/,0+ <*01419B*
<-431.*> 5>6./5* <>+7/*D +,01, <*5/+.0+, 2+I+. >+5/I/>
0>*0*3/+.01 /.3+2/*01G

Esquema de diversas circunst

circunstancias
ancias detectadas en una onda pletismográfi
pletismográfica
ca

K4 >$=&)# =# D(%F6()&*$ ./6 /3&+#%6>( =# .F':/ :/E6# '(

<6())&*$ ]$:.&6(=( =# A3>?#$/ @D.A57<&A5B <-+2+ -0/4/?*>,+
<*>* 31./01>/?*> 2+ 81>3* .1 /.7*,/7* 4* 1A/9+.*5/6.: 51. 4*

 VENTILACIÓN MECÁNICA AVENTHO $"

 

 
$(

9>*. 7+.0*L* ,1I>+ 4* N*R(fd/R( <1> .1 >+;-+>/> 2+ -.

+,0-2/1 9*,13=0>/51 *>0+>/*4G

)* H<R(fd/R( 2+ (#% * #"X 51>>+4*5/1.* 51. -.* N*R(fd/R(

2+ (PP * #PP C -.* H<R(f d/R( O(#% 51>>+4*5/1.* 51. -.*
N*R(fd/R( O(PP 51.54-C+.21 >+,-40*21, ,/3/4*>+,:
,1I>+0121 +. <*5/+.0+, 51. 2/,0>=, >+,</>*01>/1 *9-21G

Capnografía y capnometría en monitorización

de la Ventilación Mecánica.
)* 5*<.19>*8B*
*.EB2>/21 +, 4*1 3+2/5/6.
5*>I6./51 2/6A/21 2+51.0/.-* C .1 +AE*4*21
5*>I1.1 @VR(D /.7*,/7* 2+4
+.
-.* 4B.+* 2+4 0/+3<1G

K, /3<1>0*.0+ 2+,0*5*> ;-+ +4 VR( +AE*4*21 ,+ <-+2+ 3+2/>

51. 4* 3+2/5/6. 5*<.19>J8/5* C ,+ 51.15+
/.0+>.*5/1.*43+.0+ 51. 4*, ,/94*, KcVR(G V1. +4 8/. 2+ +7/0*>
+>>1>+, <1,0+>/1>+, 2+ /.0+><>+0*5/6.: 0*3I/=. 51.7/+.+

+A<4/5*> 4* 2/8+>+.5/* +.0>+ 5*<.13+0>B* C 5*<.19>*8B*: C*

;-+ ,1. 0=>3/.1, * 3+.-21 +3<4+*21, /.2/,0/.0*3+.0+ 2+
81>3* /.*2+5-*2*G Y,B <-+,: 3/+.0>*, 4* 5*<.13+0>B*
,/3<4+3+.0+ .1, <+>3/0+ 51.15+> +4 7*41> .-3=>/51: 3+2/21
9+.+>*43+.0+ +. 33Q9: c1>> 1 nN* 2+4 VR( +AE*4*21 L-.01
51. 4* 8>+5-+.5/* >+,</>*01>/* @doD: 9>*5/*, * -. 5*<.69>*81: 4*
5*<.19>*8B* 18>+5+: *2+3J, 2+ 0121 41 *.0+>/1>: 4*
>+<>+,+.0*5/6. 9>J8/5* 2+ 2/5E* +AE*4*5/6. +. 8-.5/6. 2+4

0/+3<1: +4 2+.13/.*21 5*<.19>*3*G

$(  VENTILACIÓN MECÁNICA AVENTHO
 

 
$#

Esquema de onda normal de capnografía.

Factores que modifican la medición del CO2 exhalado.

)* 3+2/5/6. 2+4 VR( +AE*4*21 ,+ <12>J 7+> *8+50*2* <1> #
8*501>+,M
"VUB J' +#%(E/'&:+/ @21.2+ ,+ <>12-5+Di
(GUD W( .#6KF:&*$ @+4 3+2/1 2+ 0>*.,<1>0+ E*,0* +4 <-436.D: C
#GUD W( "#$%&'()&*$ @,/,0+3* 2+ +4/3/.*5/6.DG

)* *40+>*5/6. 54B./5* 2+ 5-*4;-/+>* 2+ +,01, <>15+,1,

<>12-5/>J 7*>/*5/1.+, 51.0/.-*, C ,/9./8/5*0/7*, +. 41, 7*41>+,
1I0+./21, C 3+2/21, +. +4 5*<.69>*81 @K0VR(D: 2+4 3/,31
3121 ;-+ 4*, *40+>*5/1.+, ;-+ <-+2*. <>1715*> -. +,0*21
2+ E/<1A+3/* ,+ 7+>J. >+84+L*21, +. 41, >+,-40*21,
*45*.?*21, <1> 4* 1A/3+0>B* 2+ <-4,1 @H<R(DG

 Alteraciones que incrementan el EtCO2.

EtCO2 .
wL#%(E/'&:+/M Y-3+.01 2+4 3+0*I14/,31 C 2+4 51.,-31 2+
R(: <1> +L+3<41: +. 5-*2>1, /.8+55/1,1,f,+<,/,: +,0*21,
/./5/*4+, 2+ ,E15n: E/<+>0+>3/* 3*4/9.*: 2141>:
 VENTILACIÓN MECÁNICA AVENTHO $#
 

 
$$

0+3I41>+,f51.7-4,/1.+, @*-3+.01 2+ 4* *50/7/2*2 3-,5-4*>DG

Y23/./,0>*5/6. /.0>*7+.1,* 2+ I/5*>I1.*01 ,62/51G
wG#6KF:&*$M Y-3+.01 2+4 9*,01 5*>2B*51: *40+>*5/1.+, 2+ 41,
3+5*./,31, 2+ *-01>>+9-4*5/6. @<1> +L+3<41: +. <*5/+.0+,
51. E/<+>0+.,/6. /.0>*5>*.+*4DG
w8#$%&'()&*$M a.,-8/5/+.5/* >+,</>*01>/*: 2+<>+,/6.
>+,</>*01>/*: <>15+,1, 2+ ,+2*5/6. Cf1 *.*49+,/*: 5-*4;-/+>
+,0*21 54B./51 ;-+ <>171;-+ -.* 2/,3/.-5/6. 2+ 4* do Cf1 2+4
714-3+. 51>>/+.0+ C 1I,0>-55/6. 2+ 4* 7B* *=>+*G
wD#)F$=(6&(: ( K(''/: =#' #^F&./M bJ47-4* 2+ /.E*4*5/6. Cf1
+AE*4*5/6. 2+8+50-1,*: +A5+,/71 +,<*5/1 3-+>01 @0-I1,
4*>91,: 51415*5/6. 2+ 2/,<1,/0/71, /.0+>3+2/1,DG

 Alteraciones que disminuyen el EtCO2.

_L#%(E/'&:+/1 K,0*21, ;-+ /.5>+3+.0*. +4 51.,-31 2+ R(
5131 15->>+ 2->*.0+ 4* E/<+>0+>3/*: ,+<,/, 1 ;-+3*2->*,:
V+01*5/21,/,G
_G#6KF:&*$1 Z/,3/.-5/6. 2+4 9*,01 5*>2B*51: <1> +L+3<41: +.
5-*2>1, 2+ E/<10+.,/6. *>0+>/*4: E/<1714+3/*: <*>1
5*>2/1>>+,</>*01>/1: 0>13I1+3I14/* <-431.*>G
_8#$%&'()&*$M V-*4;-/+> +,0*21 54B./51 ;-+ <>171;-+ -.
*-3+.01 2+ 4* do Cf1 2+4 714-3+. 51>>/+.0+: +, 2+5/>:
E/<+>7+.0/4*5/6.: <>+,+.5/* 2+ /3<1>0*.0+ *5-3-4*5/6. 2+
3-51,/2*2 I>1.;-/*4: 8B,0-4* I>1.51<4+->*4 C *-3+.01
8/,/1469/51 2+4 +,<*5/1 3-+>01G

$$  VENTILACIÓN MECÁNICA AVENTHO

 

 
$X

_D#)F$=(6&(: ( K(''/: =#' #^F&./M 8-9*, 2+4 ,/,0+3*:

51415*5/6. /.*2+5-*2* 2+ 4* 5J.-4*: 0*3*F1 C <1,/5/6. 2+4
0-I1 +.210>*;-+*4 @cKcD: 2+,51.+A/6. 2+4 >+,</>*21>: 8*441 +.
+4 84-L1 2+4 */>+f1AB9+.1G

Objetivos gasométricos:
! <*R(M %P k "PP 33Q9
! <VR(M #X k $X 33Q9 @* ./7+4 2+4 3*>: 1 .1>31A+3/* *
5-*4;-/+> *40->* * 4* ;-+ ,+ +.5-+.0>+ E*I/0-*21 +4
<*5/+.0+D

Monitoreo avanzado
K. 5*,1 2+ <*5/+.0+, +. +,0*21 2+ 5E1;-+ C HB.2>13+ 2+ Z/,0>=,
o+,</>*01>/1 Y9-21 ,+ <-+2+ 51.,/2+>*> +4 31./01>+1 *7*.?*21: ;-+
/.54-C+ 4* c+>312/4-5/6.c>*.,<-431.*> <*>* +7*4-*> 4*, 7*>/*I4+,
E+312/.J3/5*, *,B 5131 +4 *9-* +A0>*7*,5-4*> <-431.*> + B.2/5+ 2+
<+>3+*I/4/2*2 7*,5-4*> <-431.*>i 0*3I/=. <-+2+ 51.,/2+>*>,+ +4
+3<4+1 2+ 5*0+0+>/,31 * 4* *>0+>/* <-431.*> +. <*5/+.0+, 51. *40*
,1,<+5E* 2+ 2/,8-.5/6. 7+.0>/5-4*> 2+>+5E*: 5*2* 5*,1 2+I+>J ,+>
/.2/7/2-*4/?*21 C ,1<+,*> +4 51,01U>/+,91UI+.+8/5/1 2+4 31./01>+1 *
+3<4+*>G

paciente-ve
 Asincronía pa ciente-ventilador.
ntilador.
La asincronía paciente-ventilador existe si las fases de la respiración
suministrada por el ventilador no se ajustan a las del paciente. Es común
que durante la ventilación mecánica más del 10% de las respiraciones
son asíncronas en aproximadamente el 24% de los pacientes con
ventilación mecánica, lo cual puede causar lesión inducida por ventilación
mecánica, disnea, aumentar el trabajo respiratorio y prolongar la duración

 VENTILACIÓN MECÁNICA AVENTHO $X

 

 
$%

de la ventilación mecánica. Se puede detectar mediante una cuidadosa

observación del paciente y el examen de las formas de onda del ventilador

Los profesores AVENTHO estarán al pendiente para que logres desarrollar

las habilidades necesarias para la adecuada Ventilación Mecánica de un
paciente crítico.

$%  VENTILACIÓN MECÁNICA AVENTHO

 

 
$&

V1. +4 ,/9-/+.0+ 512/91 e> <-+2+, 2+,5*>9*> 4*, 0*>L+0*, 2+

0>*I*L1 YbKTcQRG

`8]DA ]LGAT-`M-J1
Z->*.0+ .-+,0>1, 5->,1, <12>*, +.51.0>*> 4* ">*G K2/5/6. 2+4
L($F(' =# 8#$%&'()&*$ L#),$&)( `8JM-2A  2+ K2/01>/*4
NoYZRG
V1.0*501M
KU3*/4M 5>/0/5*4G;*>+x93*/4G513 
5>/0/5*4G;*>+x93*/4G513 
d*5+I11nM b+.0/4*5/6. [+5J./5* Y7+.0E1
N*9/.* _+IM ___G,/+3<>+7/>0-*4G513f+.0>+.*3/+.015>/0/51 
___G,/+3<>+7/>0-*4G513f+.0>+.*3/+.015>/0/51 

yE*0,Y<<M mX( " $$( "'" 'X""

 VENTILACIÓN MECÁNICA AVENTHO $&
 

 
$'

Referencias y literatura recomendada

  V*,0>1 c>/441 tY: ]*>5B* d+>.J.2+? tYG N>1015141 2+ /.0-I*5/6.
•

+.210>*;-+*4G K.M [*>0B. o12>B9-+? [Z: ]63+? bJ?;-+? o: N-+.0+

d+>.J.2+? tG V11>2G N>1015141, 2+ Y,/,0+.5/* N>+E1,</0*4*>/* *4 N*5/+.0+
N14/0>*-3*0/?*21G H*.0/*91 2+ V13<1,0+4*M d-.2*5/6. NgI4/5* P%"U
u>A+.5/*, H*./0*>/*, 2+ ]*4/5/*: \-.0* 2+ ]*4/5/*: "hhhG
 
• ]>-<1 2+ c>*I*L1 +. o+*./3*5/6. V*>2/1<-431.*> Y7*.?*2* 2+ 4*
H15/+2*2 K,<*F14* 2+ [+2/5/.* 2+ K3+>9+.5/*,G o+513+.2*5/1.+, +.
o+*./3*5/6. V*>2/1<-431.*> Y7*.?*2*G [*2>/2M K2/513<4+0: "hhhG
#G a.81>3*5/6. 2+ 3+2/5*3+.01, <*>* +4 <>18+,/1.*4 ,*./0*>/1G "$z +2G
[*2>/2M [/./,0+>/1 2+ H*./2*2 C V1.,-31: H+5>+0*>B* ]+.+>*4 c=5./5*:
"hhXG
 
• ]>-<1 2+ c>*I*L1 2+ Y,/,0+.5/* a./5/*4 *4 N*5/+.0+ c>*-3*0/?*21 2+ 4*
H15/+2*2 K,<*F14* 2+ [+2/5/.* 2+ K3+>9+.5/*,G o+513+.2*5/1.+,
Y,/,0+.5/*4+, +. c>*-3* ]>*7+G [*2>/2M K2/513<4+0: "hhhG
 
• H+<g47+2* H: H*-7*9+1. \: t+2>+5 tN: H*4*3*9.+ tV: o/05E+> d: d-/44* V +0
*4G ]-B* N>J50/5* 2+ [+2/5/.* 2+ u>9+.5/*, N>+E1,</0*4*>/*,G ^*>5+41.*M
dcT +2/01>+,: "hhhG
 
• V4/.+ Z[G Y<1C1 *7*.?*21 * 4*, 7B*, >+,</>*01>/*,G K.M Y3+>/5*. V144+9+
18 K3+>9+.5C NEC,/5/*G [*.-*4 2+ [+2/5/.* 2+ u>9+.5/*,G $Gz +2G
[=A/51 ZdM [5]>*_UQ/44 a.0+>*3+>/5*.*: "hh'i #U"PG
 
• o+9/1.*4 9*, KA5E*.9+ *.2 5+4-4*> 3+0*I14/5 *50/7/0C /. 7+.0/4*01>U
/.2-5+2 4-.9 /.L->CG [-,5E ]: b+.+9*, t]: ^+44*./ ]: y/.n4+> c:
H5E1>1+2+> c: N+0+>,+. ^: Q*>>/, oH: [+41 [dG Y.+,0E+,/1419C (PP&i "P%
@$DM &(#U&#X
 
• a.L->/1-, 7+.0/4*0/1. /.2-5+, _/2+,<>+*2 <-431.*>C +</0+4/*4 +A<>+,,/1.
1> 0-31> .+5>1,/, 8*501> *4<E* *.2 /.0+>4+-n/.U% 3+,,+.9+> oTYG
c+3I4*C )T: [/*001 Z: Q*3/2 e: ]17/.2*>*L*. Y: H4-0,nC YH: V>/0/5*4 V*>+
[+2G (PP( #P @'D: "%h#U"&PPG
 
• K88+50 18 >10+50/7+ 7+.0/4*0/1. ,0>*0+9C 1. 31>0*4/0C /. 0E+ *5-0+
>+,</>*01>C 2/,0>+,, ,C.2>13+G Y3*01 [^: ^*>I*, VH: [+2+4>1, Z[G TG
K.94t[+2 "hh'M ##'i #$&U#X$G
 
• Y5-0+ o+,</>*01>C Z/,0>+,, ,C.2>13+ .+0_1nb+.0/4*0/1._/0E 41_+> 0/2*4
714-3+. 513<*>+2 _/0E 0>*2/0/1.*4 0/2*4 714-3+, 81> *5-0+ 4-.9 /.L->C

$'  VENTILACIÓN MECÁNICA AVENTHO

 

 
$h

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"#P"U"#P'G
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Y>*.5/I/* Q+>.*.2+?: o12>/91 H101 d/9-+>1*G o+7/,0*VE/4+.* 2+
[+2/5/.*a.0+.,/7* (P"Pi 714 (X @$DM(PXU("P
•
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^+.0+, [: ^*>I1?* c: V*<+41??/ b): [1>*4+, [[: ]*>5/* V,: H1-?* HY:
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•   Z>/7/.9 <>+,,->+ *.2 ,->7/7*4 /. 0E+ *5-0+ >+,</>*01>C 2/,0>+,, ,B.2>13+G
[*>5+41 ^N: Y3*01 [Z: [*->++. R: [+*2+ Z[: Y>0E-> H: H4-0,nC [Z:
)*->+.0 ^>15E*>2 [Z: K2-*>21 )b: V1,0* [Z: Z*7/2 YG H5E1+.8/+42: NQ
Z cE13*, K: H0+_*>0 [Z: [*00E/*, ^>/+4 [Z: Z*./+4 c*431> [Z: [NQ
Y4*/. [+>5*0: [Z t+*.UVE/,01<E+ [G o/5E*>2 [Z: V*>41, oo: V*>7*4E1

[Z: *.2 o1C ]G ^>1_+> [ZG

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YoZHG 9 :,;. < ='1  (P"Xi
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3+5J./5*G ja.0+>.+0l "z +2/5/6.G [*2>/2M [*>9+ [=2/5* ^11n,i (P"(G
jT17/+3I>+ (P"%l Z/,<1./I4+ +.M
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