Resumen
Objetivo: Evaluar la relación entre el riesgo de hipoxemia en pacientes sometidos a intubación orotraqueal mediante el método de secuencia rápida y el uso de preoxigenación con ventilación no invasiva como herramienta de prevención. Métodos: Revisión bibliográfica integradora, que utilizó la base de datos electrónica PubMed Central (PMC). Los términos de búsqueda incluyeron “Ventilación no invasiva”, “Preoxigenación”, “Hypoxemia” de 2019 a 2024. Luego de aplicar la estrategia de búsqueda, se encontraron 594 artículos y se seleccionaron un total de 13 artículos para su análisis detallado. Resultados: Los resultados mostraron mejores resultados en pacientes adultos pré-oxigenados con ventilación no invasiva sometidos a intubación orotraqueal de secuencia rápida. Los estudios comparativos sobre la implementación de nuevos dispositivos de ventilación asociados, como CNAF, COT y HFNC - en el procedimiento discutido - aún no resultaron concluyentes en cuanto a un aumento en la mejora de estos resultados. Consideraciones finales: Es evidente la importancia de individualizar la terapia para cada grupo de pacientes, la cual debe realizarse según patologías y comorbilidades. Así, será posible definir la herramienta más eficaz para prevenir la hipoxemia relacionada con el procedimiento de intubación orotraqueal.
Referencias
ADAMS JY, et al. Association Between Peripheral Blood Oxygen Saturation (SpO2)/Fraction of Inspired Oxygen (FiO2) Ratio Time at Risk and Hospital Mortality in Mechanically Ventilated Patients. The Permanente Journal, 2020; 24(9): 1-7.
BARBOSA A e MOSIER JM. Preoxygenation and apneic oxygenation in emergency airway management. Clinical and Experimental Emergency Medicine, 2024; 11(2): 136-144.
CHAUDHURI D, et al. High-flow nasal cannula compared with noninvasive positive pressure ventilation in acute hypoxic respiratory failure: a systematic review and meta-analysis. 2023; 5(4).
FONG KM, et al. Preoxygenation before intubation in adult patients with acute hypoxemic respiratory failure: a network meta-analysis of randomized trials. Critical Care, 2019; 23(1): 319.
GRIECO DL, et al. Non-invasive ventilatory support and high-flow nasal oxygen as first-line treatment of acute hypoxemic respiratory failure and ARDS. Intensive Care Med, 2021, 47: 851-866.
HAMEED IZS, et al. Does apneic oxygenation with nasopharyngeal cannula during intubation improve the oxygenation in patients with acute hypoxemic respiratory failure compared to the standard bag valve mask preoxygenation? An open‐labeled randomized control trial. Turkish Journal of Emergency Medicine, 2024; 24: 33-40.
HEN R, et al. High-flow nasal oxygenation versus face mask oxygenation for preoxygenation in patients undergoing double-lumen endobronchial intubation: protocol of a randomised controlled trial. BMJ Open, 2024; 14: 1-9.
JAIN R, et al. Correlation of oxygenation índices in invasive mechanical ventilated adult patients. Lung India 2024; 41: 176-80.
KESHAVJEE S, et al. Non-invasive support for the hypoxaemic patient. British Journal of Hospital Medicine, 2023; 84(1): 1-10.
LIU K, et al. Management of Postoperative Hypoxemia. Respiratory Care, 2021; 66: 1136-1145.
OSMAN A, et al. Helmet continuous positive airway pressure vs. high flow nasal cannula oxygen in acute cardiogenic pulmonary oedema: a randomized controlled trial. European Heart Journal: Acute Cardiovascular Care, 2021; 10: 1103-1111.
OWENS RL, et al. Supplemental oxygen and noninvasive ventilation. EUROPEAN RESPIRATORY REVIEW SERIES, 2023; 32: 220159.
RODRIGUEZ M, et al. Noninvasive ventilation vs. high-flow nasal cannula oxygen for preoxygenation before intubation in patients with obesity: a post hoc analysis of a randomized controlled trial. Ann. Intensive Care, 2021; 11: 1-14.
SHANG X e WANG Y. Comparison of outcomes of high-flow nasal cannula and noninvasive positive-pressure ventilation in patients with hypoxemia and various APACHE II scores after extubation. Therapeutic Advances in Respiratory Disease, 2021; 15: 1-11.
STEFAN M, et al. Protocol for two-arm pragmatic cluster randomized hybrid implementation-effectiveness trial comparing two education strategies for improving the uptake of noninvasive ventilation in patients with severe COPD exacerbation. Implement Sci Commun, 2020; 1: 46.
TONG X, et al. Clinical outcomes of high-flow nasal cannula oxygen therapy in acute heart failure patients with hypoxemia: A retrospective cohort study. Medicine, 2022; 101(43): 31124.
VETRUGNO L, et al. Noninvasive respiratory support in the perioperative setting: a narrative review, Frontiers in Medicine, 2024; 11: 1364475.
WETSCH WA, et al. A special oropharyngeal oxygenation device to facilitate apneic oxygenation in comparison to high flow oxygenation devices. Med Gas Res, 2022; 12(1): 28-31.
ZHANG C e OU M. Comparison of hypoxemia, intubation procedure, and complications for non-invasive ventilation against high-flow nasal cannula oxygen therapy for patients with acute hypoxemic respiratory failure: a non-randomized retrospective analysis for effectiveness and safety (NIVaHIC-aHRF). BMC Emerg Med, 2021; 21: 1-10.
ZHANG W, et al. Incidence of oxygen desaturation using a high-flow nasal cannula versus a facemask during flexible bronchoscopy in patients at risk of hypoxemia: a randomised controlled trial. BMC Pulm Med, 2022; 22: 1-8.
