Formato Vancouver:
Frade Mera MJ, Vergara Díez L, Fernández Gaute N, Montes Gil D. Decúbito prono en paciente portador de dispositivo de extracción extracorpórea de CO2 Novalung®. Enferm Intensiva. 2012 Jul-Sep;23(3):132-41.

PMID: 22726348

Contiene 40 referencias

OBJECTIVE: To describe the course of a patient with the extracorporeal CO2 removal device and discover the effect of Novalung on ventilation, considering the patient's prone position and its influence on the device's blood flow. To develop a protocol of managing and specific care of a patient with Novalung. MATERIAL AND METHODS: A case report of a patient with Novalung in a tertiary hospital ICU unit is reported. Parameters considered are hemodynamic, respiratory, pharmacological, analytical, neuromonitoring, managing of the Novalung and length of decubitus prone cycles. Anova Test, Student's T test, Wilcoxon-Mann Whitney and Spearman correlation. Significance p <0.05. RESULTS: A 46-year old women with nosocomial pneumonia and acute respiratory failure with indication of Novalung to decrease hypercapnia and optimize ventilatory management of refractory hypoxemia. ICU Stay 26 days, MBP 82 9 mmHg, HR 110 6l pm during the admission, monitoring PICCO 5 days CI 3.2 0.8 l/min/m2, ELWI 33 4 ml, continuous hemofiltration 13.2 days with a median removal 50 cc/h. Norepinephrine dose 0.68 0.79 mu/kg/min for 15 days. Respiratory parameters during the admission: PO2 59 13 mmHg, PCO2 68 35 mmHg, SatO2 85 12%, PO2/FIO2 69 35, tidal volume 389 141 cc. Novalung 13 days, heparin dose 181.42 145 mIU/Kg/min, Cephalin time 57.56 16.41 sec, O2 flow 7 3 l/min, median blood flow 1030 cc/h, interquartile range 1447-612 cc/h. Prone cycles 4, duration 53 27 hours. With Novalung PCO2 decreased regardless of position 66 21:56 9, p=0.005. Tidal volume 512 67:267 72, p=0.0001. Blood flow on supine-prone position 1053 82:113 112, p=0.001. There was no link between blood flow and PCO2 (p=0.2) and between O2 and PO2 flow (p=0.05). Specific care: pedal and tibial pulse monitoring, keep circuit safe to prevent and detect signs of bleeding, femoral arterial and venous catheter care, coagulation monitoring. COMMENTS: During the use of Novalung protective, ventilation, low tidal volumes, decreased pressure plateau, PEEP and hypercapnia were achieved. Blood flow decreased in prone position, but the PCO2 did not increase. The device did not coagulate.