Ventilación no invasiva en insuficiencia respiratoria aguda

Abstract

Non-invasive ventilation in acute respiratory failure Background: Non-invasive ventilation (NIV) has become a therapeutic tool for acute respiratory failure in pediatric patients. Objective: To describe NIV experience at a Pediatric Intensive Care Unit, identifying factors associated to modality failure. Methods: Patients cohort who received NIV in acute respiratory failure during 2005-2007. Recolection of clinical and gasometrical variables previous and subsequent to connection to NIV. Descriptive statistic and logistic regression analysis were performed. Results: 51 events of NIV, where 55% cases were congenital cardiopathies. NIV main indication was respiratory distress post-extubation (31.4%). 15 patients (29.4%) required CMV. In univariate logistic regression for variables, an independent association was found between FiO2 pre-connection and FiO2 subsequent to NIV connection, with necessity of CMV. 9% presented complications and mortality was not related to ventilatory modality. Conclusions: NIV is useful in pediatric patients with acute respiratory insufficiency, with low risk of complications. The variables associated with failure are easy to obtain and interpretate.

Las políticas públicas para el cultivo de palma de aceite. El caso de la región Soconusco, Chiapas, México

“…In Mexico, diverse are the governmental policies that explicitly or implicitly have as one of their adjectives and objectives the territorial part. Almost all the secretariats of state have a strategy with a territorial approach in their programs; this approach became a trend when it was launched by the Instituto Interamericano de Cooperación para la Agricultura (IICA) at the beginning of the first decade of this century (Sepúlveda, Rodríguez, Echeverri, & Portilla, 2003). The IICA identified the persistence of rural poverty and inequality, the already recognized insufficiency of structural reforms, the importance of non-agricultural activities in rural areas and the increasingly widening sectoral and regional gaps.…”

“…The IICA promoted territorial rural development; this approach considers the territory "as a social and historical product, which gives it a unique social fabric, gifted with a certain base of natural resources, certain forms of production, consumption and exchange, and a network of institutions and forms of organization that are responsible for giving cohesion to the rest of the elements" (Sepúlveda, et al, 2003). Ideally, the approach sought to break with the productivist and sectoral vision in rural development, since in its consideration the notion of territory "explains better the inter-sectoral relations and enhances the multidisciplinary work. "…”

“…Las políticas gubernamentales y los territorios de la palma de aceite En México, diversas son las políticas gubernamentales que explícita o implícitamente tienen como uno de sus adjetivos y objetivos lo territorial. Casi todas las secretarías de estado tienen en sus programas una estrategia con enfoque territorial, dicho enfoque se puso de moda cuando fue lanzado por el Instituto Interamericano de Cooperación para la Agricultura (IICA) a principios de la primera década del presente siglo (Sepúlveda, Rodríguez, Echeverri, & Portilla, 2003). El IICA identificaba la persistencia de la pobreza rural y la desigualdad, la ya reconocida insuficiencia de las reformas estructurales, la importancia de las actividades no agrícolas del medio rural y las cada día más amplias brechas sectoriales y regionales.…”

“…El IICA impulsó el desarrollo rural territorial, dicho enfoque considera al territorio "como un producto social e histórico -lo que le confiere un tejido social único-, dotado de una determinada base de recursos naturales, ciertas formas de producción, consumo e intercambio, y una red de instituciones y formas de organización que se encargan de darle cohesión al resto de los elementos" (Sepúlveda, et al, 2003), idealmente el enfoque buscaba romper con la visión productivista y sectorial en el desarrollo rural, ya que en su consideración la noción de territorio "explica mejor las relaciones intersectoriales y potencia el trabajo multidisciplinario". Discursiva y operativamente el enfoque fue adoptado por el gobierno mexicano a través de la SAGARPA, y para ello, en donde existían, se impulsó a través de los approximately 34 815 are harvested, generating 4 % of the total production value of the Chiapas sector and ranking eighth among all crops (CEIEGCh, 2016).…”

Impact of a Noninvasive Ventilation Protocol in Hospitalized Children With Acute Respiratory Failure

“…In addition, there is evidence that NIV may improve ventilation and oxygenation in patients with acute lower respiratory infection, even reducing the need for intubation. [6][7][8][9][10][11] However, despite the benefits of NIV, the development of specific criteria for its initiation and discontinuation in the pediatric population is limited mainly because of poorly detailed ventilatory strategies and heterogeneity of patients and their pathologies. 6,[11][12][13] The use of standardized criteria and guidelines in clinical practice constitutes a safe, uniform therapeutic approach capable of preventing potential harm to the patient.…”