Eficacia sobre la instilación de suero fisiológico endotraqueal, previo a la aspiración de secreciones

Irene López Martín

Irene López Martín Enfermera en Unidad de Cuidados Intensivos del Hospital Universitario Clínico San Carlos. Madrid

Palabras clave: Suero, Fisiología, Tubos endotraqueales, secreciones respiratorias, secreciones de aspiración, ventilación mecánica, instilación de solución salina normal

Key-words: Endotracheal tubes, respiratory secretions, aspiration secretions, mechanical ventilation, normal saline instillation

Resumen

Objetivo: El objetivo de este trabajo es encontrar las evidencias científicas que acrediten la eficacia de instilar suero fisiológico en el tubo endotraqueal previamente a la aspiración de secreciones, y los riesgos que su práctica conlleva. Métodos: se realiza una revisión bibliográfica sobre la realización de la técnica, las indicaciones, beneficios y efectos secundarios, se compara con la aspiración sin instilación previa y cuál de ellas es la más apropiada aplicar. La muestra son pacientes adultos ingresados en Unidades de Cuidados Intensivos. Resultados: Se ha encontrado una gran controversia en los estudios sobre si es aconsejable su uso. La aspiración de secreciones tiene efectos secundarios que pueden agravar la situación basal del paciente, cuando se instilaba previamente suero fisiológico estos efectos eran más duraderos e incluso a veces más graves, pero en pocos estudios las diferencias eran significativas estadísticamente como para poder llegar a una conclusión. No se han encontrado más beneficios al instilar suero fisiológico antes de la aspiración. Por ello, no se aconseja su uso rutinario. Serían necesarios más ensayos clínicos para valorar si las diferencias son significativas y poder llegar a una conclusión en la que se aconseje o no el uso de la técnica en base al riesgo/beneficio que conlleva. Por tanto también es importante conocer las formas de prevención de formación de secreciones en el tubo endotraqueal

Abstract

Background: The objective of this work is to find the scientific evidence that proves the effectiveness of instilling physiological serum in the endotracheal tube prior to the aspiration of secretions, and the risks that its practice entails. Methods: For this, a bibliographic review is performed on the performance of the technique, indications, benefits and side effects, compared with aspiration without previous instillation and which one is the most appropriate to apply. The sample are adult patients admitted to Intensive Care Units. Results: A great controversy has been found in the studies on whether its use is advisable. The aspiration of secretions has side effects that may aggravate the patient's baseline situation, when previous physiological serum was instilled were more durable and sometimes even more serious but in few studies the differences were statistically significant to be able to reach a conclusion. No further benefits have been found by instilling prior physiological serum. Therefore, its routine use is not advised. Further clinical trials would be needed to assess whether the differences are significant and to be able to make a conclusion in which the use of the technique is advised based on the risk / benefit that it entails. Therefore it is also important to know the forms of prevention of formation of secretions in the endotracheal tube

Bibliografía

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Eficacia sobre la instilación de suero fisiológico endotraqueal, previo a la aspiración de secreciones

Efficacy on the instillation of serum physiological endotracheal, prior to Secretions aspiration

Resumen

Abstract

Bibliografía