Palabras clave
SARS-CoV-2
Neumonía Viral
Insuficiencia Respiratoria
Cánula Nasal de Alto Flujo
Intubación Intratraqueal
Cómo citar
Resumen
Introducción: el soporte ventilatorio es considerado primordial para la insuficiencia respiratoria aguda. Comprender la relación entre el uso del alto flujo y el resultado en pacientes con enfermedad por COVID-19 es relevante ya que ha surgido como alternativa a la intubación orotraqueal. Objetivo: determinar el efecto de la cánula nasal de alto flujo en la estancia hospitalaria y la mortalidad de pacientes con infección por SARS-CoV-2 y falla respiratoria hipoxémica durante los años 2020 y 2021 en un hospital universitario nacional. Metodología: estudio de cohorte retrospectivo entre marzo 2020 y febrero 2021, de pacientes con neumonía grave por SARS-CoV-2 y falla ventilatoria. Se evaluó la cánula nasal de alto flujo comparado con ventilación mediante intubación orotraqueal utilizando un puntaje de propensión para estancia, mortalidad y desenlaces secundarios (Infección torrente sanguíneo, insuficiencia renal aguda, entre otros). Finalmente se evaluó mortalidad a 30 días y egreso con vida mediante modelo Poisson. Resultados: se analizaron 160 pacientes (40 con cánula y 120 con intubación orotraqueal), siendo hombres 66,9 % y edad promedio 63,8 años. Fallecieron 81 pacientes (50,6 %) en los primeros 30 días de hospitalización. Después de ajuste, no se encontró asociación con mortalidad (RTIa 1,13, IC 95 %: 0,93-1,38), pero sí con menor estancia hospitalaria, frecuencia de intubación orotraqueal e insuficiencia renal aguda. Conclusión: el grupo de pacientes que recibió cánula nasal de alto flujo mostró una menor frecuencia de ventilación mecánica invasiva, estancia hospitalaria e insuficiencia renal aguda no descrita previamente, aunque no se encontró reducción en mortalidad.
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