Abstract

MACHADO GARCIA, Jorge Luis; FUENTES DIAZ, Zaily  and  RODRIGUEZ SALAZAR, Orlando. Oxygenation monitoring in seriously ill patients. AMC [online]. 2011, vol.15, n.4, pp.697-704. ISSN 1025-0255.

Background: the oxygen transport in the patient on critical condition is often altered, since the adaptational mechanisms to keep tissues adequately may become insufficient, therefore it is essential to evaluate and correct them. Objective: to identify and to associate the hemodynamic, metabolic, gasometric parameters that allow an oxygenation monitoring integrated analysis. Method: a prospective analytical study was conducted in the intensive care unit at the University Hospital Manuel Ascunce Domenech, from January 1989 to January 2011 (22 years). The universe of study was made up of 533 patients in shock state, of which 332 were hipovolemic, 93 were cardiogenic and 108 were septic. As inclusion criterion was suggested to all patients in shock during the first 72h of evolution and invasive monitoring. It was estimated the model using the technique of multivariate analysis, binary logistic regression and coefficients for each of the independent variables introduced. Results: mean arterial pressure association with a level of significance of 0.012 and importance 0.99 prevailed, base excess with significance of 0.012 and importance 0.82, oxygen blood pressure with significance of 0.012, importance of 0.89 and venous oxygen saturation with a level of statistical significance of 0.005 and importance 1.061. Conclusions: do not interpret in an integral way all these variables or to wait for noticeable changes of one or another, just for acting, it means loss of time, the patient may be at marked metabolic dysfunction and the difficulty of oxygen may be irreversible.

Keywords : MONITORING, PHYSIOLOGIC; CRITICAL CARE; OXYGENATION; METABOOLISM [phisiology]; PROSPECTIVE STUDIES.

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