RESUMENLa movilización temprana (MT) es la implementación de ejercicio físico en los pacientes ingresados en la Unidad de Cuidados Intensivos (UCI) observándose beneficios importantes como reducción de neumonías asociadas con ventilación mecánica (NAVM), trombosis venosa profunda, úlceras por presión, debilidad adquirida en la UCI (DAUCI). Además, tiene un impacto financiero al reducir los días de estancia hospitalaria y en la UCI. Cabe mencionar que la MT impacta en el desenlace posterior al alta hospitalaria reduciendo la aparición de síndrome postcuidados intensivos (PICS).
Invasive mechanical ventilation is a frequent therapy in critically ill patients in critical care units. To achieve favorable outcomes, patient and ventilator interaction must be adequate. However, many clinical situations could attempt against this principle and generate a mismatch between these two actors. These asynchronies can lead the patient to worst outcomes; because of that is vital to recognize and treat these entities as soon as possible. Early detection and recognition of the different asynchronies could favor the reduction of the days of mechanical ventilation, the days of hospital stay, and in intensive care and improve clinical results.
Ultrasound is a pluripotential tool that has been shown to be useful in the diagnostic study and evolutionary control of different pathologies. The use of protocols (BLUE, FALLS, PINK) has shown high diagnostic precision in entities such as pneumonia, pulmonary embolism, pneumothorax, heart failure, diaphragmatic or musculoskeletal evaluation. Its exponential growth has positioned the technique as the preferred option for non-invasive and bedside evaluation. This article proposes a simplified and non-systematic review, of quick and easy reading, of the reasons why ultrasound has become, in recent years, a standard of care for critically ill patients.
The patient with tracheostomy could has a functional progression as soon as possible if the clinical stability allow the intervention in the critical ill patient. It is important to remove the mechanical ventilation quickly and safety. Every day is needed to make evaluation and interventions for progress thinking in a tracheostomy protocol decannulation.
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