Estratificación de la gravedad del síndrome de distrés respiratorio agudo en pediatría.

• Main Author: Rubén Ferreras Vega
• Format: Article
• Language: Spanish
• Published: AnestesiaR 2019-03-01
• Series: Revista Electrónica de AnestesiaR
• Subjects: síndrome de distres repiratorio agudo pediatrico; SDRAP; estratificación; riesgo índice; oxigenación; IO; saturación; pediatric acute respiratory distress sydrome; PARDS; Risk Stratification; oxygenation index; oxygen saturation index; OI; OSI
• Online Access: http://revistaanestesiar.org/index.php/rear/article/view/739

El síndrome de distrés respiratorio agudo pediátrico (SDRAP) es una entidad propia y diferenciada del adulto. En el año 2.015, se llegó a un consenso en la conferencia Pediatric Acute Lung Injury Consensus Conference (PALICC); dónde se realizan distintas recomenciones según el acuerdo llegado entre sus integrantes. Así, para la estratificación de la gravedad del SDRAP, en pacientes en ventilación mecánica invasiva (VMI), se utiliza el índice de oxigenación (IO). En su defecto, si no es posible obtener la PaO2, utilizaremos el índice de saturación.  ABSTRACT Risk Stratification in pediatric acute respiratory distress syndrome Is necessary to make a diference between adults and children in acute respiratory distress sydrome. Different concepts have been introduced and modified. However, it was not until 2015, at the Acute Lung Injury Consensus Conference (PALICC) (1), when pediatric acute respiratory distress sydrome (PARDS) has been recognized as an entity well differentiated from adults. Acording to PALICC agreement, some recomendations about risk stratification in PARDS for patients receiving invasive mechanical ventilation, must be followed. Instead of Pao2/Fio2 ratio, It is recommended the use of oxygenation index (OI = ([Fio2 × mean airway pressure (Paw) × 100]/Pao2)), in order to know PARDS severity (strong agreement). When arterial oxygen pressure (Pa o2) is not avalible, oxygen saturation index (OSI= ([Fio2 × Paw × 100]/Spo2)) can be used (strong agreement). Based on these recommendations, mild PARDS is defined as an OI of 4–8 (oxygen saturation index = 5–7.5), moderate as an OI of 8–16 (oxygen saturation index = 7.5–12.3), and severe as an OI > 16 (oxygen saturation index > 12.3).