<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0186-4866</journal-id>
<journal-title><![CDATA[Medicina interna de México]]></journal-title>
<abbrev-journal-title><![CDATA[Med. interna Méx.]]></abbrev-journal-title>
<issn>0186-4866</issn>
<publisher>
<publisher-name><![CDATA[Edición y Farmacia S.A. de C.V.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0186-48662017000400459</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Extubación fallida en una unidad de cuidados intensivos de la Ciudad de México]]></article-title>
<article-title xml:lang="en"><![CDATA[Failed extubation in an intensive care unit of Mexico City]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sosa-Medellín]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Marín-Romero]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,IMSS Unidad Médica de Alta Especialidad Unidad de Cuidados Intensivos]]></institution>
<addr-line><![CDATA[Monterrey Nuevo León]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,ISSSTE Unidad de Cuidados Intensivos ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2017</year>
</pub-date>
<volume>33</volume>
<numero>4</numero>
<fpage>459</fpage>
<lpage>465</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0186-48662017000400459&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0186-48662017000400459&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0186-48662017000400459&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  ANTECEDENTES: el soporte ventilatorio invasivo es una medida terapéutica de uso común en las unidades de cuidados intensivos; una vez aliviada la enfermedad que ocasionó el apoyo ventilatorio se inicia con el retiro de esta modalidad. Cuando se realiza el retiro puede ocurrir una extubación fallida incluso en 20% de los pacientes, requiriendo reintubación.  OBJETIVO: reportar la frecuencia de extubación fallida en la Unidad de Cuidados Intensivos Adultos del Hospital 1° de Octubre del ISSSTE.  MATERIAL Y MÉTODO: estudio analítico, observacio4nal y transversal, realizado en la Unidad de Cuidados Intensivos, en el que se analizaron expedientes en el periodo del 1 de marzo de 2014 al 28 de febrero de 2015, con apoyo de ventilación mecánica invasiva por más de 24 horas y que se extubaron después de una prueba de ventilación espontánea exitosa.  RESULTADOS: se incluyeron 146 expedientes, 74 (51%) fueron de pacientes del sexo femenino, con promedio de edad de 56 años. Las indicaciones de la ventilación mecánica fueron: estado de choque, n=44 (30%), posquirúrgicos, n=40 (27%). El porcentaje de falla del retiro de la ventilación fue de 18%. El riesgo de prevalencia de extubación fallida fue: midazolam OR 4.8 (IC95% 1.56-14.8, p=0.002), obesidad OR 2.5 (IC95% 1.07-6.16), deterioro neurológico como indicación de ventilación OR 6 (IC95% 3.14-11.8), acidosis metabólica OR 5.2 (IC95% 1.2-22.6).  CONCLUSIONES: la prevalencia de extubación fallida en nuestra unidad de cuidados intensivos es de 18%, similar a lo reportado en la bibliografía.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  BACKGROUND: Invasive ventilatory support is a therapeutic measure commonly used in the Intensive Care Units, cured the disease that caused the ventilatory support begins with withdrawal of this modality. Once the withdrawal is performed, a failed extubation can occur in up to 20% of patients, requiring reintubation.  OBJECTIVE: To report the frequency of failed extubation in the Adult Intensive Care Unit from the Hospital 1° de Octubre, ISSSTE, Mexico.  MATERIAL AND METHOD: An analytical, observational and transversal study was made in the intensive care unit; files were analyzed in the period from March 1st, 2014 to February 28, 2015, with support of mechanical ventilation for more than 24 hours and extubated after a successful spontaneous breath trail.  RESULTS: One hundred forty-six records were identified, 74 (51%) were female, with a mean age of 56 years. The indications for mechanical ventilation were: shock state 44 (30%), postoperative 40 (27%). The percentage of ventilation withdrawal failure was 18%. The risk of prevalence for failed extubation: for midazolam OR 4.8 (95% CI 1.56-14.8, p=0.002), obesity OR 2.5 (95% CI 1.07-6.16), neurological deterioration as an indication of ventilation OR 6 (95% CI 3.14-11.8), metabolic acidosis OR 5.2 (95% CI 1.2-22.6).  CONCLUSIONS: The prevalence of failed extubation in our intensive care unit is 18%, similar to that reported in the literature.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[extubación fallida]]></kwd>
<kwd lng="es"><![CDATA[weaning]]></kwd>
<kwd lng="es"><![CDATA[prueba de ventilacion espontánea]]></kwd>
<kwd lng="es"><![CDATA[índice de respiración superficial]]></kwd>
<kwd lng="es"><![CDATA[prueba de fuga]]></kwd>
<kwd lng="en"><![CDATA[failed extubation]]></kwd>
<kwd lng="en"><![CDATA[weaning]]></kwd>
<kwd lng="en"><![CDATA[spontaneous breath trail]]></kwd>
<kwd lng="en"><![CDATA[rapid shallow breathing index]]></kwd>
<kwd lng="en"><![CDATA[cuff leak test]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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