<?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>2448-8909</journal-id>
<journal-title><![CDATA[Medicina crítica (Colegio Mexicano de Medicina Crítica)]]></journal-title>
<abbrev-journal-title><![CDATA[Med. crít. (Col. Mex. Med. Crít.)]]></abbrev-journal-title>
<issn>2448-8909</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Medicina Crítica A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-89092018000500277</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Pronóstico de la ventilación mecánica invasiva en el paciente obeso críticamente enfermo]]></article-title>
<article-title xml:lang="en"><![CDATA[Prognosis of critically ill obese patients under invasive mechanical ventilation]]></article-title>
<article-title xml:lang="pt"><![CDATA[Prognóstico da ventilação mecânica invasiva no paciente obeso em estado crítico]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Montaño Jiménez]]></surname>
<given-names><![CDATA[Alejandro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Olvera Guzmán]]></surname>
<given-names><![CDATA[Claudia Ivette]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguirre Sánchez]]></surname>
<given-names><![CDATA[Janet Silvia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Camarena Alejo]]></surname>
<given-names><![CDATA[Gilberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Franco Granillo]]></surname>
<given-names><![CDATA[Juvenal]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Médico ABC  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>10</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>10</month>
<year>2018</year>
</pub-date>
<volume>32</volume>
<numero>5</numero>
<fpage>277</fpage>
<lpage>284</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092018000500277&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092018000500277&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092018000500277&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción: La obesidad es una enfermedad crónica que se relaciona de manera causal con múltiples patologías y aumento de morbilidad y mortalidad. A nivel respiratorio genera disminución de distensibilidad y volumen pulmonar, con colapso de vías aéreas; esto, junto con la limitación del diafragma, favorece el colapso pulmonar y formación de atelectasias, con disminución de oxigenación y aumento en el riesgo de infección.  Métodos: Estudio retrospectivo, transversal, en pacientes con ventilación mecánica invasiva (VMI) por más de 48 horas. Se valoraron datos demográficos y de VM.  Resultados: Se analizaron 50 pacientes, en dos grupos: no obesos con IMC &lt; 30 kg/m2, y obesos con IMC &#8805; 30 kg/m2, con 35 y 15 pacientes respectivamente. Se encontró diferencia en la relación PaO2/FiO2 siendo mayor en no obesos 193 ± 112 (54-415) que en obesos 116 ± 58 (41-260) p &lt; 0.0001. Se utilizó mayor PEEP (Presión positiva al final de la espiración) en los obesos 11 ± 2.8 (5-16) cmH2O que en los no obesos 9 ± 2.4 (5-16) cmH2O p &lt; 0.007. La mortalidad fue de 28.6% (n = 10) en no obesos y de 40% (n = 6) en obesos; no presentó diferencia estadísticamente significativa. No se encontraron diferencias en los tiempos de ventilación mecánica y de estancia en UCI e intrahospitalaria.  Análisis: En este estudio no se encontró diferencia significativa en mortalidad entre pacientes obesos y no obesos, a diferencia de lo que se ha encontrado en otros estudios; aunque la diferencia fue de 12%, en el grupo de obesos, se encontró de manera inicial menor oxigenación y requirieron de mayor PEEP para ventilarse, recuperando la oxigenación a las 24 horas.  Conclusiones:  No se encontró diferencia en este estudio. Se requiere mayor número de pacientes para valorar efecto en mortalidad.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  Obesity has become a chronic illness which casually relates with multiple pathologies as well as with an increase in morbidity and mortality rates. On the respiratory system, it diminishes lung compliance, and tidal volume with airway collapse. This issue along with movement limitation from the diaphragm favors lung collapse, and atelectasis appearance causing oxygenation reduction while rising the risk of infection.  Methodology:  Retrospective transversal assay performed on patients undergoing invasive mechanical ventilation for over 48 hours. Demographic and mechanical ventilation values are to be evaluated.  Results:  50 patients were analyzed having a tow group distribution, non-obese with a Body mass index (BMI) under 30 kg/m2, and obese with a Body mass index (BMI) over 30 kg/m2, having 35 and 15 patients respectively. A difference between the relation of the values PaO2/FiO2 was found been higher in the non-obese group 193 ± 112 (54-415), while in the obese group it was 116 ± 58 (41-260) p &lt; 0.0001. A bigger value for the Positive end-expiratory pressure (PEEP) was used in obese patients 11 ± 2.8 (5-16) cmH2O compared to the non-obese group with which the PEEP value was 9 ± 2.4 (5-16) cmH2O p &lt; 0.007. The mortality was of 28.6% (n = 10) in the non-obese group while it was 40% (n = 6) in the obese group, no relevant statistical differences were observed. There were no differences in the ventilation time values, neither was a difference for the hospital care or the Intensive Care Unit admission times.  Analysis:  No significant difference was observed regarding mortality rates between obese and non-obese group, in contrast to other assays. While a 12% difference was found in the oxygenation values between the two groups, having the obese group a lower oxygenation value.  Conclusion:  No significant differences were found in this study. A greater number of patients would be needed to evaluate the effect on the mortality rate.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução:  A obesidade é uma doença crônica que está casualmente relacionada a múltiplas patologias e aumento da morbidade e mortalidade. A nível respiratório, causa diminuição da complacência e do volume pulmonar com colapso das vias aéreas; isso, juntamente com a limitação do diafragma favorece o colapso dos pulmões e a formação de atelectasias com diminuição da oxigenação e aumento do risco de infecção.  Métodos:  Estudo retrospectivo, transversal com ventilação mecânica invasiva (VMI) por mais de 48 horas. Se valoraron datos demográficos y de VM.  Resultados:  Foram analisados 50 pacientes em 2 grupos: não obesos com IMC &lt; 30 kg/m2, e obesos com IMC &#8805; 30 kg/m2 com 35 e 15 pacientes respectivamente. Foi encontrada uma diferença na relação PaO2/FiO2, sendo maior em não obesos 193 ± 112 (54-415) do que em obesos 116 ± 58 (41-260) p &lt; 0.0001. Utilizadou-se maior PEEP (pressão expiratória final positiva) nos obesos 11 ± 2.8 (5-16) cmH2O do que nos não obesos 9 ± 2,4 (5-16) cmH2O p &lt; 0.007. A mortalidade foi de 28.6% (n = 10) em pacientes não-obesos e de 40% (n = 6) em obesos, não apresentando diferença estatisticamente significante. Não foram encontradas diferenças no tempo de ventilação mecânica, permanência em UTI e hospitalar.  Análise:  Neste estudo não foi encontrada diferença significativa na mortalidade entre pacientes obesos e não obesos, em contraste com outros estudos, embora a diferença tenha sido de 12%, no grupo de pacientes obesos inicialmente encontrou-se eles menor oxigenação e necessitaram de maior PEEP para ventilar, recuperando a oxigenação às 24 horas.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Ventilación mecánica invasiva]]></kwd>
<kwd lng="es"><![CDATA[obesidad]]></kwd>
<kwd lng="es"><![CDATA[sobrepeso]]></kwd>
<kwd lng="en"><![CDATA[Invasive mechanical ventilation]]></kwd>
<kwd lng="en"><![CDATA[obesity]]></kwd>
<kwd lng="en"><![CDATA[overweight]]></kwd>
<kwd lng="pt"><![CDATA[Ventilação mecânica invasiva]]></kwd>
<kwd lng="pt"><![CDATA[obesidade]]></kwd>
<kwd lng="pt"><![CDATA[excesso de peso]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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