<?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>S2448-89092022000400240</article-id>
<article-id pub-id-type="doi">10.35366/105796</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Lesión pulmonar autoinflingida por el paciente en la Unidad de Cuidados Intensivos]]></article-title>
<article-title xml:lang="en"><![CDATA[Patient Self-Inflicted Lung Injury (P-SILI) in the Intensive Care Unit]]></article-title>
<article-title xml:lang="pt"><![CDATA[Lesão pulmonar auto-infligida pelo paciente na Unidade de Cuidados Intensivos]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guerrero Topete]]></surname>
<given-names><![CDATA[Hugo Eduardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rosales López]]></surname>
<given-names><![CDATA[Sandra Luz]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Contreras Chávez]]></surname>
<given-names><![CDATA[Marisol]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez Cázares]]></surname>
<given-names><![CDATA[Carlos Eduardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez González]]></surname>
<given-names><![CDATA[María Natalia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Centro Médico Nacional del Bajío Hospital de Especialidades No. 1]]></institution>
<addr-line><![CDATA[León Guanajuato]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2022</year>
</pub-date>
<volume>36</volume>
<numero>4</numero>
<fpage>240</fpage>
<lpage>248</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092022000400240&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092022000400240&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092022000400240&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: Hasta la fecha, no se ha demostrado superioridad de algún modo de ventilación mecánica invasiva en particular, la mayoría de los autores destacan la individualización de la programación y modalidad de la ventilación mecánica, teniendo en cuenta la presencia de asincronías y buscando el mejor confort del paciente, incluso la ventilación espontánea, aunque al parecer se asemeja a la manera fisiológica de la mecánica respiratoria, no está exenta de complicaciones. Tres mecanismos potenciales se proponen para el desarrollo de lesión pulmonar por esfuerzo respiratorio espontáneo: sobredistensión global y local, aumento de la perfusión pulmonar y la presencia de asincronías paciente-ventilador, derivadas en una lesión autoinfligida por el paciente o «P-SILI», por sus siglas en inglés Patient Self Inflicted Lung Injury. En los últimos 20 años se han desarrollado estrategias que permiten minimizar los riesgos asociados a la ventilación mecánica, la más importante de todas es mantener soporte ventilatorio guiado por metas, identificación del posible desarrollo del paciente y extubar al paciente lo más rápido posible, siempre y cuando sus condiciones lo permitan.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: To date, the superiority of any particular mode of invasive mechanical ventilation has not been demonstrated; most authors emphasize the individualization of the programming and modality of mechanical ventilation, taking into account the presence of asynchronies and seeking the best patient comfort; even spontaneous ventilation, although it seems to resemble the physiological manner of respiratory mechanics, is not free of complications. Three potential mechanisms are proposed for the development of lung injury by spontaneous respiratory effort: global and local overdistension, increased pulmonary perfusion and the presence of patient-ventilator asynchronies, resulting in a Patient Self-Inflicted Injury or «P-SILI». In the last twenty years, strategies have been developed to minimize the risks associated with mechanical ventilation, the most important of which is to maintain goal-directed ventilatory support, identify the possible development of the patient and extubate the patient as quickly as possible, as long as the patient&#8217;s conditions allow it.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo: Até o momento, nenhum modo específico de ventilação mecânica invasiva se mostrou superior, a maioria dos autores enfatiza a individualização da programação e modalidade de ventilação mecânica, levando em consideração a presença de assincronia e buscando o melhor conforto do paciente. Mesmo a ventilação espontânea, embora pareça assemelhar-se à maneira fisiológica da mecânica respiratória, não é isenta de complicações. Três mecanismos potenciais são propostos para o desenvolvimento de lesão pulmonar por esforço respiratório espontâneo: hiperdistensão global e local, aumento da perfusão pulmonar e presença de assincronia paciente-ventilador, derivada de uma lesão autoinfligida pelo paciente ou «P-SILI» por suas siglas em inglês patient self inflicted lung injury. Nos últimos vinte anos, foram desenvolvidas estratégias para minimizar os riscos associados à ventilação mecânica. O mais importante de tudo é manter o suporte ventilatório guiado por metas, identificar o possível desenvolvimento do paciente e extubar o paciente o mais rápido possível, enquanto suas condições permitirem.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Respiración espontánea]]></kwd>
<kwd lng="es"><![CDATA[impulso respiratorio]]></kwd>
<kwd lng="es"><![CDATA[P-SILI]]></kwd>
<kwd lng="es"><![CDATA[síndrome de distrés respiratorio agudo]]></kwd>
<kwd lng="en"><![CDATA[Spontaneous breathing]]></kwd>
<kwd lng="en"><![CDATA[respiratory drive]]></kwd>
<kwd lng="en"><![CDATA[P-SILI]]></kwd>
<kwd lng="en"><![CDATA[acute respiratory distress syndrome]]></kwd>
<kwd lng="pt"><![CDATA[Respiração espontânea]]></kwd>
<kwd lng="pt"><![CDATA[impulso respiratório]]></kwd>
<kwd lng="pt"><![CDATA[P-SILI]]></kwd>
<kwd lng="pt"><![CDATA[síndrome do desconforto respiratório agudo]]></kwd>
</kwd-group>
</article-meta>
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