<?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>S2448-89092024000600433</article-id>
<article-id pub-id-type="doi">10.35366/119229</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Cálculo de PEEP: método de mejor distensibilidad versus retroceso elástico pulmonar en síndrome de distrés respiratorio agudo por SARS-CoV-2]]></article-title>
<article-title xml:lang="en"><![CDATA[PEEP calculation: best compliance method vs. pulmonary elastic recoil in acute respiratory distress syndrome due to SARS-CoV-2]]></article-title>
<article-title xml:lang="pt"><![CDATA[Cálculo PEEP: método de melhor distensibilidade vs. recuo elástico do pulmão na síndrome do desconforto respiratório agudo por SARS-CoV-2]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ruiz Castorena]]></surname>
<given-names><![CDATA[Álvaro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez Zarate]]></surname>
<given-names><![CDATA[Cecilia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Oliva Meza Hernández]]></surname>
<given-names><![CDATA[Óscar Miguel]]></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[Martínez Díaz]]></surname>
<given-names><![CDATA[Braulia Aurelia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Médico ABC  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<volume>38</volume>
<numero>6</numero>
<fpage>433</fpage>
<lpage>438</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092024000600433&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092024000600433&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092024000600433&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  En pacientes con síndrome de dificultad respiratoria agudo (SDRA) moderado-grave secundario a infección por SARS-CoV-2 que se encuentran bajo ventilación mecánica, es necesario realizar una adecuada titulación de PEEP dentro del manejo. Actualmente se dispone de diversos métodos; enfocamos el estudio en dos métodos útiles que se pueden llevar a cabo en cualquier centro. El uso del mejor método de distensibilidad se describió anteriormente y es un enfoque eficaz para obtener una PEEP adecuada que mantendrá los objetivos de protección pulmonar. Se propone que la fórmula simplificada para la presión de retroceso elástico pulmonar, expuesta a continuación, sirva como una nueva propuesta dentro de las medidas terapéuticas: PEEPel = presión meseta &#8722; 13.5 ± 2.  Objetivos:  Demostrar que el cálculo de la PEEP mediante la fórmula de retroceso elástico pulmonar presenta resultados similares al mejor método de cumplimiento.  Material y métodos:  Se realizó un análisis retrospectivo de pacientes que presentaron SDRA moderado-grave secundario a infección por SARS-CoV-2 y que se encontraban bajo ventilación mecánica. Como estudio de proceso donde se obtuvo la PEEP por mejor cumplimiento, se comparó el cálculo con la presión meseta inicial con prueba estadística, frecuencias, porcentajes y rango intercuartílico. Para la comparación entre ambos métodos se utilizó prueba de Wilcoxon.  Resultados:  Se incluyeron 200 pacientes sometidos a ventilación mecánica, a quienes se les realizó la titulación de PEEP mediante ambos métodos descritos, la correlación realizada por prueba de Wilcoxon de 0.426 con significancia estadística &lt; 0.001, con intervalos de confianza inferiores de 0.296 y superiores de 0.541. Valores demográficos: edad media 60 ± 12.7, predominio masculino 143 (77.7%), puntuación SOFA media 6 (2.8), APACHE II 12 (8.19), SAPS II 27.5 (22.43).  Conclusiones:  Con los resultados anteriores existe correlación entre ambos métodos para la titulación de la PEEP adecuada; sin embargo, el uso de la fórmula en este estudio se realizó con la presión meseta establecida para un mejor cumplimiento del método. Se recomendaría realizar un estudio prospectivo en la misma población de pacientes, con presión meseta basal para evaluar como una nueva opción de método de titulación de PEEP de fácil acceso para el futuro.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  In patients with moderate-severe Acute Respiratory Distress Syndrome (ARDS) secondary to SARS-CoV-2 infection who were under mechanical ventilation, it is necessary to perform an adequate titration of PEEP within the management. Currently, various methods are available; we focused the study on two useful methods that can be carried out in any center. The use of the best compliance method was described above and is an effective approach to obtain an adequate PEEP that will maintain lung protection goals. It is proposed that the following simplified formula for pulmonary elastic recoil pressure serve as a new proposal within therapeutic measures. PEEPel = P. plateau &#8722; 13.5 ± 2.  Objectives:  To demonstrate that the calculation of PEEP using the pulmonary elastic recoil formula presents similar results to the best compliance metho d.  Material and methods:  A retrospective analysis was performed on patients who presented moderate-severe ARDS secondary to SARS-CoV-2 infection and who were under mechanical ventilation. As a process study where PEEP was obtained by better compliance, the calculation was compared with the initial plateau pressure with a statistical test, frequencies, percentages and interquartile range. For the comparison between both metho ds, the Wilcoxon test was used.  Results:  Two hundred patients were included: undergoing mechanical ventilation; who underwent PEEP titration using both metho ds described, the correlation performed by the Wilcoxon test was 0.426 with statistical significance &lt; 0.001, with lower confidence intervals of 0.296 and higher of 0.541. Demographic values: mean age 60 ± 12.7, male predominance 143 (77.7%), mean SOFA score 6 (2.8), APACHE II 12 (8.19), SAPS II 27.5 (22.43).  Conclusions:  The above results show a correlation between both metho ds for titrating the appropriate PEEP; however, the formula was used in this study with the plateau pressure established for better compliance with the metho d. A prospective study would be recommended in the same patient population, with a baseline plateau pressure to evaluate it as a new option for an easily accessible PEEP titration metho d in the future.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução:  Em pacientes com SDRA moderada-grave secundária à infecção por SARS-CoV-2 que estavam em ventilação mecânica, é necessária para realizar a titulação adequada da PEEP dentro do manejo. Vários métodos estão disponíveis atualmente, mas vamos nos concentrar em dois métodos úteis que podem ser usados em qualquer centro. O uso do melhor método de distensibilidade foi descrito anteriormente e é uma abordagem eficaz para obter a PEEP adequada que manterá as metas de proteção pulmonar. Propõe-se que a seguinte fórmula simplificada para a pressão de recuo elástico pulmonar sirva como uma nova abordagem para medidas terapêuticas. PEEPel = P. Plateau -13.5 ± 2.  Objetivos:  Demonstrar que o cálculo da PEEP usando a fórmula do recuo elástico pulmonar tem resultados semelhantes ao melhor método de conformidade.  Material e métodos:  Foi realizada uma análise retrospectiva de pacientes que apresentaram SDRA moderada a grave secundária à infecção por SARS-COV-2 e que estavam em ventilação mecânica. Como um estudo de processo em que a PEEP foi obtida para melhor conformidade, o cálculo foi comparado com a pressão de platô inicial com teste estatístico, frequências, porcentagens e intervalo interquartil. Para a comparação entre os dois métodos, foi usado o teste de Wilcoxon.  Resultados:  Duzentos pacientes foram incluídos: submetidos à ventilação mecânica; que foram submetidos à titulação da PEEP por ambos os métodos descritos, a correlação realizada pelo teste de Wilcoxon de 0.426 com significância estatística &lt; 0.001, com intervalos de confiança inferiores de 0.296 e intervalos de confiança superiores de 0.541. Valores demográficos: idade média de 60 ± 12.7 anos, predominância do sexo masculino 143 (77.7%), escore SOFA médio 6 (2.8), APACHE II 12 (8. 19), SAPS II 27.5 (22.43).  Conclusões:  Com os resultados acima, há uma correlação entre os dois métodos para a titulação adequada da PEEP; no entanto, o uso da fórmula neste estudo foi realizado com a pressão de platô estabelecida para melhor conformidade com o método. Um estudo prospectivo na mesma população de pacientes com uma pressão de platô de base seria recomendado para avaliar como uma nova opção para um método de titulação de PEEP facilmente acessível no futuro.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[síndrome de dificultad respiratoria agudo (SDRA)]]></kwd>
<kwd lng="es"><![CDATA[capacidad residual funcional]]></kwd>
<kwd lng="es"><![CDATA[distensibilidad del sistema respiratorio]]></kwd>
<kwd lng="es"><![CDATA[PEEP]]></kwd>
<kwd lng="en"><![CDATA[Acute Respiratory Distress Syndrome (ARDS)]]></kwd>
<kwd lng="en"><![CDATA[functional residual capacity]]></kwd>
<kwd lng="en"><![CDATA[respiratory system compliance]]></kwd>
<kwd lng="en"><![CDATA[PEEP]]></kwd>
<kwd lng="pt"><![CDATA[síndrome do desconforto respiratório agudo (SDRA)]]></kwd>
<kwd lng="pt"><![CDATA[capacidade residual funcional]]></kwd>
<kwd lng="pt"><![CDATA[complacência do sistema respiratório]]></kwd>
<kwd lng="pt"><![CDATA[PEEP]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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