<?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>S2448-89092018000500253</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Score sonográfico predictor de éxito en el destete ventilatorio en la Unidad de Cuidados Intensivos]]></article-title>
<article-title xml:lang="en"><![CDATA[A new scoring system to predict success in discontinuation from mechanical ventilation in Intensive Care Unit]]></article-title>
<article-title xml:lang="pt"><![CDATA[Escore ultrassonográfico para prever o sucesso do desmame da ventilação mecânica na Unidade de Terapia Intensiva]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández Plata]]></surname>
<given-names><![CDATA[Alma Erika]]></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 contrib-type="author">
<name>
<surname><![CDATA[Soriano Orozco]]></surname>
<given-names><![CDATA[Raúl]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Díaz Rodríguez]]></surname>
<given-names><![CDATA[Jorge Adalid]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González Carrillo]]></surname>
<given-names><![CDATA[Pedro Luis]]></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 Bajío Núm. 1 Unidad Médica de Alta Especialidad]]></institution>
<addr-line><![CDATA[León Guanajuato]]></addr-line>
<country>Mexico</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>253</fpage>
<lpage>257</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092018000500253&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092018000500253&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092018000500253&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  La ventilación mecánica (VM) ha sido fundamental en el manejo del paciente crítico. Cerca de 25% de los pacientes ventilados presentarán dificultades en el destete ventilatorio, su retraso está asociado a complicaciones diversas. En la actualidad se reconocen factores importantes del fracaso del destete ventilatorio, tal como la disfunción diafragmática que tras el surgimiento de la sonografía crítica se ha utilizado de manera más frecuente, encontrándose asociada a un incremento en los días de VM con un impacto en la mortalidad; a pesar de ello usualmente es infradiagnosticada. Se han establecido parámetros sonográficos predictores de éxito o fracaso en el destete ventilatorio; sin embargo, se encuentran como parámetros aislados, por lo que es necesaria la elaboración de modelos predictivos sonográficos para un destete ventilatorio exitoso.  Métodos:  Se analizó en una primera etapa un total de 90 pacientes con ingreso a la unidad de cuidados intensivos bajo VM y protocolo de destete del mismo. Se realizaron mediciones clínicas, ventilatorias y sonográficas, siendo las de mayor peso estadístico las sonográficas; razón por la que se diseñó un score predictivo sonográfico para destete ventilatorio (SPSDV) consistente en cuatro rubros con puntuación máxima de 8 puntos y mínima de 0. Se estableció el punto de mayor sensibilidad y especificidad para la prueba.  Resultados:  Tras la aplicación y análisis estadístico del SPSDV se obtuvo una sensibilidad de 91% y especificidad de 69%, con valor predictivo positivo y negativo de 89 y 75% respectivamente, con un área bajo la curva de 0.80.  Conclusiones:  El score predictivo sonográfico para destete ventilatorio es útil para identificar a pacientes con posible éxito de retiro.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  Mechanical ventilation has been fundamental in the management of critical patients. Almost 25% of patients ventilated will present difficulties in weaning process, which may be due to multiple causes. Delay or prolongation is associated with various complications. There are currently important factors for the failure of ventilatory weaning, such as diaphragmatic dysfunction, which has been consistently characterized following the advent of critical ultrasonography, it is associated with increase in days of ventilation and impact on mortality, despite of this facti, is underdiagnosed. Predictors of success or failure in weaning process has been established by means of diaphragmatic ultrasound; however, they are found as isolated parameters, so it is necessary to develop ultrasonic predictive models, in addition to the clinical ones, for a safe ventilatory weaning.  Methods:  A total of 90 patients with admission to the intensive care unit with mechanical ventilation and weaning protocol were analyzed in a first stage. Clinical, ventilatory and ultrasonographic measurements were performed, being the most statistically significant, ultrasonographic, and therefore an ultrasonographic predictive model was designed consisting of 4 items with a maximum score of 8 points and a minimum of 0. It was established a point of greater sensitivity and specificity for the test.  Results:  After the application and statistical analysis of the ultrasonographic predictive model, sensitivity of 0.91 and specificity of 0.69 were obtained, with positive and negative predictive value of 89% and 75%, respectively, with ROC area of &#8203;&#8203;0.80.  Conclusions:  The ultrasonographic predictive model, designed to identify patients with possible success, is also a predictor of the failure of mechanical ventilation.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução:  A ventilação mecânica (VM) tem sido fundamental no manejo de pacientes em estado crítico. Quase 25% dos pacientes ventilados terão dificuldades no desmame ventilatório, seu atraso está associado a várias complicações. Atualmente, fatores importantes são reconhecidos pelo fracasso do desmame ventilatório, como a disfunção diafragmática que após o surgimento da ultrassonografia crítica tem sido utilizado com maior frequência, estando associada a um aumento nos dias de VM, com impacto na mortalidade; apesar disso geralmente é subdiagnosticada. Estabelecemos parâmetros ultrassonográficos preditores de sucesso ou fracasso de desmame ventilatório, porém são parâmetros isolados sendo necessário o desenvolvimento de modelos ultrassonográficos preditivos para o sucesso do desmame ventilatório.  Métodos:  Em uma primeira etapa foram analisados um total de 90 pacientes internados na unidade de terapia com VM e protocolo de desmame. Medidas clínicas, ventilatórias e ultrassonográficas foram realizadas, sendo a de maior peso estatístico a ultrassonografia; portanto, foi desenhado um escore ultrassonográfico preditivo para o desmame ventilatório (SPSDV), composto por 4 itens com escore máximo de 8 pontos e escore mínimo de 0. O ponto de maior sensibilidade e especificidade para o teste foi estabelecido.  Resultados:  Após a aplicação e análise estatística do SPSDV, obteve-se sensibilidade de 91% e especificidade de 69% com valor preditivo positivo e negativo de 89% e 75%, respectivamente, com área sob a curva de 0.80.  Conclusões:  O escore preditivo ultrassonográfico para o desmame ventilatório é útil para identificar pacientes com possível sucesso na retirada.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Destete ventilatorio mecánico]]></kwd>
<kwd lng="es"><![CDATA[score predictivo sonográfico]]></kwd>
<kwd lng="en"><![CDATA[Weaning mechanical ventilation]]></kwd>
<kwd lng="en"><![CDATA[ultrasonographic model of sucess prediction]]></kwd>
<kwd lng="pt"><![CDATA[Desmame ventilatório mecânico]]></kwd>
<kwd lng="pt"><![CDATA[escore preditivo ultrassonográfico]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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