Órgano oficial de Instituto Panvascular de Occidente, S.C.
Efectos del Posicionamiento Prono Vigil en la Evolución Clínica de Adultos Ingresados por COVID-19 al Hospital de Mayor Complejidad de la Región de la Araucanía, Chile
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Palabras clave

COVID-19
Prono vigil
Mortalidad
Ventilación Mecánica Invasiva

Categorías

Cómo citar

1.
Efectos del Posicionamiento Prono Vigil en la Evolución Clínica de Adultos Ingresados por COVID-19 al Hospital de Mayor Complejidad de la Región de la Araucanía, Chile. Rev Med Clin [Internet]. 2024 Jun. 3 [cited 2024 Nov. 2];8(2):e03062408010. Available from: https://medicinaclinica.org/index.php/rmc/article/view/558

Resumen

Introducción: Analizar los efectos del posicionamiento prono vigil en la evolución clínica de adultos hospitalizados por COVID-19. Pacientes y métodos: Estudio de cohorte en el Hospital Hernán Henríquez, Temuco-Chile. Se incluyó a sujetos ingresados entre marzo y septiembre del año 2020 con diagnóstico de COVID-19. Variables de interés principales: El factor de exposición fue el posicionamiento prono vigil y el resultado fue el requerimiento de ventilación mecánica invasiva (VMI) y la mortalidad. Resultados: La cohorte estuvo compuesta por 346 sujetos, con un promedio de 57 años, 52% eran hombres y 37% tenía 2 o más comorbilidades. De la cohorte estudiada, 20% requirió terapia de prono vigil, y entre ellos, el promedio de días en posición prono vigil fue de 3 días, 28% requirió apoyo de VMI con un promedio de uso 14 días. Las características clínicas basales, no mostraron diferencias significativas entre los sujetos que se posicionaron en prono y los que no se sometieron a este tratamiento. Los modelos de regresión logística ajustados por edad, sexo, comorbilidades y uso de cánula nasal de alto flujo (CNAF) mostraron una disminución del riesgo de requerir VM en los sujetos posicionados en prono vigil [Odds Ratio (OR)= 0.362, Intervalo de confianza (IC)= 0.16-0.77, p=0.009]. Existen diferencias clínicamente relevantes en la curva de sobrevida entre aquellos con posicionamiento prono vigil. Sin embargo, el modelo de regresión de Cox ajustado no evidencia diferencias significativas [Hazard Ratio (HR)= 0.63 (IC)= 0.18-217, p=0.46]. Conclusión: El posicionamiento prono vigil está asociado a menores requerimientos de VMI.

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Referencias

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Derechos de autor 2024 Franco Pavez-Guerrero, Sergio Muñoz-Navarro, Teresa Balboa-Castillo

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