000			03310na a2200265 4500
003			H12O
005			20180417112637.0
008			130622s2012 xxx||||| |||| 00| 0 eng d
040			_cH12O
041			_aspa
100			_aFernández Gaute, Nieves _92018 _eMedicina Intensiva
100			_aFrade Mera, María Jesús _91295 _eMedicina Intensiva
100			_aMontes Gil, Diego _92019 _eMedicina Intensiva
100			_aVergara Díez, Laura _92020 _eMedicina Intensiva
245	0	0	_aDecúbito prono en paciente portador de dispositivo de extracción extracorpórea de CO2 Novalung®. _h[artículo]
260			_c2012 _bEnfermería Intensiva,
300			_a23(3):132-41.
500			_aFormato Vancouver: Frade Mera MJ, Vergara Díez L, Fernández Gaute N, Montes Gil D. Decúbito prono en paciente portador de dispositivo de extracción extracorpórea de CO2 Novalung®. Enferm Intensiva. 2012 Jul-Sep;23(3):132-41.
501			_aPMID: 22726348
504			_aContiene 40 referencias
520			_aOBJECTIVE: To describe the course of a patient with the extracorporeal CO2 removal device and discover the effect of Novalung on ventilation, considering the patient's prone position and its influence on the device's blood flow. To develop a protocol of managing and specific care of a patient with Novalung. MATERIAL AND METHODS: A case report of a patient with Novalung in a tertiary hospital ICU unit is reported. Parameters considered are hemodynamic, respiratory, pharmacological, analytical, neuromonitoring, managing of the Novalung and length of decubitus prone cycles. Anova Test, Student's T test, Wilcoxon-Mann Whitney and Spearman correlation. Significance p <0.05. RESULTS: A 46-year old women with nosocomial pneumonia and acute respiratory failure with indication of Novalung to decrease hypercapnia and optimize ventilatory management of refractory hypoxemia. ICU Stay 26 days, MBP 82 9 mmHg, HR 110 6l pm during the admission, monitoring PICCO 5 days CI 3.2 0.8 l/min/m2, ELWI 33 4 ml, continuous hemofiltration 13.2 days with a median removal 50 cc/h. Norepinephrine dose 0.68 0.79 mu/kg/min for 15 days. Respiratory parameters during the admission: PO2 59 13 mmHg, PCO2 68 35 mmHg, SatO2 85 12%, PO2/FIO2 69 35, tidal volume 389 141 cc. Novalung 13 days, heparin dose 181.42 145 mIU/Kg/min, Cephalin time 57.56 16.41 sec, O2 flow 7 3 l/min, median blood flow 1030 cc/h, interquartile range 1447-612 cc/h. Prone cycles 4, duration 53 27 hours. With Novalung PCO2 decreased regardless of position 66 21:56 9, p=0.005. Tidal volume 512 67:267 72, p=0.0001. Blood flow on supine-prone position 1053 82:113 112, p=0.001. There was no link between blood flow and PCO2 (p=0.2) and between O2 and PO2 flow (p=0.05). Specific care: pedal and tibial pulse monitoring, keep circuit safe to prevent and detect signs of bleeding, femoral arterial and venous catheter care, coagulation monitoring. COMMENTS: During the use of Novalung protective, ventilation, low tidal volumes, decreased pressure plateau, PEEP and hypercapnia were achieved. Blood flow decreased in prone position, but the PCO2 did not increase. The device did not coagulate.
710			_967 _aServicio de Medicina Intensiva
856			_uhttp://pc-h12o-es.m-hdoct.a17.csinet.es/pdf/pc/8/pc8488.pdf _ySolicitar documento
942			_n0 _2ddc _cART
999			_c8488 _d8488