Prevalencia y desenlaces clínicos de la disnea en pacientes bajo ventilación mecánica invasiva en la Unidad de Cuidados Intensivos
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Fecha
2026
Autores
Cianci Palmet, Irene Beatriz
Palomino Zabaleta, Karl
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
La disnea es un síntoma frecuente, aunque subestimado, en pacientes sometidos a ventilación mecánica invasiva (VMI). Se ha asociado con dificultades durante el destete ventilatorio y con una peor experiencia en la Unidad de Cuidados Intensivos (UCI).
Objetivo: Determinar la prevalencia y evolución de la disnea en pacientes adultos bajo ventilación mecánica invasiva durante los primeros siete días de estancia en la Unidad de Cuidados Intensivos de una clínica de alta complejidad en Barranquilla (Atl, CO), y analizar su relación con los parámetros ventilatorios, mecánica respiratoria y la progresión del destete ventilatorio.
Métodos: Estudio observacional, longitudinal y prospectivo realizado en una clínica de alta complejidad de Barranquilla, Colombia. Se incluyeron 51 pacientes adultos bajo VMI. La disnea se evaluó mediante la Mechanical Ventilation–Respiratory Distress Observation Scale (MV-RDOS) en los días 1, 4 y 7. Se analizaron variables clínicas, ventilatorias, de mecánica respiratoria y desenlaces relacionados con el destete.
Resultados: LLa prevalencia de disnea clínicamente significativa fue del 66,6% (n=34) al ingreso y disminuyó al 26% al séptimo día (p<0,001). Los pacientes con disnea presentaron mayores valores de presión de conducción (p=0,037) y presión meseta (p=0,049). Aquellos con mejor evolución clínica tuvieron mayor éxito en la prueba de ventilación espontánea (41% vs. 18%; p=0,032). No hubo diferencias en la mortalidad intra-UCI ni hospitalaria y no se registró delirium.
Conclusiones: La disnea fue altamente prevalente durante los primeros días de VMI y disminuyó significativamente con la evolución clínica. Su asociación con la mecánica respiratoria y el éxito del destete respalda su utilidad como marcador clínico en pacientes críticos ventilados.
Dyspnea is a common yet often underrecognized symptom in patients receiving invasive mechanical ventilation (IMV). It has been associated with difficulties during ventilator weaning and a poorer experience in the Intensive Care Unit (ICU). Objective: To determine the prevalence and evolution of dyspnea in adult patients receiving invasive mechanical ventilation during the first seven days of ICU stay at a high-complexity hospital in Barranquilla, Colombia, and to analyze its relationship with ventilatory parameters, respiratory mechanics, and progression of ventilator weaning. Methods: A prospective, longitudinal, observational study was conducted at a high-complexity hospital in Barranquilla, Colombia. Fifty-one adult patients receiving IMV were included. Dyspnea was assessed using the Mechanical Ventilation–Respiratory Distress Observation Scale (MV-RDOS) on days 1, 4, and 7. Clinical, ventilatory, respiratory mechanics, and weaning-related outcomes were analyzed. Results: The prevalence of clinically significant dyspnea was 66.6% (n = 34) at ICU admission and decreased to 26% by day 7 (p < 0.001). Patients with dyspnea had higher driving pressure (p = 0.037) and plateau pressure (p = 0.049). Those with greater clinical improvement showed a higher rate of successful spontaneous breathing trials (41% vs. 18%; p = 0.032). No significant differences were observed in ICU or in-hospital mortality, and no cases of delirium were recorded. Conclusions: Dyspnea was highly prevalent during the early phase of invasive mechanical ventilation and decreased significantly with clinical improvement. Its association with respiratory mechanics and successful ventilator weaning supports its value as a clinically relevant marker in critically ill mechanically ventilated patients.
Dyspnea is a common yet often underrecognized symptom in patients receiving invasive mechanical ventilation (IMV). It has been associated with difficulties during ventilator weaning and a poorer experience in the Intensive Care Unit (ICU). Objective: To determine the prevalence and evolution of dyspnea in adult patients receiving invasive mechanical ventilation during the first seven days of ICU stay at a high-complexity hospital in Barranquilla, Colombia, and to analyze its relationship with ventilatory parameters, respiratory mechanics, and progression of ventilator weaning. Methods: A prospective, longitudinal, observational study was conducted at a high-complexity hospital in Barranquilla, Colombia. Fifty-one adult patients receiving IMV were included. Dyspnea was assessed using the Mechanical Ventilation–Respiratory Distress Observation Scale (MV-RDOS) on days 1, 4, and 7. Clinical, ventilatory, respiratory mechanics, and weaning-related outcomes were analyzed. Results: The prevalence of clinically significant dyspnea was 66.6% (n = 34) at ICU admission and decreased to 26% by day 7 (p < 0.001). Patients with dyspnea had higher driving pressure (p = 0.037) and plateau pressure (p = 0.049). Those with greater clinical improvement showed a higher rate of successful spontaneous breathing trials (41% vs. 18%; p = 0.032). No significant differences were observed in ICU or in-hospital mortality, and no cases of delirium were recorded. Conclusions: Dyspnea was highly prevalent during the early phase of invasive mechanical ventilation and decreased significantly with clinical improvement. Its association with respiratory mechanics and successful ventilator weaning supports its value as a clinically relevant marker in critically ill mechanically ventilated patients.
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Respiración artificial, Disnea, Unidades de Cuidados Intensivos, Destete del respirador, Intercambio de gases
