Ultrasonido para el diagnóstico diferencial de la patología pulmonar en el paciente crítico

Ultrasound for the diagnosis of pulmonary disease in the critically ill patient

Publicado 2018-11-13

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Vol. 30 Núm. 1 (2018)
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Ultrasonido para el diagnóstico diferencial de la patología pulmonar en el paciente crítico.
rev. colomb. neumol. [Internet]. 2018 Nov. 13 [cited 2024 Nov. 26];30(1):29-42. Disponible en: https://doi.org/10.30789/rcneumologia.v30.n1.2018.299
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https://doi.org/10.30789/rcneumologia.v30.n1.2018.299
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María Camila Arango-Granados
    Virginia Zarama Córdoba
      Mostrar biografía de los autores
      Durante los últimos años, la ecografía se ha convertido en una herramienta diagnóstica de primera línea para el enfoque y el manejo del paciente críticamente enfermo y es considerada hoy día uno de los pilares en la evaluación integral de todos los pacientes. Se ha demostrado que el ultrasonido mejora el rendimiento diagnóstico de la patología pulmonar y de la falla respiratoria aguda. Su utilidad radica en la capacidad de realizar el estudio a la cabecera del paciente, sin irradiación, de manera inmediata por el mismo médico tratante, sumado a la capacidad diagnóstica para identificar condiciones tales como el edema pulmonar cardiogénico y no cardiogénico, describir los patrones de ocupación alveolar y consolidación pulmonar, caracterizar y cuantificar el derrame pleural y diagnosticar la presencia de neumotórax. Adicionalmente, de la mano de una ecografía cardíaca enfocada, aumenta el rendimiento diagnóstico tempranamente en el tromboembolismo pulmonar con compromiso de ventrículo derecho (VD) o la falla cardíaca descompensada. En esta revisión se ilustran los hallazgos ultrasonográficos más importantes en el diagnóstico diferencial de la patología pulmonar y se revisa la evidencia disponible sobre su rendimiento diagnóstico. Es indiscutible la utilidad de esta herramienta para el abordaje del paciente crítico en las unidades de cuidados intensivos (UCI) o en los servicios de emergencias. Su prontitud, el buen rendimiento diagnóstico y la oportunidad de inicio temprano de terapias específicas obligan a los clínicos que manejan pacientes críticos a incorporar el ultrasonido en la práctica diaria.

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