{"id":1428,"date":"2021-05-19T11:36:12","date_gmt":"2021-05-19T18:36:12","guid":{"rendered":"http:\/\/localhost:8080\/mywordpress\/trach-tube-size\/"},"modified":"2021-06-09T15:34:23","modified_gmt":"2021-06-09T22:34:23","slug":"size","status":"publish","type":"page","link":"http:\/\/142.11.238.239\/es\/size\/","title":{"rendered":"Tama\u00f1o Del Tubo Traqueal"},"content":{"rendered":"<div class=\"l3-header-con no-banner\">\n<div class=\"l3-header-icon\">\n\t\t<img decoding=\"async\" alt=\"trach tube icon Passy Muir\" src=\"\/wp-content\/uploads\/2018\/12\/Trach-Tube-Icon.jpg\" \/>\n\t<\/div>\n<div class=\"l3-header-text no-banner\">\n\t\t\t\t\tTama\u00f1o Del Tubo Traqueal\n                         <\/div>\n<\/p><\/div>\n<div style=\"clear:both\"><\/div>\n\r\n<ul class=\"breadcrumb\">\r\n\t<li class=\"active\">Claves Del \u00c9xito<\/li>\r\n\t<li class=\"dropdown\">\r\n\t\t<a href=\"#\" class=\"dropdown-toggle\" data-toggle=\"dropdown\">See All Articles <b class=\"caret\"><\/b><\/a>\r\n\t\t<ul class=\"dropdown-menu\">\r\n\r\n\t\t\t<li class=\"\"><a href=\"http:\/\/142.11.238.239\/es\/cuff_aspiration\/\">Desinflado del manguito<\/a><\/li>\r\n\r\n\t\t\t<li class=\"\"><a href=\"http:\/\/142.11.238.239\/es\/secretions\/\">Manejo de la Secreciones<\/a><\/li>\r\n\r\n\t\t\t<li class=\"\"><a href=\"http:\/\/142.11.238.239\/es\/size\/\">Tama\u00f1o del tubo de traqueostom\u00eda<\/a><\/li>\r\n\r\n\t\t\t<li class=\"\"><a href=\"http:\/\/142.11.238.239\/es\/vent_weaning\/\">Ventilaci\u00f3n mec\u00e1nica<\/a><\/li>\r\n\r\n\t\t\t<li class=\"\"><a href=\"http:\/\/142.11.238.239\/es\/vent_adjust\/\">Alarmas de Ventilaci\u00f3n mec\u00e1nica<\/a><\/li>\r\n\r\n\t\t<\/ul>\r\n\t<\/li>\r\n<\/ul>\r\n\n<h2 class=\"seminars_header\">Concepto err\u00f3neo: \u00bfQu\u00e9 sucede si el tubo de\ntraqueostom\u00eda es demasiado grande?<\/h2>\n<p class=\"font20-TopMargin\">Muchos m\u00e9dicos desconocen que los tubos de\ntraqueostom\u00eda m\u00e1s grandes causan resistencia al flujo de\naire a trav\u00e9s de la v\u00eda a\u00e9rea superior y reducen la\npermeabilidad de la v\u00eda a\u00e9rea.<\/p>\n<ul>\n<li>\n<p class=\"font20-TopMargin translation-block\">Cuando el paciente inhala, la V\u00e1lvula <span class=\"pm_ws\">Passy Muir<\/span><sup>\u00ae<\/sup> se\nabre, permitiendo que el aire entre en el tubo de\ntraqueostom\u00eda y en los pulmones. Al final de la\ninspiraci\u00f3n, la V\u00e1lvula se cierra autom\u00e1ticamente y\npermanece cerrada durante la exhalaci\u00f3n y a prueba de\nfugas. Durante la espiraci\u00f3n, el aire se redirige alrededor\ndel tubo de traqueostom\u00eda y hacia arriba a trav\u00e9s de la\nboca y la nariz para permitir el habla.<\/p>\n<\/li>\n<li>\n<p class=\"font20-TopMargin\">Por lo tanto, si el tubo de traqueostom\u00eda tiene un di\u00e1metro\no una longitud demasiado grandes en proporci\u00f3n a la\ntr\u00e1quea, el paciente no podr\u00e1 exhalar adecuadamente el\naire alrededor del tubo.<\/p>\n<\/li>\n<\/ul>\n<h2 class=\"seminars_header\">Investigaci\u00f3n cl\u00ednica que apoya la reducci\u00f3n del tama\u00f1o\ndel tubo de traqueostom\u00eda:<\/h2>\n<ul>\n<li>\n<p class=\"font20-TopMargin\">De acuerdo con la American Thoracic Society y los\nEst\u00e1ndares y Directrices de la Sociedad de Cuidados\nIntensivos, se debe considerar la selecci\u00f3n inicial del tubo\nde traqueostom\u00eda para evitar da\u00f1os en la pared traqueal,\nminimizar el trabajo respiratorio y promover el flujo de aire\ntranslar\u00edngeo.<sup>1-2<\/sup> Los criterios para el uso de V\u00e1lvulas de\nhabla deben incluir un tama\u00f1o de tubo de traqueostom\u00eda\nque no exceda las dos terceras partes de la luz traqueal.<\/p>\n<\/li>\n<li>\n<p class=\"font20-TopMargin translation-block\">Reducir el tama\u00f1o del tubo de traqueostom\u00eda mejora la\ntolerancia de la V\u00e1lvula de habla. Los pacientes con tubos\nde mayor di\u00e1metro exterior o con manguitos desinflados\nm\u00e1s grandes tienen presiones espiratorias m\u00e1s altas.\nReducir el tama\u00f1o del tubo conduce a una reducci\u00f3n\nsignificativa de las presiones espiratorias, lo que da como\nresultado m\u00e1s recomendaciones para V\u00e1lvulas de habla y\ntapones. Con tubos de traqueostom\u00eda de tama\u00f1o\napropiado, los pacientes han mejorado los niveles de\nconfort y la tolerancia cuando la V\u00e1lvula <span class=\"pm_ws\">Passy Muir<\/span> se\nutiliza.<sup>3<\/sup><\/p>\n<\/li>\n<li>\n<p class=\"font20-TopMargin\">La reducci\u00f3n de tama\u00f1o dentro de los siete d\u00edas\nposteriores al procedimiento de traqueostom\u00eda se asocia\ncon el uso m\u00e1s temprano de una V\u00e1lvula de habla, la\ningesta oral m\u00e1s temprana y la duraci\u00f3n reducida de la\nestad\u00eda hospitalaria.<sup>4<\/sup><\/p>\n<\/li>\n<li>\n<p class=\"font20-TopMargin\">La reducci\u00f3n de tama\u00f1o y el desinflado del manguito\nmejoran la desconexi\u00f3n en pacientes con pruebas de\nventilaci\u00f3n espont\u00e1nea. En un estudio controlado\naleatorizado de pacientes cr\u00edticos, el aumento del\ndi\u00e1metro efectivo de las v\u00edas respiratorias al desinflar el\nmanguito traqueal y reducir el tama\u00f1o de la c\u00e1nula\ntraqueal acort\u00f3 el tiempo de desconexi\u00f3n, redujo las\ninfecciones respiratorias y mejor\u00f3 la degluci\u00f3n.<sup>5<\/sup><\/p>\n<\/li>\n<\/ul>\n<hr>\n<h2>Videos Relacionados<\/h2>\n<div class=\"row\">\n<div class=\"col-sm-3\">\n<div class=\"youtube-player\" data-id=\"eg4-gcxcdNs\" data-related=\"0\" data-control=\"1\" data-info=\"1\" data-fullscreen=\"1\" style=\"width:100%;display: block; position: relative;cursor: pointer;max-height:360px;height:100%; overflow:hidden;padding-bottom:56.25%;margin:0 auto\"> <img decoding=\"async\" alt=\"Youtube video\" src=\"\/\/i.ytimg.com\/vi\/eg4-gcxcdNs\/hqdefault.jpg\" style=\"bottom: -100%; display: block; left: 0; margin: auto; max-width: 100%; width: 100%;height:auto; position: absolute; right: 0; top: -100%;\"> <\/p>\n<div style=\"height: 72px; width: 72px; left: 50%; top: 50%; margin-left: -36px; margin-top: -36px; position: absolute; background: url('http:\/\/i.imgur.com\/TxzC70f.png') no-repeat;\"><\/div>\n<\/p><\/div>\n<p>      <center><strong><font size=\"4\"><\/font><\/strong><\/center>\n  <\/div>\n<div class=\"col-sm-3\">\n<div class=\"youtube-player\" data-id=\"g4NPvtsG5w0\" data-related=\"0\" data-control=\"1\" data-info=\"1\" data-fullscreen=\"1\" style=\"width:100%;display: block; position: relative;cursor: pointer;max-height:360px;height:100%; overflow:hidden;padding-bottom:56.25%;margin:0 auto\"> <img decoding=\"async\"  alt=\"Youtube video\" src=\"\/\/i.ytimg.com\/vi\/g4NPvtsG5w0\/hqdefault.jpg\" style=\"bottom: -100%; display: block; left: 0; margin: auto; max-width: 100%; width: 100%;height:auto; position: absolute; right: 0; top: -100%;\"> <\/p>\n<div style=\"height: 72px; width: 72px; left: 50%; top: 50%; margin-left: -36px; margin-top: -36px; position: absolute; background: url('http:\/\/i.imgur.com\/TxzC70f.png') no-repeat;\"><\/div>\n<\/p><\/div>\n<p>      <center><strong><font size=\"4\"><\/font><\/strong><\/center>\n  <\/div>\n<div class=\"col-sm-3\">\n<div class=\"youtube-player\" data-id=\"g4NPvtsG5w0\" data-related=\"0\" data-control=\"1\" data-info=\"1\" data-fullscreen=\"1\" style=\"width:100%;display: block; position: relative;cursor: pointer;max-height:360px;height:100%; overflow:hidden;padding-bottom:56.25%;margin:0 auto\"> <img decoding=\"async\" alt=\"Youtube video\" src=\"\/\/i.ytimg.com\/vi\/g4NPvtsG5w0\/hqdefault.jpg\" style=\"bottom: -100%; display: block; left: 0; margin: auto; max-width: 100%; width: 100%;height:auto; position: absolute; right: 0; top: -100%;\"> <\/p>\n<div style=\"height: 72px; width: 72px; left: 50%; top: 50%; margin-left: -36px; margin-top: -36px; position: absolute; background: url('http:\/\/i.imgur.com\/TxzC70f.png') no-repeat;\"><\/div>\n<\/p><\/div>\n<p>     <center><strong><font size=\"4\"><\/font><\/strong><\/center>\n  <\/div>\n<div class=\"col-sm-3\">\n<div class=\"youtube-player\" data-id=\"iyczrjLlmgo\" data-related=\"0\" data-control=\"1\" data-info=\"1\" data-fullscreen=\"1\" style=\"width:100%;display: block; position: relative;cursor: pointer;max-height:360px;height:100%; overflow:hidden;padding-bottom:56.25%;margin:0 auto\"> <img decoding=\"async\" alt=\"Youtube video\" src=\"\/\/i.ytimg.com\/vi\/iyczrjLlmgo\/hqdefault.jpg\" style=\"bottom: -100%; display: block; left: 0; margin: auto; max-width: 100%; width: 100%;height:auto; position: absolute; right: 0; top: -100%;\"> <\/p>\n<div style=\"height: 72px; width: 72px; left: 50%; top: 50%; margin-left: -36px; margin-top: -36px; position: absolute; background: url('http:\/\/i.imgur.com\/TxzC70f.png') no-repeat;\"><\/div>\n<\/p><\/div>\n<p>     <center><strong><font size=\"4\"><\/font><\/strong><\/center>\n  <\/div>\n<\/div>\n<hr>\n<h3 class=\"benefits\">Fuentes: <\/h3>\n<ol>\n<li>American Thoracic Society Official Statement, Care of the Child with a Chronic Tracheostomy, American Journal of Respiratory Critical Care Medicine, Vol 161. pp 297-308, 2000.<\/li>\n<li>Standards for the care of adult patients with a temporary tracheostomy, Intensive Care Society (2008)<\/li>\n<li>Johnson DC, Campbell SL and Rabkin JD. Tracheostomy tube manometry: evaluation of speaking valves, capping and need for downsizing. The Clinical Respiratory Journal 2009; 3: 8\u201314.<\/li>\n<li>Fisher, D. et al. (2013). Tracheostomy Tube Change Before Day 7 is Associated With Earlier Use of Speaking Valve and Earlier Oral Intake. Respiratory Care. 2013 Feb;58(2):257-63.<\/li>\n<li>Hernandez, G. et al. (2013). The effects of increasing effective airway diameter on weaning from mechanical ventilation tracheostomized patients: a randomized controlled trial. Intensive Care Medicine. Jun;39(6):1063-70<\/li>\n<\/ol>","protected":false},"excerpt":{"rendered":"Trach Tube Size Misconception: What if the Tracheostomy Tube is Too Large? Many clinicians are unaware that larger tracheostomy tubes cause resistance to airflow through the upper airway and reduced airway patency. When the patient inhales, the <span class=\"pm_ws\"><span class=\"pm_ws\">Passy Muir<\/span><\/span><sup>\u00ae<\/sup> Valve opens, allowing air to enter the tracheostomy tube and the lungs. At the end of [&hellip;]","protected":false},"author":6,"featured_media":5634,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"yst_prominent_words":[2289,2283,2291,2286,2292,2285,2282,730,2284,2293,2288,72,2294,202,460,2290,89,1491,60,2287],"_links":{"self":[{"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/pages\/1428"}],"collection":[{"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/comments?post=1428"}],"version-history":[{"count":5,"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/pages\/1428\/revisions"}],"predecessor-version":[{"id":16251,"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/pages\/1428\/revisions\/16251"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/media\/5634"}],"wp:attachment":[{"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/media?parent=1428"}],"wp:term":[{"taxonomy":"yst_prominent_words","embeddable":true,"href":"http:\/\/142.11.238.239\/es\/wp-json\/wp\/v2\/yst_prominent_words?post=1428"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}