Una Revisión Narrativa de la Intubación de Secuencia Rápida en Pacientes con Riesgo de Broncoaspiración
A narrative review of rapid sequence intubation in patients at risk of pulmonary aspiration
DOI:
https://doi.org/10.56712/latam.v7i1.5453Palabras clave:
aspiración pulmonar, intubación de secuencia rápida, vía aérea, preoxigenación, inducción, bloqueador neuromuscular, extubaciónResumen
La broncoaspiración pulmonar sigue siendo una de las complicaciones más graves y potencialmente mortales asociadas al manejo de la vía aérea durante la anestesia general. Una de las estrategias para reducir su incidencia en pacientes con alto riesgo de aspiración es la intubación de secuencia rápida, ya que permite asegurar la vía aérea rápidamente sin necesidad de ventilar con bolsa mascarilla, evitando la insuflación gástrica. Desde su descripción original en 1970 por Stept y Safar, los protocolos han evolucionado, incorporando técnicas nuevas como la evaluación gástrica en tiempo real mediante ultrasonido y la utilización de rocuronio a dosis altas como alternativa a la succinilcolina. Esta revisión narrativa, basada en una búsqueda no sistemática de la literatura, resume intervenciones clave en la estratificación del riesgo de aspiración, las indicaciones de intubación de secuencia rápida, la evaluación del volumen gástrico en tiempo real con ultrasonido, estrategias para optimizar la preoxigenación, selección de agentes inductores y bloqueadores neuromusculares, el uso de la maniobra de Sellick en la intubación, el algoritmo de rescate de una intubación fallida, técnicas de extubación segura y el manejo de una broncoaspiración instaurada.
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Derechos de autor 2026 Julianne Maynard Carmiol, Nhur Sharaf El Yasin, Cristian Andrei Jiménez Solís, Rebeca Hernández Solano, Gabriel Esteban Arroyo Chacón, Paola Cristhina Alegría De Arco
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
