Índices de oxigenación en relación con el grado de compromiso infeccioso pulmonar en tomografía computarizada
Resumen
La investigación se fundamentó en describir los índices de oxigenación en relación al compromiso del parénquima pulmonar evaluado mediante imágenes diagnósticas de tórax en pacientes con diagnóstico de infección respiratoria de vía baja. Estudio de cohorte retrospectivo en sujetos en quienes se realizaron mediciones de índices de oxigenación y al menos una tomografía computarizada de tórax con evidencia de opacidades, consolidación, derrame pleural o sin hallazgos anormales. Se realizó un análisis descriptivo resumiendo las variables cualitativas en frecuencias y porcentajes, y las variables cuantitativas en promedio y desviación estándar si su distribución era normal, mediana y rango intercuartílico si su distribución no era normal. Al análisis final ingresaron un total de 3150 pacientes de los cuales el 71,4% (2248/3150) tenían hallazgos tomográficos anormales. La edad promedio de los pacientes con opacidad fue de 62,6 (DE:18,15) frente a 60,6 (DE: 17,97) de los pacientes sin opacidad (p=0,014). La SpO2/FiO2 fue 8,7 puntos promedio menor (353,1 vs. 361,8; p=0,026) y la PaO2/FiO2 fue 12,6 puntos promedio menor (231,9 vs. 244,5; p=0,001) en pacientes con opacidades intersticiales frente a pacientes sin hallazgos anormales. La SpO2/FiO2, SaO2, PaO2 y PaO2/FiO2 presentó un mayor deterioro en los pacientes con consolidación bilateral frente a los pacientes sin opacidades (p<0,001, p<0,001, p<0,001 y p<0,001, respectivamente). Opacidades de tipo intersticial y/o alveolares, consolidación y derrame pleural presentan un mayor deterioro en los índices de oxigenación frente a los pacientes sin compromiso pulmonar descrito en tomografía de tórax.
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