D e c is ió n d e in c ia r d e s t e t e e n P . S o p . P a r t im o s d e P . S o p d e 2 0 - 3 0 s o b r e P E E P < 7 E x p lic a r a l p a c ie n t e lo q u e v a m o s a h a c e r D is m in u ir P . S o p . 2 - 4 c m H 2 O c a d a 3 0 m in V ig ila n d o : F R , V t , S p O 2 , F C , t r a b a jo r e s p ir a t o r io B u e n t o le r a n c ia * I r b a ja n d o h a s t a P . S o p . 7 s o b r e P E E P 5
M a la t o le r a n c ia * R e t r o c e d e r a l p a s o a n t e r io r B u s c a r la c a u s a
A la s 2 h o r a s : G a s o m e tría
* M a la t o le r a n c ia : - FR >=35, - S a O 2 < 9 0 % , ( s a lv o in d ic a c io n p r e v ia d e o t r o o b je t iv o ) - F C > 1 4 0 ( o a u m e n t o o d is m in u c ió n m a n t e n id a d e la F C > 2 0 % d e la b a s a l) , - TAS > 200 o < 80, - a g it a c ió n , d ia fo r e s is , a n s ie d a d , in c o o r d in a c io n t o r a c o a b d o m in a l - F R / V t > 1 0 0 c o n s o p o r t e m í n im o .
V a lo r a c io n fin a l d e t o le r a n c ia * T o s e y d e fie n d e V a é r e a P re p a ra r V m a s k P re p a ra r R e IO T A s p ir a r fa r in g e E x tu b a r
Weaning: Mala Tolerancia: 1. FR > 35 rpm