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Vol. 29. Issue 3.
Pages 123-128 (April 1993)
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Vol. 29. Issue 3.
Pages 123-128 (April 1993)
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Oxigenoterapia. Efectos secundarios. Yatrogenia
Oxygen terapy. Secondary effects. latrogenesis
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J. Escarrabill, C. Monasterio, R. Estopá
Servei de Pneumologia. Hospital de Bellvitge. L’Hospitalet (Barcelona)
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Los riesgos de la administración aguda de oxígeno se refieren a los efectos secundarios precoces, como la hipercapnia o las atelectasias por absorción y al daño tisular, como la citotoxicidad pulmonar o la retinopatía de los prematuros.

No se han demostrado riesgos relacionados con la administración crónica de oxígeno en pacientes estables. La oxigenoterapia crónica no incrementa significativamente la PaC02 ni se reconocen lesiones tisulares atribuibles al tratamiento. El riesgo de explosión puede minimizarse con unas precauciones elementales.

El mal funcionamiento de las fuentes de oxígeno pueden condicionar la efectividad del tratamiento, especialmente en el caso del concentrador si no se somete a revisiones periódicas.

Los accesorios utilizados para recibir oxígeno pueden producir irritación local, especialmente si se administran flujos elevados. Pueden producirse fugas en los tubos acodados o con múltiples conexiones. El uso de humidificadores no está justificado en la mayoría de pacientes, siendo además otra fuente de fugas.

El catéter transtraqueal (CTT) es una forma invasiva de administrar oxígeno muy eficaz pero que plantea problemas en el momento de la insercisón (enfisema subcutáneo, hematoma, broncoespasmo), o a largo plazo (tapones de moco alrededor del CTT o las infecciones locales).

The risks of the acute administration of oxygen refer to early secondary effects such as hypercapnia or atelectasis by absorption and to tissue damage as in pulmonary cytotoxicity or retinopathy of premature newborns.

No risks related with the chronic administration of oxygen have been demonstrated in stable patients. Chronic oxygen therapy does not significantly increase PaC02, nor have tissue lesions attibutable to this treatment been recognized. The risk of explosion may be minimized by elemental precautions. Bad functioning of the sources of oxygen may condition the efficacy of the treatment specially in the case of the concentrator if not submitted to periodic revision.

The accessories used for receiving oxygen may produce local irritation, specialy if high flows are administered. Leaks may be produced in jointed tubes or in those with multiple connections. The use of humidifiers is not justified in most patients, and is rather, another source of leaks.

The transtracheal catheter (TTC) is a very effective invasive form of administering oxygen but presents problems at the time of inserction (subcutaneous emphysema, hematoma, bronchospasm) or during long term administration (blockage by mucous around the TTC or local infections).

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Copyright © 1993. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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