Estrategias actuales de evaluación de la función pulmonar y manejo de disfunciones respiratorias en la esclerosis lateral amiotrófica: una revisión de alcance
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Introducción: La esclerosis lateral amiotrófica (ELA) es una enfermedad neurodegenerativa progresiva que afecta las neuronas motoras del sistema nervioso central. La insuficiencia respiratoria es la principal causa de muerte en estos pacientes.
Objetivo: Mapear las estrategias utilizadas recientemente (2019–2024) para la evaluación de la función pulmonar y el manejo de disfunciones respiratorias en personas con ELA, identificando avances emergentes y su alineación con las guías clínicas actuales.
Métodos: Se realizó una revisión de alcance siguiendo las recomendaciones del Instituto Joanna Briggs (JBI) y la extensión PRISMA-ScR para revisiones. Se consultaron las bases de datos PubMed, Scopus y Web of Science hasta marzo de 2024. Se incluyeron estudios originales publicados entre 2019 y 2024.
Resultados: De 4.427 registros, 28 estudios cumplieron los criterios de inclusión. Las estrategias más frecuentes fueron espirometría, presiones respiratorias máximas, capnografía/gasometría, ventilación no invasiva (VNI) y técnicas de asistencia para la tos. Herramientas emergentes como la ventilación máxima voluntaria calculada (MVVc), la ecografía diafragmática y la medición de presión a los 0,1 segundos (P0.1) mostraron potencial clínico, pero requieren validación. El uso de telemonitorización se destacó como complemento al manejo domiciliario de la VNI.
Conclusiones: Aunque se han ampliado las opciones de evaluación y manejo respiratorio en la ELA, las guías internacionales continúan recomendando métodos consolidados como base del cuidado. La incorporación de técnicas debe ser cautelosa y respaldada por evidencia robusta.
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