CRITERIO PEDIÁTRICO

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Aspiración de cuerpo extraño

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177
 Acta Pediátrica de México 2019 mayo-junio;40(3)

Sospecha fundada de aspiración

de cuerpo extraño

El paciente tiene datos de

Estudio endoscópico de la Paciente estable
insuficiencia respiratoria o
vía aérea
inestabilidad cardio-respiratoria

Realizar estudios de
imagen
Seguir algoritmo de pals.
asegurar vía aérea y garantizar
ventilación

Se confirma presencia de Se confirma presencia de Se descarta presencia de

cuerpo extraño y se logra su cuerpo extraño pero no se cuerpo extraño
extracción logra su extracción

Vigilancia en hospitalización
Vigilancia hospitalaria según Cirugía urgente
clínica del paciente

Paciente asintomático Persiste dificultad

respiratoria
Egreso a domicilio

Iniciar abordaje de diagnósticos

diferenciales

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ĨŝďĞƌŽƉƚŝĐ ďƌŽŶĐŚŽƐĐŽƉLJ ŝŶ ŝŶĨĂŶƚƐ ĂŶĚ ĐŚŝůĚƌĞŶ͘ WĞĚŝĂƚƌ
Z\ WYmJ[PJH TPLU[YHZ ZL LZWLYH \U LZ[\KPV KL WƵůŵŽŶŽů͘ϮϬϬϱ͖ϰϬ;ϱͿ͗ϯϵϮͲϵϳ͘ĚŽŝ͗ϭϬ͘ϭϬϬϮͬƉƉƵů͘ϮϬϮϰϮ͘
PTHNLUFigura 8 ϯ͘ <ŝŵ/͕^ŚĂƉŝƌŽE͕ŚĂƚƚĂĐŚĂƌLJLJĂE͘dŚĞŶĂƚŝŽŶĂůĐŽƐƚďƵƌ-
ĚĞŶŽĨďƌŽŶĐŚŝĂůĨŽƌĞŝŐŶďŽĚLJĂƐƉŝƌĂƚŝŽŶŝŶĐŚŝůĚƌĞŶ͘>ĂƌLJŶ-
ŐŽƐĐŽƉĞ͘ϮϬϭϱ͖ϭϮϱ;ϱͿ͗ϭϮϮϭͲϮϰ͘ĚŽŝ͗ϭϬ͘ϭϬϬϮͬůĂƌLJ͘ϮϱϬϬϮ͘
REFERENCIAS
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ŝŶƐ͘ŵŵũ͘ϯ͘ ďƌŽŶĐŚŽƐĐŽƉLJ ĨŽƌ ƐƵƐƉĞĐƚĞĚ ĨŽƌĞŝŐŶ ďŽĚLJ ĂƐƉŝƌĂƚŝŽŶ ŝŶ

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ďĞƌͿ͗ϳϮͲϳϱ͘ĚŽŝ͗ϭϬ͘ϭϬϭϲͬũ͘ŝũƉŽƌů͘ϮϬϭϳ͘ϭϬ͘ϬϯϬ͘
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ƉĞĚŝĂƚƌşĂ͘džƉĞƌŝĞŶĐŝĂĚĞϭϱĂŹŽƐ͘ŶĄůŝƐŝƐĚĞϯϯϳĐĂƐŽƐ͘
ŝƌƵŐşĂWĞĚŝĄƚƌŝĐϮϬϭϯ͖Ϯϲ͗ϰ͘
ϳ͘ ĂƌůŽƐ>͕ĞƚĂů͘ŝĂŐŶſƐƚŝĐŽƚĂƌĚşŽĚĞůĂĂƐƉŝƌĂĐŝſŶĚĞƵŶ
ĐƵĞƌƉŽĞdžƚƌĂŹŽ͘Žů,ŽƐƉ/ŶĨĂŶƚDĞdž͘ϮϬϭϭ͖ϲϴ;ϯͿ͗ϮϮϬͲϮϰ͘
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ĚƌĞŶ͗ dŚĞ ZŽůĞ ŽĨ ŵĞƌŐĞŶĐLJ ZŝŐŝĚ ƌŽŶĐŚŽƐĐŽƉLJ͘ 'ůŽď
WĞĚŝĂƚƌ ,ĞĂů͘ ϮϬϭϳ͖ϰ͗ϮϯϯϯϳϵϰyϭϳϳϰϯϲϲĚŽŝ͗ϭϬ͘ϭϭϳϳͬϮϯϯ
ϯϳϵϰyϭϳϳϰϯϲϲϯ͘
ϵ͘ ŚĞŶ y͕ ŚĂŶŐ ͘ &ŽƌĞŝŐŶ ďŽĚLJ ĂƐƉŝƌĂƚŝŽŶ ŝŶ ĐŚŝůĚƌĞŶ͗
&ŽĐƵƐ ŽŶ ƚŚĞ ŝŵƉĂĐƚ ŽĨ ĚĞůĂLJĞĚ ƚƌĞĂƚŵĞŶƚ͘ /Ŷƚ : WĞĚŝĂ-
ƚƌ KƚŽƌŚŝŶŽůĂƌLJŶŐŽů͘ ϮϬϭϳ͖ϵϲ͗ϭϭϭͲϭϱ͘ ĚŽŝ͗ϭϬ͘ϭϬϭϲͬũ͘
ŝũƉŽƌů͘ϮϬϭϳ͘Ϭϯ͘Ϭϭϯ͘
ϭϬ͘ WŝƚŝŽƚs͕ĞƚĂů͘dŚĞƵƐĞŽĨdͲƐĐĂŶŝŶĨŽƌĞŝŐŶďŽĚLJĂƐƉŝƌĂƚŝŽŶŝŶ
ĐŚŝůĚƌĞŶ͗ϲLJĞĂƌƐ͛ĞdžƉĞƌŝĞŶĐĞ͘/Ŷƚ:WĞĚŝĂƚƌKƚŽƌŚŝŶŽůĂƌLJŶ-
ŐŽů͘ϮϬϭϳ͖ϭϬϮ͗ϭϲϵͲϳϯ͘ĚŽŝ͗ϭϬ͘ϭϬϭϲͬũ͘ŝũƉŽƌů͘ϮϬϭϳ͘Ϭϴ͘Ϭϯϲ͘
ϭϭ͘ ďĞƌ ͕ Ğƚ Ăů͘ Z^ ƐƚĂƚĞŵĞŶƚ͗ ŝŶƚĞƌǀĞŶƚŝŽŶĂů ďƌŽŶĐŚŽƐ-
copy in children. Eur Respir J͘ ϮϬϭϳ͖ϱϬ;ϲͿ͗ϭϳϬϬϵϬϭ͘
ĚŽŝ͗ϭϬ͘ϭϭϴϯͬϭϯϵϵϯϬϬϯ͘ϬϬϵϬϭͲϮϬϭϳ͘
ϭϮ͘ dĞŶĞŶďĂƵŵ d͕ Ğƚ Ăů͘ DĂŶĂŐĞŵĞŶƚ ŽĨ &ŽƌĞŝŐŶ ŽĚLJ
ZĞŵŽǀĂů ŝŶ ŚŝůĚƌĞŶ ďLJ &ůĞdžŝďůĞ ƌŽŶĐŚŽƐĐŽƉLJ͘ : ƌŽŶ-
ĐŚŽů /ŶƚĞƌǀ WƵůŵŽŶŽů͘ ϮϬϭϳ͖Ϯϰ;ϭͿ͗ϮϭͲϮϴ͘ ĚŽŝ͗ϭϬ͘ϭϬϵϳͬ
>Z͘ϬϬϬϬϬϬϬϬϬϬϬϬϬϯϭϵ͘
ϭϯ͘ <ŝƌĂŶ ^͕ Ğƚ Ăů͘ ƌŽŶĐŚŽƚŽŵLJ ĨŽƌ ƌĞŵŽǀĂů ŽĨ ĨŽƌĞŝŐŶ ďŽĚLJ
ďƌŽŶĐŚƵƐŝŶĂŶŝŶĨĂŶƚ͘/ŶĚŝĂŶ:ŶĂĞƐƚŚ͘ϮϬϭϰ͖ϱϴ;ϲͿ͗ϳϳϮͲϯ͘
doi: ϭϬ͘ϰϭϬϯͬϬϬϭϵͲϱϬϰϵ͘ϭϰϳϭϱϲ
ϭϰ͘ ŵĞƌŝĐĂŶĐĂĚĞŵLJŽĨWĞĚŝĂƚƌŝĐƐ͕͘ΘŵĞƌŝĐĂŶ,ĞĂƌƚƐƐŽĐŝĂ-
ƚŝŽŶ͘;ϮϬϭϲͿ͘WĞĚŝĂƚƌŝĐĂĚǀĂŶĐĞĚůŝĨĞƐƵƉƉŽƌƚ͘
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