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Glossary entry

Spanish term or phrase:

tolerancia al medio externo

English translation:

capable of breathing spontaneously

Added to glossary by Joseph Tein
This question was closed without grading. Reason: Other
Nov 11, 2018 06:59
5 yrs ago
4 viewers *
Spanish term

tolerancia al medio externo

Spanish to English Medical Medical (general) surgery complications/outcomes
This is from a description of complications during surgery and the patient's subsequent recovery:

" ... al intentar realizar destete del soporte ventilatorio presentó cuadro de apnea con incapacidad de adaptación a la respiración no asistida ... se estabilizo y se mantuvo bajo asistencia médica y de observación por 24 horas sin presentar otros signos de descompensación con tolerancia al medio externo."

The writers of these reports don't always use clear, logical language in describing their patients' treatment, and I have no idea what they mean here by 'tolerancia al medio externo'. There is no more information in the report, and no mention of whether or when the patient was actually weaned from the respiratory support. (This is a child who underwent nasolaryngoscopy, adenoidectomy and turbinoplasty.)

Thanks for your help or suggestions.
Change log

Dec 9, 2018 22:22: Joseph Tein Created KOG entry

Discussion

Joseph Tein (asker) Dec 9, 2018:
Thank you all (again) ... for your helpful suggestions.

I think the simplest approach here is to borrow from Chema's first comment ("... the original text refers specifically to the child's capacity to breathe spontaneously ... ") since it explains things very concisely. (Gracias otra vez, Chema.)
Chema Nieto Castañón Dec 7, 2018:
Not necessarily so, David. Patient most surely -though not necessarily- uses some oxygen therapy, other than intubation. That is why I suggest using the opposite (without intubation) in this case. Medio externo is opposing "("internal") oxygen therapy by means of intubation"; patient "does alright" without intubation. I wonder how Joseph -or anyone- might finally express this in proper English!
David Brown Dec 7, 2018:
"medio externo" In this case it would just be room air....?
Chema Nieto Castañón Nov 25, 2018:
Thanks Joseph! I think patient does alright without intubation conveys the meaning and yet I am not sure how to naturally say that in English!
Thanks anyhow. It is a pleasure if it helped!
Joseph Tein (asker) Nov 11, 2018:
Thanks Everyone ... for your comments and suggestion. There is no further information in the report about subsequent developments. I think Chema has explained it ... muchísimas gracias, Chema, puedes poner una respuesta si quieres.
Stuart and Aida Nelson Nov 11, 2018:
@ Joseph In your source text: is there anything mentioned about any problems with the patient's vitals signs after ' a la respiración no asistida .....?? se estabilizo' I think this might give us a clue. Is there also mentioned that the kind was discharged and was able to breath without assisted ventilation?
Anne Schulz Nov 11, 2018:
OK, thanks again :-)
Chema Nieto Castañón Nov 11, 2018:

No; it is reasonable in the context but it is not necessarily implied. I would say that the original expression conveys (in this particular case) the opposite/negative idea; patient does alright without intubation [tolera, desde un punto de vista ventilatorio, su situación sin intubación]
Anne Schulz Nov 11, 2018:
Chema, thank you very much for those explanations! Does "medio externo" imply then, that the child received some sort of 'external', non-invasive respiratory support (you mentioned nasal cannula or mask)?
Chema Nieto Castañón Nov 11, 2018:
@Anne Medio externo se contrapone a medio interno, en este caso al soporte ventilatorio "interno" (IOT; intubación). Así, tolerancia a medio externo se refiere a que el niño tolera (es capaz de respirar) sin soporte ventilatorio "interno" (sin intubación); tolera, no plantea dificultades, ante un soporte ventilatorio "externo" (pej. gafas o mascarilla). Me temo que es bastante más difícil de explicar que de leer ;)
Cecilia Gowar Nov 11, 2018:
Not clear whether the weaning was successful after what sounds like a failed spontaneous breathing trial. Anything about that where the dots are? Anything after the cryptic "medio externo" mention?
Anne Schulz Nov 11, 2018:
Finally, a knowledgeable person enters the scene :-)) <br >Linguistically speaking, is the tolerated medio externo the 'externalised auxiliary means', namely the withdrawn endotracheal tube, then??
Chema Nieto Castañón Nov 11, 2018:
Not sure how to say it in English but the original refers specifically to the child's capacity to breath spontaneously (without ventilatory support) in spite of initial complications after extubation.
Anne Schulz Nov 11, 2018:
Spontaneously, I would think along the same lines: the child tolerated the environment of the ICU/recovery room. The doctor may have desired to comment not only on the physical, but also on the emotional state of the patient, or the implication is that no extra sedation or stress management was required for this child. This is just a guess, however, as my Spanish is not good enough to reliably deal with unusual language. Have a nice Sunday, Joseph :-)
GGruia Nov 11, 2018:
tolerance to the external environment?
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