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dc.contributor.advisorCarrizosa Gonzalez, Jorge Armando 
dc.contributor.advisorCarreño Rodríguez, José Nel 
dc.creatorPalomino Mantilla, Carlos Mario 
dc.date.accessioned2020-02-14T20:31:20Z
dc.date.available2020-02-14T20:31:20Z
dc.date.created2020-01-31
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/20883
dc.descriptionIntroducción: la hemorragia subaracnoidea (HSA) es una patología del sistema nervioso central, con una elevada morbimortalidad. Los ensayos clínicos con terapias farmacológicas posiblemente no se vean afectados por la ubicación geográfica del paciente, particularmente por la altura a diferencia de la terapia con hemoderivados cuya relación con la presión atmosférica y el transporte de oxigeno genera incógnitas en ciudades de diferente altitud. Objetivo: Evaluar la relación del desenlace funcional neurológico favorable (Rankin modificado <3) vs. desfavorable (Rankin modificada 4) y su relación con el punto de corte de 10 gr/dl hemoglobina previo a transfusión, en pacientes con diagnóstico de hemorragia subaracnoidea, hospitalizados en la unidad de cuidados neurocríticos del Hospital Universitario Fundación Sante Fe de Bogotá a 2600 ms. n. m. Metodología: Estudio observacional retrospectivo de casos y controles basado en una cohorte histórica de pacientes con HSA, de enero 2010 a diciembre 2018 en Unidad de Cuidado Intensivo Neurológico. Resultados: No se encontró una relación entre desenlace funcional favorable y transfusión con nivel de hemoglobina con punto de corte de 10 gr/dL OR 1.111 (p= 0.865 95% IC 0.328 - 3.755). Conclusión: No se demostró una asociación favorable o desfavorable entre el punto de corte de hemoglobina y el desenlace neurológico funcional, no es posible realizar una recomendación frente al umbral transfusional. No se evidenció un efecto deletéreo de la transfusión sanguínea, no se evidencio aumento de episodios de vaso espasmo o isquemia cerebral tardía.
dc.description.abstractIntroduction: subarachnoid hemorrhage (SAH) is a devastating pathology of the central nervous system, with high morbidity and mortality. Clinical trials of pharmacological therapies may not be affected by the patient's geographic location, particularly by height as therapy with blood products whose relationship with atmospheric pressure and oxygen transport generates areas of uncertainty in cities of higher altitude. Objective: To evaluate the relationship of favorable neurological functional outcome (modified Rankin <3) vs. unfavorable (modified Rankin  4) with a cut-off point of 10 gr / dl hemoglobin prior to transfusion in patients diagnosed with subarachnoid hemorrhage, hospitalized in the neurocritical care unit of the Santa Fe de Bogotá Foundation at 2600 ms. n. m. Methodology: Retrospective observational study of cases and controls based on a historical cohort of patients with SAH, from January 2010 to December 2018 in the Neurological Intensive Care Unit. Results: No relationship was found between favorable functional outcome and transfusion with hemoglobin level with cut-off point of 10 gr / dL OR 1,111 (p = 0.865 95% CI 0.328 - 3.755) Conclusion: A favorable or unfavorable association between the hemoglobin cut-off point and the functional neurological outcome was not demonstrated, it is not possible to make a recommendation against the transfusion threshold. No deleterious effect of blood transfusion was evident, no increase in episodes of spasm vessel or late cerebral ischemia.
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dc.language.isospa
dc.rightsAtribución-NoComercial-SinDerivadas 2.5 Colombia
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/
dc.sourceinstname:Universidad del Rosario
dc.sourcereponame:Repositorio Institucional EdocUR
dc.subjectHemoglobina
dc.subjectAltitud
dc.subjectHemorragia Subaracnoidea
dc.subjectTransfusión
dc.subjectFuncionalidad
dc.subject.ddcGinecología & otras especialidades médicas 
dc.subject.lembCuidados intensivos neurológicos
dc.subject.lembHemorragia cerebral-Tratamiento-Investigaciones
dc.subject.lembHemorragia subaracnoidea (HSA)
dc.subject.lembOxígeno en la sangres-Análisis
dc.titleDesenlace funcional y hemoglobina en pacientes neurocríticos con hemorragia subaracnoidea a 2600 msnm
dc.typemasterThesis
dc.publisherUniversidad del Rosario
dc.creator.degreeEspecialista en Medicina Crítica y Cuidado Intensivo
dc.publisher.programEspecialización en Medicina Crítica y Cuidado Intensivo
dc.publisher.departmentFacultad de Medicina
dc.subject.keywordHemoglobin
dc.subject.keywordAltitude
dc.subject.keywordSubarachnoid Hemorrhage
dc.subject.keywordTransfusion
dc.subject.keywordFunctionality
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.type.spaTrabajo de grado
dc.rights.accesoAbierto (Texto Completo)
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
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dc.rights.licenciaEL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.
dc.type.documentTrabajo de grado
dc.creator.degreetypeFull time
dc.rights.economicrightsFundacion Santa Fe De Bogota
dc.title.TranslatedTitleFunctional outcome and hemoglobin in neurocritical patients with subarachnoid hemorrhage at 2600 masl


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