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dc.contributor.advisorCortés Puentes, Luis Arcadio 
dc.creatorNieto Angel, Maria Victoria 
dc.creatorCortes-Puentes, Luis Arcadio 
dc.creatorLinares-Mendoza, Gerardo 
dc.creatorNavarrete, Norberto 
dc.creatorFernandez, Fderico 
dc.date.accessioned2014-07-08T18:53:31Z
dc.date.available2014-07-08T18:53:31Z
dc.date.created2014-05-14
dc.date.issued2014
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/6378
dc.descriptionIntroducción: Los pacientes con lesiones térmicas presentan alteraciones fisiológicas complejas que hacen difícil la caracterización del estado ácido-base y así mismo alteraciones electrolíticas e hipoalbuminemia que pudieran estar relacionados con un peor pronóstico. Se ha estudiado la base déficit (BD) y el lactato, encontrando una gran divergencia en los resultados. Por lo anterior, el análisis físico-químico del estado ácido-base podría tener un rendimiento superior a los métodos tradicionales. Metodología: Se realizó el análisis de una serie de casos de 15 pacientes mayores de 15 años, con superficie corporal quemada mayor al 20% que ingresaron a una unidad de cuidado intensivo (UCI) de quemados, dentro de las siguientes 48 horas del trauma. Para el análisis se utilizaron tres métodos distintos: 1) método convencional basado en la teoría de Henderson-Hasselbalch, 2) anión-gap (AG) y anión-gap corregido por albúmina, 3) análisis físico-químico del estado ácido-base según la teoría de Stewart modificado por Fencl y Figge. Resultados: Por el método de Henderson-Hasselbalch, 8 pacientes cursaron con acidosis metabólica, 4 pacientes con una BD leve, 5 pacientes con una BD moderada y 5 pacientes con una BD severa. El AG resultó menor a 16 mmol/dl en 10 pacientes, pero al corregirlo por albumina sólo 2 pacientes cursaron con AG normal. La diferencia de iones fuertes (DIF) se encontraba anormalmente elevada en la totalidad de los pacientes. Conclusión:El análisis del AG corregido por albumina y el análisis físico-químico del estado ácido-base, podrían tener mayor rendimiento al identificar las alteraciones metabólicas de estos pacientes.
dc.description.abstractIntroduction: Patients with acute thermal injuries have physiological disorders that make difficult characterizing their acid-base status and identifying factors of poor prognosis. Studies with non-conclusive results have being done on base deficit (BD) and a serum lactate. Due to the complexity of the pathophysiological characteristics that define burn patients; the physic-chemical analysis of the acid-base status may hypothetically provide a higher accuracy in detecting metabolic and perfusion disturbances as well as in predicting bad outcomes than the other methods. Methodology: We performed the acid-base analysis of 15 patients older than 15 years-old, with a burned body surface area greater than 20% that were admitted to a burn intensive care unit within 48 hours after the injury. The analysis was performed by using three methods: 1) Conventional method based on Henderson-Hasselbalch’s theory, 2) Anion-Gap (AG),and albumin-corrected AG, and 3) Physic-chemical approach of Stewart’s acid-base state theory. Results: After using the Henderson-Haselbach’s method: 8 patients had metabolic acidosis, 4 patients had a low BD, 5 patients had medium BD, and 5 patients had severe BD elevations. When AG analysis was performed, only 5 patients showed an abnormal AG. In contrast, implementing the albumin-corrected AG it increased the number of patients with abnormal AG to 13 patients. Strong-ion difference was abnormally elevated in all the patients. Conclusions:A higher agreement between abnormal acid-base statuses was observed when using the albumin-corrected AG method and Physic-chemical approach of Stewart’s acid-base state theory.
dc.format.mimetypeapplication/pdf
dc.language.isospa
dc.rights.urihttp://creativecommons.org/licenses/by-nd/2.5/co/
dc.sourceinstname:Universidad del Rosario
dc.sourcereponame:Repositorio Institucional EdocUR
dc.subjectpor Quemaduras
dc.subjectequilibrio ácido-base
dc.subjectBrecha Aniónica
dc.subject.ddcCiencias médicas, Medicina 
dc.titleDescripción del estado acido base en pacientes con quemaduras térmicas agudas: serie de casos
dc.typemasterThesis
dc.publisherUniversidad del Rosario
dc.creator.degreeEspecialista en Medicina de Emergencias
dc.publisher.programEspecialización en Medicina de Emergencias
dc.publisher.departmentFacultad de Medicina
dc.subject.keywordBurn Injuries
dc.subject.keywordAcid-Base Equilibrium
dc.subject.keywordLactic Acid
dc.subject.keywordAnion gap.
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.subject.decsQuemaduras
dc.subject.decsMedicina de emergencias
dc.subject.decsUrgencias médicas
dc.subject.decsEquilibrio ácido-base
dc.type.spaTrabajo de grado
dc.rights.accesoAbierto (Texto completo)
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
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dc.rights.ccAtribución-SinDerivadas 2.5 Colombia
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.


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