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Desenlace funcional y hemoglobina en pacientes neurocríticos con hemorragia subaracnoidea a 2600 msnm

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dc.contributor.advisorCarrizosa Gonzalez, Jorge Armando
dc.contributor.advisorCarreño Rodríguez, José Nel
dc.creatorPalomino Mantilla, Carlos Mario
dc.creator.degreeEspecialista en Medicina Crítica y Cuidado Intensivospa
dc.creator.degreetypeFull timespa
dc.date.accessioned2020-02-14T20:31:20Z
dc.date.available2020-02-14T20:31:20Z
dc.date.created2020-01-31
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.spa
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.spa
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dc.identifier.doihttps://doi.org/10.48713/10336_20883
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/20883
dc.language.isospaspa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentFacultad de Medicinaspa
dc.publisher.programEspecialización en Medicina Crítica y Cuidado Intensivospa
dc.rightsAtribución-NoComercial-SinDerivadas 2.5 Colombiaspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.rights.economicrightsFundacion Santa Fe De Bogotaspa
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dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/
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dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subjectHemoglobinaspa
dc.subjectAltitudspa
dc.subjectHemorragia Subaracnoideaspa
dc.subjectTransfusiónspa
dc.subjectFuncionalidadspa
dc.subject.ddcGinecología & otras especialidades médicasspa
dc.subject.keywordHemoglobinspa
dc.subject.keywordAltitudespa
dc.subject.keywordSubarachnoid Hemorrhagespa
dc.subject.keywordTransfusionspa
dc.subject.keywordFunctionalityspa
dc.subject.lembCuidados intensivos neurológicosspa
dc.subject.lembHemorragia cerebral-Tratamiento-Investigacionesspa
dc.subject.lembHemorragia subaracnoidea (HSA)spa
dc.subject.lembOxígeno en la sangres-Análisisspa
dc.titleDesenlace funcional y hemoglobina en pacientes neurocríticos con hemorragia subaracnoidea a 2600 msnmspa
dc.title.TranslatedTitleFunctional outcome and hemoglobin in neurocritical patients with subarachnoid hemorrhage at 2600 masleng
dc.typemasterThesiseng
dc.type.documentTrabajo de gradospa
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTrabajo de gradospa
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