2026-06-15T18:27:48Zhttps://repository.urosario.edu.co/oai/requestoai:repository.urosario.edu.co:10336/90692021-06-03T00:47:39Zcom_10336_925com_10336_562col_10336_926
Efecto del Heliox sobre la resistencia en la vía aérea en niños con patología bronquial obstructiva que requieren ventilación mecánica
Contreras Díaz, María
Fernández Sarmiento, Jaime
niños
Heliox
patología bronquial obstructiva
The heliox effect on airway resistance in children with bronchial obstructive pathology who require mechanical ventilation
Contreras, ML; Angarita, D; Fernandez, J; Godoy, J; Mullet, H; Briceño, G.
Summary: Patients with obstructive airway disease who require mechanical ventilation have an increased airway resistance that produces deleterious effects on the respiratory mechanics. Use of Heliox has been proposed as a therapy in obstructive airway disease due to its physical properties: it reduces airway resistance, improves gas exchange and reduces ventilatory time support. The aim of this Quasi-experimental study was to measure and compare the resistance of the airway in children with obstructive airway disease, before and after the use of Heliox during mechanical ventilation.
Methods: Children who needed mechanical ventilation were included. Airway inspiratory and expiratory resistances of with Hamilton G5 ventilator were measured, before the start of mechanical ventilation and every 30 minutes after until extubation was done. Friedman’s Test and Kendall’s Coefficient of Concordance were used to analyze the differences of all measurements.
Results: In a sample of 17 patients, it was found that there was a statistical significant decrease (p<0.05), of airway inspiratory and expiratory resistance the measurements, from the second hour after the beginning of mechanical ventilation with Heliox. This effect was maintained until the time of extubation.
2014-12-10T16:35:51Z
2014-12-10T16:35:51Z
2014-12-10T16:35:51Z
2014
masterThesis
https://doi.org/10.48713/10336_9069
http://repository.urosario.edu.co/handle/10336/9069
spa
info:eu-repo/semantics/openAccess
Abierto (Texto completo)
Atribución-SinDerivadas 2.5 Colombia
EL 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.
http://creativecommons.org/licenses/by-nd/2.5/co/
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
3. Wong Judith, Lee Jan Hau, Turner David A, Rehder Kyle J, A review of the use of adjunctive therapies in severe acute asthma exacerbation in critically ill children. Expert Review of Respiratory Medicine. 2014 Aug; 8(4):423-441
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/190352025-10-09T14:46:00Zcom_10336_925com_10336_562col_10336_926
Caracterización de pacientes pediátricos con cetoacidosis diabética de acuerdo a la presentación de la diabetes mellitus en hospitales de Colombia, 2017 – 2018
Lara Bernal, Marleny Aurora
Pardo, Rosalba
Cetoacidosis
Diabetes mellitus
Acidosis metabólica
Niños
Tratamiento
Introduction: Diabetic ketoacidosis (CAD) in pediatrics is a common complication of diabetes mellitus type 1 (DM-1). Several factors influence the response to treatment and its metabolic behavior may vary according to whether the diabetic is known or is a debut. Objective: We describe the variables associated with CAD in patients under 18 years of age, including demographic, clinical, paraclinical characteristics, hospital stay and complications. Materials and methods: Cross-sectional study of a sample of 391 pediatric patients stratified by severity of CAD on admission between July 2007 and August 2018. Demographic, clinical, biochemical and omplications during the event (CAD) are described. Results: Of the 391 patients, 236 patients identified as known diabetics. 155 patients debut. Of the total 59.8% women vs 40.2% men. If CAD is classified by the pH value, the percentage of patients with mild CAD is 43.7% followed by moderate CAD 25.6% and severe CAD 30.7%, while if it is classified by the value of bicarbonate cases of CAD are predominantly moderate with 43.1%, followed by severe CAD with 28.3% and slight 28.1%. The stay of patients with CAD debut is greater both in hospitalization and in the intensive care unit. Conclusion: CAD has a different metabolic behavior and a degree of severity according to the variable used to classify it either pH or bicarbonate, using the bicarbonate values allows biochemically classifying the disorder more specifically, the most frequent complication was cerebral edema and it occurs in cases of severe CAD. The hospital stay is longer in cases of severe CAD.
2019-02-11T16:41:00Z
2019-02-11T16:41:00Z
2019-02-11T16:41:00Z
2019
masterThesis
https://doi.org/10.48713/10336_19035
http://repository.urosario.edu.co/handle/10336/19035
spa
info:eu-repo/semantics/openAccess
Abierto (Texto Completo)
EL 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.
Universidad del Rosario
Escuela de Medicina y Ciencias de la Salud
Especialización en Cuidado Intensivo Pediátrico
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Sperling MA. Cerebral edema in diabetic ketoacidosis: an underestimated complication? Pediatr Diabetes. 2006;7(2):73-4.
Yuen N, Anderson SE, Glaser N, Tancredi DJ, O'Donnell ME. Cerebral blood flow and cerebral edema in rats with diabetic ketoacidosis. Diabetes. 2008;57(10):2588-94.
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Vavilala MS, Richards TL, Roberts JS, Chiu H, Pihoker C, Bradford H, et al. Change in blood-brain barrier permeability during pediatric diabetic ketoacidosis treatment. Pediatr Crit Care Med. 2010;11(3):332-8
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Glaser NS, Tancredi DJ, Marcin JP, Caltagirone R, Lee Y, Murphy C, et al. Cerebral hyperemia measured with near infrared spectroscopy during treatment of diabetic ketoacidosis in children. J Pediatr. 2013;163(4):1111-6.
Hoffman WH, Siedlak SL, Wang Y, Castellani RJ, Smith MA. Oxidative damage is present in the fatal brain edema of diabetic ketoacidosis. Brain Res. 2011;1369:194- 202.
Dekker TJ, Janson JA, Hoorn EJ, Sijpkens YW. [Fatal cerebral oedema during the treatment of diabetic ketoacidosis in an adult male]. Ned Tijdschr Geneeskd. 2017;161(0):D734.
Glaser NS, Ghetti S, Casper TC, Dean JM, Kuppermann N, Group PECARNPDFS. Pediatric diabetic ketoacidosis, fluid therapy, and cerebral injury: the design of a factorial randomized controlled trial. Pediatr Diabetes. 2013;14(6):435-46.
Edge JA, Jakes RW, Roy Y, Hawkins M, Winter D, Ford-Adams ME, et al. The UK casecontrol study of cerebral oedema complicating diabetic ketoacidosis in children. Diabetologia. 2006;49(9):2002-9.
Bureau MA, Bégin R, Berthiaume Y, Shapcott D, Khoury K, Gagnon N. Cerebral hypoxia from bicarbonate infusion in diabetic acidosis. J Pediatr. 1980;96(6):968-73.
Durward A, Ferguson LP, Taylor D, Murdoch IA, Tibby SM. The temporal relationship between glucose-corrected serum sodium and neurological status in severe diabetic ketoacidosis. Arch Dis Child. 2011;96(1):50-7.
Edge JA, Ford-Adams ME, Dunger DB. Causes of death in children with insulin dependent diabetes 1990-96. Arch Dis Child. 1999;81(4):318-23.
Rosenbloom AL. Intracerebral crises during treatment of diabetic ketoacidosis. Diabetes Care. 1990;13(1):22-33.
Karvonen M, Viik-Kajander M, Moltchanova E, Libman I, LaPorte R, Tuomilehto J. Incidence of childhood type 1 diabetes worldwide. Diabetes Mondiale (DiaMond) Project Group. Diabetes Care. 2000;23(10):1516-26.
Harjutsalo V, Sund R, Knip M, Groop PH. Incidence of type 1 diabetes in Finland. Jama. 2013;310(4):427-8.
Svensson J, Cerqueira C, Kjærsgaard P, Lyngsøe L, Hertel NT, Madsen M, et al. Danish Registry of Childhood and Adolescent Diabetes. Clin Epidemiol. 2016;8:679-83.
11. Children and Adolescents (Standards of Medical Care in Diabetes—2016). Diabetes Care. 2016;39(Supplement 1):S86-S93.
Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia. Geneva: World Health Organization; 2006. Available from: http://www.who.int/diabetes/publications/diagnosis_diabetes2006/en/.
2. Classification and Diagnosis of Diabetes (Standards of Medical Care in Diabetes —2016). Diabetes Care. 2016;39(Supplement 1):S13-S22.
Rewers A, Klingensmith G, Davis C, Petitti DB, Pihoker C, Rodriguez B, et al. Presence of diabetic ketoacidosis at diagnosis of diabetes mellitus in youth: the Search for Diabetes in Youth Study. Pediatrics. 2008;121(5):e1258-66.
Gale EA. Dying of diabetes. Lancet. 2006;368(9548):1626-8.
Hekkala A, Reunanen A, Koski M, Knip M, Veijola R, Register FPD. Age-related differences in the frequency of ketoacidosis at diagnosis of type 1 diabetes in children and adolescents. Diabetes Care. 2010;33(7):1500-2.
Usher-Smith JA, Thompson MJ, Sharp SJ, Walter FM. Factors associated with the presence of diabetic ketoacidosis at diagnosis of diabetes in children and young adults: a systematic review. BMJ. 2011;343:d4092.
de Vries L, Oren L, Lazar L, Lebenthal Y, Shalitin S, Phillip M. Factors associated with diabetic ketoacidosis at onset of Type 1 diabetes in children and adolescents. Diabet Med. 2013;30(11):1360-6.
Rewers A, Chase HP, Mackenzie T, Walravens P, Roback M, Rewers M, et al. Predictors of acute complications in children with type 1 diabetes. JAMA. 2002;287(19):2511-8.
Curtis JR, To T, Muirhead S, Cummings E, Daneman D. Recent trends in hospitalization for diabetic ketoacidosis in ontario children. Diabetes Care. 2002;25(9):1591-6.
Wolfsdorf JI, Allgrove J, Craig ME, Edge J, Glaser N, Jain V, et al. ISPAD Clinical Practice Consensus Guidelines 2014. Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes. 2014;15 Suppl 20:154-79.
Corwell B, Knight B, Olivieri L, Willis GC. Current diagnosis and treatment of hyperglycemic emergencies. Emerg Med Clin North Am. 2014;32(2):437-52.
Dunger DB, Sperling MA, Acerini CL, Bohn DJ, Daneman D, Danne TP, et al. ESPE/LWPES consensus statement on diabetic ketoacidosis in children and adolescents. Arch Dis Child. 2004;89(2):188-94.
Chase HP, Garg SK, Jelley DH. Diabetic ketoacidosis in children and the role of outpatient management. Pediatr Rev. 1990;11(10):297-304.
Rosival V. Pathophysiology of diabetic ketoacidosis. Diabet Med. 2015;32(11):1527.
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Komatsu M, Takei M, Ishii H, Sato Y. Glucose-stimulated insulin secretion: A newer perspective. J Diabetes Investig. 2013;4(6):511-6.
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Bhattacharya S, Dey D, Roy SS. Molecular mechanism of insulin resistance. J Biosci. 2007;32(2):405-13.
Kalsbeek A, la Fleur S, Fliers E. Circadian control of glucose metabolism. Mol Metab. 2014;3(4):372-83.
Donnelly D. The structure and function of the glucagon-like peptide-1 receptor and its ligands. Br J Pharmacol. 2012;166(1):27-41.
Quesada I, Tudurí E, Ripoll C, Nadal A. Physiology of the pancreatic alpha-cell and glucagon secretion: role in glucose homeostasis and diabetes. J Endocrinol. 2008;199(1):5-19.
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Patel SG, Hsu JW, Jahoor F, Coraza I, Bain JR, Stevens RD, et al. Pathogenesis of A⁻β⁺ ketosis-prone diabetes. Diabetes. 2013;62(3):912-22.
Feenstra RA, Kiewiet MK, Boerma EC, ter Avest E. Lactic acidosis in diabetic ketoacidosis. BMJ Case Rep. 2014;2014.
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Foster DW, McGarry JD. The metabolic derangements and treatment of diabetic ketoacidosis. N Engl J Med. 1983;309(3):159-69.
Abdulaziz S, Dabbagh O, Al Daker MO, Hassan I. Hypokalaemia and refractory asystole complicating diabetic ketoacidosis, lessons for prevention. BMJ Case Rep. 2012;2012.
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Linares MY, Schunk JE, Lindsay R. Laboratory presentation in diabetic ketoacidosis and duration of therapy. Pediatr Emerg Care. 1996;12(5):347-51.
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Al-Matrafi J, Vethamuthu J, Feber J. Severe acute renal failure in a patient with diabetic ketoacidosis. Saudi J Kidney Dis Transpl. 2009;20(5):831-4.
Mitsuishi S, Matoba K, Yamazaki H. Acute respiratory distress syndrome in diabetic ketoacidosis. Intern Med. 2014;53(14):1581.
Aboulhosn K, Arnason T. Acute pancreatitis and severe hypertriglyceridaemia masking unsuspected underlying diabetic ketoacidosis. BMJ Case Rep. 2013;2013.
Carmody D, Naylor RN, Philipson LH. Insulin dosing in pediatric diabetic ketoacidosis: where to start? JAMA. 2015;313(22):2274-5.
Al Hanshi S, Shann F. Insulin infused at 0.05 versus 0.1 units/kg/hr in children admitted to intensive care with diabetic ketoacidosis. Pediatr Crit Care Med. 2011;12(2):137-40.
Duhon B, Attridge RL, Franco-Martinez AC, Maxwell PR, Hughes DW. Intravenous sodium bicarbonate therapy in severely acidotic diabetic ketoacidosis. Ann Pharmacother. 2013;47(7-8):970-5.
Muir AB, Quisling RG, Yang MC, Rosenbloom AL. Cerebral edema in childhood diabetic ketoacidosis: natural history, radiographic findings, and early identification. Diabetes Care. 2004;27(7):1541-6.
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/29802021-06-03T00:46:51Zcom_10336_925com_10336_562col_10336_926
Modos ventilatorios avanzados : Ventilación de Soporte Adaptativo (ASV)
Miguelena Muñoz, Dayra
Fernández Sarmiento, Jaime
Mulett, Hernando
Fernández Sarmiento, Jaime
Ventilación asa cerrada
Ventilación mecánica
Ventilación Soporte Adaptativo (ASV)
Mechanical ventilation is one of the most frequently used intervention in intensive care units. Despite its “lifesaving” role, it can bear risks for the patient if not adequately performed. In order to reduce the implied risks, advanced modes of ventilation continue to be developed in order to improve the clinical outcomes of patients. These advancements include closed-loop control systems, which facilitate the manipulation of
ventilation variables based on measurements of respiratory parameters. Adaptive support ventilation (ASV) is a mode that uses this control system. It adjusts automatically
to the patient’s requirements.It is important for medical staff members to understand this mode of ventilation, including its effects on pulmonary
mechanics. This article discusses ASV with particular emphasis on its parameters, advantages, and disadvantages with
regard to oxygenation and ventilation.
2012-04-23T12:19:08Z
2012-04-23T12:19:08Z
2012-04-23T12:19:08Z
2012
masterThesis
https://doi.org/10.48713/10336_2980
TEME 0078 2011
http://repository.urosario.edu.co/handle/10336/2980
spa
info:eu-repo/semantics/closedAccess
Bloqueado (Texto referencial)
Atribución-NoComercial-SinDerivadas 2.5 Colombia
EL 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.
PARÁGRAFO: 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.
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/141942021-06-03T00:48:27Zcom_10336_925com_10336_562col_10336_926
Nutritional Support of the Critically Ill Pediatric Patient : Foundations and Controversies
Ardila Gomez, Iván Jose
Bonilla González, Carolina
Martínez Palacio, Paula Andrea
Mercado Santis, Elida Teresa
Tibaduiza Bayona, José Daniel
Contreras Hernández, Juan
Fernández Sarmiento, Jaime
Fernández Sarmiento, Jaime
Pediatric
Intensive care
Enteral nutrition
Parenteral nutrition
Critically ill children require nutritional support that will give them nutritional and non-nutritional support to successfully deal with their disease. In the past few years, we have been able to better understand the pathophysiology of critical illness, which has made possible the establishment of nutritional strategies resulting in an improved nutritional status, thus optimizing the pediatric intensive care unit (PICU) stay and decreasing morbidity and mortality. Critical illness is associated with significant metabolic stress. It is crucial to understand the physiological response to stress to create nutritional recommendations for critically ill pediatric patients in the PICU.
2018-01-15T16:55:13Z
2018-01-15T16:55:13Z
2018-01-15T16:55:13Z
2017
masterThesis
https://doi.org/10.48713/10336_14194
http://repository.urosario.edu.co/handle/10336/14194
spa
info:eu-repo/semantics/openAccess
Abierto (Texto Completo)
EL 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.
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
1. Askegard-Giesmann JR, Kenney BD. Controversies in nutritional support for critically ill children. Semin Pediatr Surg. 2015;24:20–24.
Belén A, Consuelo M. Soporte nutricional en la infancia. Nutr Enteral. 2011;9:358–366.
Oosterveld MJ, Van Der Kuip M, De Meer K, De Greef HJ, Gemke RJ. Energy expenditure and balance following pediatric intensive care unit admission: a longitudinal study of critically ill children. Pediatr Crit Care Med. 2006;7:147–153.
Joffe A, Anton N. Nutritional support for critically ill children (Review). Cochrane Database Syst Rev. 2009;2:CD005144.
Bankhead R, Boullata J, Brantley S, et al. A.S.P.E.N. Enteral nutrition practice recommendations. J Parenter Enter Nutr. 2009;33:122–167.
Joosten KFM, Kerklaan D, Verbruggen SC. Nutritional support and the role of the stress response in critically ill children. Curr Opin Clin Nutr Metab Care. 2016;19:226–233.
Puthucheary ZA, Rawal J, McPhail M, et al. Acute skeletal muscle wasting in critical illness. JAMA. 2013;310:1591–1600
Cuervo AM, MacIan F. Autophagy, nutrition and immunology. Mol Aspects Med. 2012;33:2–13.
Levine B, Mizushima N, Virgin HW. Autophagy in immunity and inflammation. Nature. 2011;469:323–335.
Casaer MP, Mesotten D, Hermans G, et al. Early versus late parenteral nutrition in critically ill adults. N Engl J Med. 2011;365:506–517
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/27052021-06-03T00:46:22Zcom_10336_925com_10336_562col_10336_926
Eficacia diagnóstica y terapéutica de las radiografías de tórax rutinarias matutinas en cuidado intensivo pediátrico
Oñoro Ramos, Oscar Antonio
Pardo, Rosalba
Suescun-Vargas, Jose-Miguel
Manrique Abril, Fred
Ospina, Juan Manuel
Radiografía de tórax
Rayos x de tórax
Radiología
Unidad de cuidado intensivo
Unidad de cuidado crítico
Introduction: The usefulness of morning routine chest X rays in under debate, some studies support their use, while on the other hand, some find marginal benefit. Objectives: To determine the diagnostic and therapeutic efficacy of morning routine chest X rays in mechanically ventilated patients and the identification of subgroups of patients in whom said X rays may be of greater usefulness. Methodology: Prospective, cross sectional, in patients under mechanical ventilation for minimum 48 hours, with age among 1 month to 18 years old, data recollected from December 2010 to November 2011. Contingency tables were done and later X2 Pearson function and Fischer´s exact test calculating the value of P, odds ratio, with confidence interval in the 95% for qualitative variables. For the data analysis we used programs Statgraphics and SPSS, version 15. Results: 53 patients and 536 chest X rays were evaluated. The findings were mostly minor. Only 10. 3% of the cases belong to major findings, mainly tube malposition and new infectious infiltrates. It was not possible to establish subgroups of patients but the data suggest greater benefit from X rays in patient with very young and low weight and those mechanically ventilated. Conclusions: The usefulness of routine films is marginal. Are needs more studies to establish the usefulness in patient’s subgroups. Key words: chest radiography, chest X ray, radiology, intensive care unit, critical care unit
2011-12-09T17:46:08Z
2011-12-09T17:46:08Z
2011-12-09T17:46:08Z
2011
masterThesis
https://doi.org/10.48713/10336_2705
TEME 0077 2011
http://repository.urosario.edu.co/handle/10336/2705
spa
info:eu-repo/semantics/openAccess
Abierto (Texto completo)
Atribución-NoComercial-SinDerivadas 2.5 Colombia
EL 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.
PARÁGRAFO: 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.
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/18002021-06-03T00:46:41Zcom_10336_925com_10336_562col_10336_926
Factores de riesgo asociados al síndrome de dificultad respiratoria aguda en una unidad de cuidados intensivos pediátrica
Brito Brito, Thirsa
Ochoa, Cristina
Pardo, Rosalba
Ibáñez Pinilla, Milcíades
Dificultad respiratoria aguda
Factores de riesgo
niños
The Acute Respiratory Distress Syndrome (ARDS) is a complex syndrome that was first described in the late "60s, affects critically ill patients and is associated with high morbidity and mortality, and touted as a serious illness.
Objective: To identify risk factors associated with the onset of ARDS, and to identify demographic, PaO2/FiO2 levels, presence of malnutrition, prematurity, chronic lung disease in pediatric ICU patients in Colsubsidio Child Clinic in Bogotá, between January 2003 to December 2008.
Materials and methods: We performed an analitical study of cases and controls were done , with relation control and cases of 2:1 .the control group was composed of 62 patients and 31 cases.
Results: It was found tobe significantly associated to the three main factors of risk for ADRS : Sepsis 33.9% vs. 15.6% (p = 0.0002, OR = 5.6, 95% CI = 2.20, 14.03), pneumonia (p = 0.6380, OR = 0.80, 95% CI = 0.32, 2.00) and bronchiolitis (p = 0.0515, OR = 0.395, CI 95 % = 0.157, 1.01). Hospital stay 14.7 ± 16.3 vs. 7.4 ± 4.7 days (p = 0.001), mechanical ventilation time 11.7 ± 14.1 vs. 5.3 ± 2.8 days (p = 0.002) and mortality 45.2% vs. 3.2% (p <0.001, OR = 25, 95% CI = 5.1, 125).
Conclusions: The factors of risk significantly presence of sepsis, hospital stay, mechanical ventilation time and mortality. And also the values of the PAFI.
2010-04-20T18:03:40Z
2010-04-20T18:03:40Z
2010-04-20T18:03:40Z
2010
masterThesis
https://doi.org/10.48713/10336_1800
TEME 0024 2010
http://repository.urosario.edu.co/handle/10336/1800
spa
info:eu-repo/semantics/openAccess
Abierto (Texto completo)
Atribución-NoComercial-SinDerivadas 2.5 Colombia
EL 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.
PARÁGRAFO: 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.
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/128332021-06-03T00:45:24Zcom_10336_925com_10336_562col_10336_926
Incidencia de síndrome de abstinencia secundario a opioides y/o benzodiacepinas en dos unidades de cuidados intensivos pediátricos
Ríos Gálvez, Blanca Isabel
Alvarado, Manuel
Pardo, Rosalba
Cárdenas Müller, Adriana
De la Hoz, Jose Antonio
Escala SOPHIA
Síndrome de abstinencia
Opioides
Benzodiacepinas
Sedación
Introduction: Withdrawal syndrome (WS) is the set of symptoms and signs that occur when abruptly stops the administration of a drug once physical dependence has been established.
•Objective: To characterize patients with secondary WS to opioids and / or benzodiazepines during hospitalization in the pediatric intensive care Clínica Infantil Colsubsidio (CIC) and the Hospital del Niño in Panama (HDN) from 1 April to 30 September 2016.
• Materials and Methods: This was a descriptive, longitudinal, prospective study. We included 189 patients in the CIC and 144 patients in the HDN. The SOPHIA scale was used for the diagnosing of withdrawal; the COMFORT scales for evaluating sedation in unrelaxed ventilated patients and the FLACC scale for evaluating analgesia. The StataV12® software was used for statistical analysis.
• Results: A global incidence rate of WS of 6.1 / 100 days people was reported. The cumulative incidence of WS was 56.08% and 29.86% for the CIC and HDN respectively. At the CIC in the 69.81% of patients who required infusion of opioids and benzodiazepines developed WS. Acumulative dose of fentanyl of 530.34 ± 276.49 mcg / kg was reported. At the HDN, 53.49% of the patients who received opioids and benzodiazepines developed the syndrome.
Conclusion: WS secondary to opioids and / or benzodiazepines is frequent in our intensive care units with a variable incidence, and a higher frequency of WS with the use of both medications, higher cumulative doses and more days of continuous infusion.
2017-02-01T13:13:59Z
2017-02-01T13:13:59Z
2017-02-01T13:13:59Z
2017
masterThesis
https://doi.org/10.48713/10336_12833
http://repository.urosario.edu.co/handle/10336/12833
spa
info:eu-repo/semantics/openAccess
Abierto (Texto completo)
EL 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.
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
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4. Valdivielso-Serna A. Analgesia, sedación y relajación en el niño con ventilación mecánica. Med Intensiva. 2008;32 Supl 1:115-24 115
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17. Twite MD, Rashid A, Zuk J, Friesen RH. Sedation, analgesia, and neuromuscular blockade in the pediatric intensive care unit: survey of fellowship training programs. Pediatr Crit Care Med. 2004;5(6):521–32.
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20. Fernández-Carrión F, Gaboli M, González-Celador R, Gómez de Quero-Masía P, Fernández-de Miguel S, Murga-Herrera V, et al. Síndrome de abstinencia en Cuidados Intensivos Pediátricos. Incidencia y factores de riesgo. Med Intensiva. 2012;37(2):67-74
21. Volkow ND, McLellan TA. Characteristics of Opioid Prescriptions in 2009. JAMA J Am Med Assoc. 2011;305(13):1299–301.
22. Rhoney DH, Murry KR. National survey on the use of sedatives and neuromuscular blocking agents in the pediatric intensive care unit. Pediatr Crit Care Med. 2002;3(2):129–33.
23. Patel SB, Kress JP. Sedation and analgesia in the mechanically ventilated patient. Am J Respir Crit Care Med. 2012;185(5):486–97.
24. Devlin J, Roberts RJ. Pharmacology of Commonly Used Analgesics and Sedatives in the ICU : Benzodiazepines, Propofol, and Opioids. Anesthesiology Clin 29(2011):567–585
25. Mencía S. Monitorización de analgesia, sedación y bnm en ucip. Protocolo del grupo de sedoanalgesia de la secip. Secip. 2013;1–10.
26. Bai J, Hsu L, Tang Y, Van Dijk M. Validation of the COMFORT Behavior Scale and the FLACC Scale for Pain Assessment in Chinese Children after Cardiac Surgery. Pain Manag Nurs. American Society for Pain Management Nursing; 2012;13(1):18–26.
27. Voepel-Lewis T, Zanotti J, Dammeyer JA, Merkel S. Reliability and validity of the face, legs, activity, cry, consolability behavioral tool in assessing acute pain in critically ill patients. Am J Crit Care. 2010;19(1):55–61.
28. Vet NJ, Ista E, De Wildt SN, Van Dijk M, Tibboel D, De Hoog M. Optimal sedation in pediatric intensive care patients: a systematic review. Intensive Care Med. 2013;39(9):1524–34.
29. Sauder P, Andreoletti M, Cambonie G, Capellier G, Feissel M, Gall O, et al. Sédation-analgésie en réanimation (nouveau-né exclu). Ann Fr Anesth Reanim. 2008;27(7–8):541–51.
30. Andersen RD, Bernklev T, Langius-Eklof A, Nakstad B, Jylli L. The COMFORT behavioural scale provides a useful assessment of sedation, pain and distress in toddlers undergoing minor elective surgery. Acta Paediatr. 2015;104(9):904–9.
31. Dorfman TL, Sumamo Schellenberg E, Rempel GR, Scott SD, Hartling L. An evaluation of instruments for scoring physiological and behavioral cues of pain, non-pain related distress, and adequacy of analgesia and sedation in pediatric mechanically ventilated patients: A systematic review. Int J Nurs Stud. Elsevier Ltd; 2014;51(4):654–76.
32. Bustos R, Fuentes C. Correlación entre análisis biespectral y escala COMFORT en la evaluación de sedación en la Unidad de Cuidados Intensivos Pediátricos. Rev Chil pediatría. 2007;78(6):592–8.
33. Harris J, Ramelet AS, Van Dijk M, Pokorna P, Wielenga J, Tume L, et al. Clinical recommendations for pain, sedation, withdrawal and delirium assessment in critically ill infants and children: an ESPNIC position statement for healthcare professionals. Intensive Care Med. Springer Berlin Heidelberg; 2016;42(6):972–86.
34. Neunhoeffer F, Kumpf M, Renk H, Hanelt M, Berneck N, Bosk A, et al. Nurse-driven pediatric analgesia and sedation protocol reduces withdrawal symptoms in critically ill medical pediatric patients. 2015;25:786–94.
35. Franck LS, Vilardi J, Durand D, Powers R. Opioid withdrawal in neonates after continuous infusions of morphine or fentanyl during extracorporeal membrane oxygenation. Am J Crit Care. 1998;7(5):364–9.
36. Franck LS, Naughton I, Winter I. Opioid and benzodiazepine withdrawal symptoms in paediatric intensive care patients. Intensive Crit Care Nurs. 2004;20:344–51.
37. Birchley G. Opioid and benzodiazepine withdrawal syndromes in the paediatric intensive care unit: a review of recent literature. Nurs Crit Care. 2009;14(1):26–37.
38. Gardner D. NIH Public Access. Neonatal Abstinence Syndrome (NAS): Transitioning Methadone Treated Infants From An Inpatient to an Outpatient Setting. 2013;32(6):425–30.
39. Finnegan LP, Connaughton JF, Kron RE, Emich JP. Neonatal abstinence syndrome: assessment and management. Addictive diseases. 1975:141–58.
40. Cunliffe M, McArthur L, Dooley F. Managing sedation withdrawal in children who undergo prolonged PICU admission after discharge to the ward. Paediatric Anaesthesia. 2004. p. 293–8.
41. Amigoni A, Vettore E, Brugnolaro V, Brugnaro L, Gaffo D, Masola M, et al. High doses of benzodiazepine predict analgesic and sedative drug withdrawal syndrome in paediatric intensive care patients. Acta Paediatr. 2014;103(12):e538–43.
42. Franck LS, Scoppettuolo L, Wypij D, Curley M. Validity and generalizability of the Withdrawal Assessment Tool-1 (WAT-1) for monitoring iatrogenic withdrawal syndrome in pediatric patients. Pain. International Association for the Study of Pain; 2012;153(1):142–8.
43. Ista E, Van Dijk M, Hoog M, Tibboel D, Duivenvoorden HJ. Construction of the Sophia Observation withdrawal Symptoms-scale (SOS) for critically ill children. Intensive Care Med. 2009;35(6):1075–81.
44. Ista E, De Hoog M, Tibboel D, Duivenvoorden HJ, Van Dijk M. Psychometric evaluation of the Sophia Observation withdrawal symptoms scale in critically ill children. Pediatr Crit Care Med. 2013;14(8):761–9.
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47. Johnson PN, Miller JL, Hagemann TM. Sedation and Analgesia in Critically Ill Children. AACN Adv Crit Care. 2012;23(4):415–34.
48. Celis-Rodríguez E, Birchenall C, De la Cal M.A, Arellano GC, Jimenez EJ, García JOS, et al. Guía de práctica clínica basada en la evidencia para el manejo de la sedoanalgesia en el paciente adulto críticamente enfermo. Med Intensiva 2013 http//dx.doi.org/101016/j.medin201304001. 2013;(xx).
49. Bicudo JN, Souza N De, Mângia CMF, Carvalho WB. Síndrome de abstinência associada à interrupção da infusão de fentanil e midazolam em pediatria. Rev Assoc Med Bras. 1999;45(1):15–8.
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55. Fisher D, Grap MJ, Younger JB, Ameringer S, Elswick RK. Opioid withdrawal signs and symptoms in children: Frequency and determinants. Hear Lung J Acute Crit Care. Elsevier Inc; 2013;42(6):407–13.
56. Subramaniam R, Playfor SD. Sedation and analgesia in critically ill children. Pediatrics and Child Health. 2011:25(4): 177-181.
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instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/348112022-08-31T07:57:15Zcom_10336_925com_10336_562col_10336_926
Marcadores inflamatorios y factores clínicos asociados en niños y adolescentes con infección por SARS COV-2 y la relación con su severidad en dos instituciones de Bogotá
Rodríguez Suesca, María Angélica
Casallas Vega, Alexander
Ruiz Rodríguez, Diana Alejandra
SARS CoV2
Covid 19
Biomarcadores
Biomarcadores en niños
Población pediátrica
Backround: To date there are few studies that describe the behavior of inflammatory markers, and its relationship with the severity of the disease, in children with SARS CoV-2 infection so it is intended to carry out a case-control study in the pediatric population of the Hospital Universitario Clínica San Rafael (HUCSR) and the Clínica Infantil Colsubsidio (CIC) in the period between April 2020 and March 2022. Methods: A multicenter case-control study was conducted. A random sampling was made, using the information of patients with severe SARS-COV2 as cases vs patients with mild SARS-COV2 as controls, the values of different serum markers of inflammation were compared in a 1:2 ratio. The analysis was done through a bivariate analysis according to the clinical variables of interest. Results: A total of 171 patients, 51 cases, 120 controls were analyzed in a ratio of approximately 1:2. Critically ill patients were smaller than controls (median 19 months vs. 30 months, cases vs. controls, respectively); when evaluating the markers for critical illness, it was found that the absolute count of leukocytes, neutrophils, platelets, LDH, CRP value and D-dimer upon admission to the institution, and the absolute count of lymphocytes, monocytes and platelet count at 72 hours made a significant difference as markers of critical illness. Discussion: The physiological characteristics of infants, maturity of the immunoassay system, vaccination and exposure to pathogens can explain the differences in response to infection when copared to adults, also reflecting the trends observed in the lab. However, leukocytes, platelets, LDH RCP value and D-dimer can guide critical disease in this population. In the same way, the variation in the count of lymphocytes, monocytes and platelets taken in a control at 72 hours of admission.
2022-08-26T14:17:04Z
2022-08-26T14:17:04Z
2022-08-26T14:17:04Z
bachelorThesis
https://doi.org/10.48713/10336_34811
https://repository.urosario.edu.co/handle/10336/34811
spa
info:eu-repo/semantics/openAccess
Abierto (Texto Completo)
EL 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.
Universidad del Rosario
Escuela de Medicina y Ciencias de la Salud
Especialización en Cuidado Intensivo Pediátrico
1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 395(10223):497–506.
2. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 382(8):727–33.
3. Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review. JAMA - J Am Med Assoc. 324(8):782–93.
4. Ministerio Protección social “La salud es de todos.” Coronavirus COVID 19. Siruación actual nuevo coronavirus (Covid 19). 2020.
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7. Chen ZM, Fu JF, Shu Q, Chen YH, Hua CZ, Li FB, et al. Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus. World J Pediatr. 2020;16(3):240–6.
8. Ciuca IM. COVID-19 in children: An ample review. Risk Manag Healthc Policy. 2020;13:661–9.
9. Elshazli, RM; Toraih, EA; Elgaml, A; El-Mowafy, M; El-Mesery, M; Amin M. Diagnostic and prognostic value of hematological and immunological markers in COVID-19 infection: A meta-analysis of 6320 patients. PLoS One. 2020;15(8):1–20.
10. Lee PI, Hu YL, Chen PY, Huang YC, Hsueh PR. Are children less susceptible to COVID-19? J Microbiol Immunol Infect. 2020;53(3):371–2.
11. Ludvigsson J. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr Int J Paediatr. 2020;109(6):1088–95.
12. Rivera-Diaz; RR-HM. Sindome inflamatorio multisistémico asociado a COVID 19 en niños y adolescentes. Rev Latinoam Infectología Pediátrica. 2020;33(3):115–8.
13. ACNP. Asociación Colombiana de Pediatría. Sagra Catalina Vasquez, et al. Guías de manejo de COVID-19 en niños [Internet]. 2020. p. 1–11. Available from: https://portal.neumopediatriacolombia.com/guias-de-manejo-de-covid-19-en-ninos/
14. Orellana;, Jesem Douglas, Geraldo Marcelo, da Cunha;Lihsieh M. Explosión de la mortalidad en el epicentro amazónico de la epidemia de COVID-19. Cad Saúde Pública. 2020;36(7).
15. Otoya, Ana M; García, María; Jaramillo, Catalina; Wills, Carlos; Campos AM. COVID-19: generalidades, comportamiento epidemiológico y medidas adoptadas en medio de la pandemia en Colombia. Acta Otorrinolaringol y Cirugía Cabeza y cuello [Internet]. 2020;4(13). Available from: https://www.revista.acorl.org.co/index.php/acorl/article/view/475
16. Wiersinga, WJ; Rhodes, A; Cheng, AC; Peacock, SJ; Prescott H. Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review. JAMA. 324(8):782–93.
17. Guan, W; Ni, Z; Hu, Y; Liang, W; Ou, C; He J. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708–12.
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19. Zhou, P; Yang X, Lou;Wang, XG; Hu, B; Zhang, L, Zhang W. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579:270–3.
20. Liu YC, Yu MM, Shou ST, Chai YF. Sepsis-induced cardiomyopathy: Mechanisms and treatments. Front Immunol. 2017;8(AUG):1–8.
21. Bohn, MK; Hall, A; Sepiashvili, L; Jung, B; Steele SA. Pathophysiology of COVID-19: Mechanisms Underlying Disease Severity and Progression. Physiol. 2020;35(5):288.
22. Liu, Y; Yan, Li-Men; Wan, L; Xiang, Tian-Xin; Le A. Viral dynamics in mild and severe cases of COVID-19. Lancet. 2020;20(6):19–21.
23. Jia, HP; Look, DC; Shi, L; Hickey, M; Pewe, L; Netland J. ACE2 Receptor Expression and Severe Acute Respiratory Syndrome Coronavirus Infection Depend on Differentiation of Human Airway Epithelia. J Virol. 2005;79(23):146–21.
24. Li, M; Yao, D; Zeng, X; Kasakovski, D; Zhang, Y; Chen S. Age related human T cell subset evolution and senescence. Immun Ageing. 2019;16(1):1–7.
25. Lee, PI; Hu, YL; Chen, PY; Huang, YC; Hsueh P. Are children less susceptible to COVID-19? J Microbiol Immunol Infect. 2020;53(3):371–2.
26. Trujillo CHS. Consenso colombiano de atención, diagnóstico y manejo de la infección por sars-cov-2/covid 19 en establecimientos de atención de la salud. Recomendaciones basadas en consenso de expertos e informadas en la evidencia. Infectio [Internet]. 2020;24(2). Available from: http://www.revistainfectio.org/index.php/infectio/article/view/851/896
27. Chen, ZM; Fu, JF; Shu, Q; Chen, YH; Hua, CZ;Li F. Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus. World J Pediatr. 2020;160(3):240–6.
28. Rothan, HA; Byrareddy S. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;
29. Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med. 2020;58(7):1131–4.
30. Lippi, G; Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med. 2020;58(7):1131–4.
31. Liu, F; Li, L; Xu, M; Wu, J; Luo, D; Zhu Y. Prognostic value of interleukin-6, C-reactive protein, and procalcitonin in patients with COVID-19. J Clin Virol. 2020;127.
32. Ruan, Q; Yang, K; Wang, W; Jiang, L; Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med [Internet]. 2020;46(5):846–8.
33. Storch-de-Gracia, P; Leoz-Gordillo, I; Andina, D; Flores, P; Villalobos, E; Escalada-Pellitero S. Espectro clínico y factores de riesgo de enfermedad complicada en niños ingresados con infección por SARS-CoV-2. An Pediatría. 2020;93(5):323–33.
34. Kosmeri, C; Koumpis, E; Tsabouri, S; Siomou, E; Makis A. Hematological manifestations of SARS-CoV-2 in children. Pediatr Blood Cancer. 2020;67(12).
35. Henry, BM; Lippi, G; Plebani M. Laboratory abnormalities in children with novel coronavirus disease 2019. Clin Chem Lab Med. 2020;58(7):1135–8.
36. Esteves, R; Castro V, De; Carla, D; Souza, D; Flavio, L; Lima P. Pediatric patients with COVID-19 admitted to intensive care units in Brazil: a prospective multicenter study. J Pediatr (Rio J). 2020;
37. Elizabeth; VPMIL. Alteraciones hematológicas en COVID-19. NOVA. 2020;18(35):73–7.
38. Pío; BReILMEL. Diferencias entre niños y adultos por el nuevo coronavirus 2019, SARS-CoV-2/COVID 19. Rev Latinoam Infectología pediátrica. 2020;33(4):165–73.
39. Mundial AM. Declaración de Helsinky. Principios éticos para las investigaciones médicas en seres humanos. Acta Bioeth. 1964;
40. MPS Ministerio de la Protección social. Resolucion 8430/1993 Por la cual se establecen las normas científicas, técnicas y administrativas para la investigación á. Bogotá. In 1993.
41. Henry, Brandon Michael et al. “Laboratory abnormalities in children with mild and severe coronavirus disease 2019 (COVID-19): A pooled analysis and review.” Clinical biochemistry vol. 81 (2020): 1-8. doi:10.1016/j.clinbiochem.2020.05.012
42. Wu H, Zhu H, Yuan C, Yao C, Luo W, Shen X, Wang J, Shao J, Xiang Y. Clinical and Immune Features of Hospitalized Pediatric Patients With Coronavirus Disease 2019 (COVID-19) in Wuhan, China. JAMA Netw Open. 2020 Jun 1;3(6):e2010895. doi: 10.1001/jamanetworkopen.2020.10895. PMID: 32492165; PMCID: PMC7272117.
43. Zheng Y, Zhang Y, Chi H, Chen S, Peng M, Luo L, Chen L, Li J, Shen B, Wang D. The hemocyte counts as a potential biomarker for predicting disease progression in COVID-19: a retrospective study. Clin Chem Lab Med. 2020 Jun 25;58(7):1106-1115. doi: 10.1515/cclm-2020-0377. PMID: 32352397.
44. Fernandes DM, Oliveira CR, Guerguis S, et al; Tri-State Pediatric COVID-19 Research Consortium. Severe acute respiratory syndrome coronavirus 2 clinical syndromes and predictors of disease severity in hospitalized children and youth. J Pediatr. 2021;230:23–31.e10.
45. Das BB. COVID-19 and Pulmonary Hypertension in Children: What Do We Know So Far?. Medicina (Kaunas). 2020;56(12):716. Published 2020 Dec 19. doi:10.3390/medicina56120716.
46. Xia, Wei et al. “Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults.” Pediatric pulmonology vol. 55,5 (2020): 1169-1174. doi:10.1002/ppul.24718.
47. Langford, B. J., So, M., Raybardhan, S., Leung, V., Soucy, J. R., Westwood, D., Daneman, N., & MacFadden, D. R. (2021). Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 27(4), 520–531. https://doi.org/10.1016/j.cmi.2020.12.018
48. Dong Y., Mo X., Hu Y., Qi X., Jiang F., Jiang Z., Tong S. Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China. Pediatrics. 2020 doi: 10.1542/peds.2020-0702.
49. CDC COVID-19 Response Team. Coronavirus Disease 2019 in Children - United States, February 12-April 2, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(14):422-426. Published 2020 Apr 10. doi:10.15585/mmwr.mm6914e4.
50. Hendren NS, de Lemos JA, Ayers C, Das SR, Rao A, Carter S, Rosenblatt A, Walchok J, Omar W, Khera R, Hegde AA, Drazner MH, Neeland IJ, Grodin JL. Association of Body Mass Index and Age With Morbidity and Mortality in Patients Hospitalized With COVID-19: Results From the American Heart Association COVID-19 Cardiovascular Disease Registry. Circulation. 2021 Jan 12;143(2):135-144. doi: 10.1161/CIRCULATIONAHA.120.051936. Epub 2020 Nov 17. PMID: 33200947.
51. Graff K, Smith C, Silveira L, Jung S, Curran-Hays S, Jarjour J, et al. Factores de riesgo de COVID-19 grave en niños. Pediatr Infect Dis J. (2021) 40 :e137–e45. 10.1097/INF.0000000000003043
52. Tsankov BK, Allaire JM, Irvine MA, et al. Severe COVID-19 Infection and Pediatric Comorbidities: A Systematic Review and Meta-Analysis. International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases. 2021 Feb;103:246-256. DOI: 10.1016/j.ijid.2020.11.163. PMID: 33227520; PMCID: PMC7679116.
53. López-Medina E, Camacho-Moreno G, Brizuela ME, Dávalos DM, Torres JP, Ulloa-Gutierrez R, et al Factors Associated With Hospitalization or Intensive Care Admission in Children With COVID-19 in Latin America. Front Pediatr. 2022 Apr 14;10:868297. doi: 10.3389/fped.2022.868297. PMID: 35498776; PMCID: PMC9048675.
54. Shekerdemian LS, Mahmood NR, Wolfe KK, et al. Características y resultados de los niños con infección por coronavirus 2019 (COVID-19) admitidos en unidades de cuidados intensivos pediátricos de EE. UU. y Canadá. JAMA Pediatría . 2020;174(9):868-873. doi:10.1001/jamapediatrics.2020.1948.
55. Woodruff RC, Campbell AP, Taylor CA, et al. Risk Factors for Severe COVID-19 in Children. Pediatrics 2021.
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/26792021-06-03T00:46:35Zcom_10336_925com_10336_562col_10336_926
Estudio de correlación entre la PaO2/FiO2 y la SO2/FiO2 en niños en ventilación mecánica de la Fundación Cardioinfantil en Bogotá entre Abril y Junio de 2011
Murcia Sánchez, Hecmar Eduardo
Fernández Sarmiento, Jaime
Síndrome de dificultad Respiratoria Aguda
lesión pulmonar aguda
Ventilación mecánica
Saturación de oxígeno
Presión arterial de oxígeno
Objectives: To determine if there is any correlation between SaFiO2 and PaFiO2 variables of patients with acute respiratory disease in the Pediatric Intensive Care Unit in Fundacion Cardioinfantil the city of Bogotá DC.
Materials and methods: The quantitative variables were analyzed with measures of central tendency like average and measures of dispersion such as standard deviation.
We used a confidence level of 95% and an estimated 80% power to test hypotheses of a proportion.
We performed a correlation analysis to measure the strength of the relation between PaO2/FiO2 and SO2/FiO2 variables through the coefficient of correlation.
Results: We included 12 patients and it took a total of 65 records of SO2/FiO2 and PaO2/FiO2 founding a positive relation between SaO2/FIO2 and PaO2/FIO2 variables, which is variable depending on the inspired fraction of oxygen to which is the patient.
According to the observations, the SaO2/FIO2 variable is moderately correlated (r = 0.602) with PaO2/FIO2 variable, when FIO2 is between 0.35 and 0.55, one degree of acceptable correlation (r = 0.319), when the FIO2 is between 0.60 to 0.80 and 0.81 - 1 (r = 0.318).
Conclusions: The noninvasive methods in the evaluation of oxygenation may be an alternative for clinical monitoring in children with acute lung injury or acute respiratory distress syndrome. It requires an analytical studies to provide a better scientific evidence which can be extrapolated to the children covered by this study.
2011-11-28T17:58:41Z
2011-11-28T17:58:41Z
2011-11-28T17:58:41Z
2011
masterThesis
https://doi.org/10.48713/10336_2679
TEME 0073 2011
http://repository.urosario.edu.co/handle/10336/2679
spa
info:eu-repo/semantics/openAccess
Abierto (Texto completo)
Atribución-NoComercial-SinDerivadas 2.5 Colombia
EL 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.
PARÁGRAFO: 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.
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/475842026-02-26T03:01:57Zcom_10336_925com_10336_562col_10336_926
Desenlaces en pacientes sépticos de una unidad de cuidado intensivo pediátrico con Programa de Optimización de Antimicrobianos (PROA). Clínica Colsubsidio Infantil 2021 - 2023
Romero Castro, Héctor Andrés
Cardenas Muller, Adriana
Bejarano, Ana María
Buitrago Medina, Daniel Alejandro
Educación Médica y en Ciencias de la Salud
Sepsis
Pediatria
Cuidado intensivo pedaitrico
Programa de optimización de antimicrobianos
Resistencia bacteriana
A retrospective observational cohort study was conducted including 395 patients aged 0–18 years with a diagnosis of sepsis admitted to the PICU between 2021 and 2023. Sociodemographic and clinical characteristics, microbiological patterns, resistance mechanisms, antibiotic decisions within the PROA framework and clinical outcomes were described. This study provides a detailed description of pediatric sepsis in a high-complexity PICU operating within an institutional antimicrobial stewardship program and offers a local baseline on clinical and microbiological characteristics and outcomes, which may inform protocol refinement and the design of future analytical or implementation studies.
2026-02-25T15:06:06Z
2026-02-25T15:06:06Z
2026-02-25T15:06:06Z
masterThesis
https://doi.org/10.48713/10336_47584
https://repository.urosario.edu.co/handle/10336/47584
spa
info:eu-repo/semantics/openAccess
Abierto (Texto Completo)
EL 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.
http://creativecommons.org/licenses/by/4.0/
Attribution 4.0 International
Universidad del Rosario
Escuela de Medicina y Ciencias de la Salud
Especialización en Medicina Crítica y Cuidado Intensivo Pediátrico
Aizawa, Y., Suwa, J., Higuchi, H., Tazumi, K., & Takeuchi, M. (2018). Antimicrobial stewardship program in a pediatric intensive care unit of a tertiary care center in Japan. Journal of the Pediatric Infectious Diseases Society, 7(3), e156–e159.
Antimicrobial Resistance Collaborators. (2023). The burden of antimicrobial resistance in the Americas in 2019: A cross-country systematic analysis. The Lancet Regional Health – Americas, 25, 100561.
Berezin, E. N., & Solórzano, F. (2014). Gram-negative infections in pediatric and neonatal intensive care units of Latin America. Journal of Infection in Developing Countries, 8(8), 942–953.
Cornistein, W., Ferrero, F., Uez, O., Speranza, N., Ardiles, R., & Ferraro, M. (2025). Prevalence and associated mortality of infections by multidrug-resistant organisms in children: A multicenter study in Latin America. Antibiotics, 14(5), 493
Fernández-Polo, A., Melendo-Pérez, S., Larrosa, N., et al. (2024). Five-year evaluation of a pediatric antimicrobial stewardship program in a tertiary-care hospital. Antibiotics, 13(6), 511
Fleischmann-Struzek, C., Goldfarb, D. M., Schlattmann, P., Schlapbach, L. J., Reinhart, K., & Kissoon, N. (2018). The global burden of paediatric and neonatal sepsis: A systematic review. The Lancet Respiratory Medicine, 6(3), 223–230.
Fonseca-Rivera, I. C., et al. (2025). Impact of an antimicrobial stewardship program on mortality and consumption of antibiotics in the intensive care units of a pediatric referral hospital in Peru. Antimicrobial Stewardship & Healthcare Epidemiology, 5(1)
Liberati, C., Brigadoi, G., et al. (2025). Antimicrobial stewardship programs in pediatric intensive care units: A systematic scoping review. Antibiotics, 14(2), 130.
Massaud-Ribeiro, L., Martinez, E. E., & Schlapbach, L. J. (2022). Pediatric sepsis research: Where are we and where are we headed? Frontiers in Pediatrics, 10, 829119.
Ministerio de Salud y Protección Social. (2017). La resistencia a los antimicrobianos: Un reto para los sistemas de salud. Ministerio de Salud y Protección Social de Colombia.
Renk, H., Regamey, N., Hitzler, M., et al. (2020). Antibiotic stewardship in the PICU: Impact of ward rounds led by pediatric infectious diseases specialists on antibiotic use. Scientific Reports, 10, 13717.
Robledo, J., Maldonado, N., Robledo, C., et al. (2022). Changes in antimicrobial resistance and etiology of blood culture isolates: Results of a decade (2010–2019) of surveillance in a northern region of Colombia. Infection and Drug Resistance, 15, 6067–6079.
Rudd, K. E., Johnson, S. C., Agesa, K. M., et al. (2020). Global, regional, and national sepsis incidence and mortality, 1990–2017: Analysis for the Global Burden of Disease Study. The Lancet, 395(10219), 200–211
Sanchez-Pinto, L. N., Schlapbach, L. J., et al. (2024). International consensus criteria for pediatric sepsis and septic shock (Phoenix criteria). JAMA, 331
Sick-Samuels, A. C., et al. (2022). Diagnostic stewardship in the pediatric intensive care unit. Current Treatment Options in Infectious Diseases, 14(1), 54–67
Watson, R. S., Carrol, E. D., Carter, M. J., et al. (2024). The burden and contemporary epidemiology of sepsis in children. The Lancet Child & Adolescent Health, 8(9), 670–681. https://doi.org/10.1016/S2352-4642(24)00135-9
Weiss, S. L., Peters, M. J., Alhazzani, W., et al. (2020). Surviving Sepsis Campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children. Intensive Care Medicine, 46(Suppl 1), 10–67
Willems, J., Hermans, E., Schelstraete, P., Depuydt, P., & De Cock, P. (2021). Optimizing the use of antibiotic agents in the pediatric intensive care unit: A narrative review. Pediatric Drugs, 23(1), 39–53.
Donà, D., Barbieri, E., Daverio, M., Lundin, R., Giaquinto, C., Zaoutis, T., & Sharland, M. (2020). Implementation and impact of pediatric antimicrobial stewardship programs: A systematic scoping review. Antimicrobial Resistance & Infection Control, 9, 3
Gaies, M. G., Gurney, J. G., Yen, A. H., et al. (2010). Vasoactive-Inotropic Score as a predictor of morbidity and mortality in infants after cardiopulmonary bypass. Pediatric Critical Care Medicine, 11(2), 234–238
Hersh, A. L., Beekmann, S. E., Polgreen, P. M., Zaoutis, T. E., & Newland, J. G. (2013). Antimicrobial stewardship programs in pediatrics. Infectious Disease Clinics of North America, 27(1), 283–298
Newland, J. G., & Gerber, J. S. (2013). Pediatric antimicrobial stewardship programs. Infectious Disease Clinics of North America, 27(1), 91–116
Selewski, D. T., Cornell, T. T., Heung, M., Troost, J. P., Ehrmann, B. J., Lombel, R. M., Shanley, T. P., et al. (2014). Validation of the KDIGO acute kidney injury criteria in a pediatric critical care population. Intensive Care Medicine, 40(10), 1481–1488
Shah, P., et al. (2022). Using aggregate vasoactive-inotrope scores to predict outcomes in pediatric sepsis. Frontiers in Pediatrics, 10, 778378
Tamma, P. D., Aitken, S. L., Bonomo, R. A., Mathers, A. J., van Duin, D., & Clancy, C. J. (2021). IDSA guidance on the treatment of AmpC β-lactamase–producing Enterobacterales, carbapenem-resistant Enterobacterales, and Pseudomonas aeruginosa with difficult-to-treat resistance. Clinical Infectious Diseases, 72(7), e169–e183
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/123222021-06-03T00:48:00Zcom_10336_925com_10336_562col_10336_926
Infección por virus sincitial respiratorio y su relación con valores de IGG en niños críticos
Bonilla González, Carolina
Ruiz, Diana Alejandra
Virus sincitial respiratorio
inmunoglobulinas
inmunodeficiencia
hipogamaglobulineamia
unidad de cuidado intensivo pediátrico
Background: Respiratory Syncytial Virus (RSV) infection represents a high morbidity and mortality, and in some cases management in pediatric intensive care units (PICU). The immune response directly influences the severity and prognosis of patients with respiratory infection. Methodology: A retrospective study of a cohort of patients with severe RSV respiratory infection and no history of immunodeficiency was conducted in the PICU of San Rafael University Hospital Clinic. Global descriptive analysis was performed and according to the categorization of IgG tests analysis. Results: Of 188 patients admitted to the PICU, 13% had RSV infection (24), with an average age of 7. 3 (SD = 3. 6) months; 79. 83% were male. Twelve point five percent had a low value of IgG, 58. 33% had a lower limit value and 29. 17% within the normal range for their age. In patients with low IgG was higher septic shock unresponsive to liquids (100 vs 92 vs 86%), median days of mechanical ventilation (8 vs 6 vs 5, respectively) and mortality (67 vs 7. 1 vs 0%). Conclusion: Our series found that patients with low levels or lower limit values of IgG had more systemic involvement, longer duration of mechanical ventilation and increased mortality. Prospective studies are needed that low levels of IgG relationships with severity and prognosis for these patients with severe RSV infection.
2016-08-30T21:16:37Z
2016-08-30T21:16:37Z
2016-08-30T21:16:37Z
2016
masterThesis
https://doi.org/10.48713/10336_12322
http://repository.urosario.edu.co/handle/10336/12322
spa
info:eu-repo/semantics/openAccess
Abierto (Texto completo)
Atribución-NoComercial-SinDerivadas 2.5 Colombia
EL 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.
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
1. Secretaría Distrital de Salud de Bogotá. Boletin II trimestre de 2014. Boletin enfermedad respiratoria aguda ERA [Internet]. 2014. [CItado 5 de julio de 2016]. Disponible en:http://www.saludcapital.gov.co/DSP/ERA/Bolet%C3%ADn%20ERA%20II%20Trimest re%202014.pdf
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43. Regnier SA, Huels J. Association between respiratory syncytial virus hospitalizations in infants and respiratory sequelae: systematic review and meta-analysis. Pediatr Infect Dis J. 2013;32(8):820-6.
44. Backman K, Piippo-Savolainen E, Ollikainen H, Koskela H, Korppi M. Adults face increased asthma risk after infant RSV bronchiolitis and reduced respiratory health-related quality of life after RSV pneumonia. Acta Paediatr. 2014;103(8):850-5.
45. Welliver RC. Review of epidemiology and clinical risk factors for severe respiratory syncytial virus (RSV) infection. J Pediatr. 2003;143(5 Suppl):S112-7.
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48. Palomino M. LM, Moraga J., Avendaño L., Luis F. Severidad clinica de la infecciòn respiratoria aguda baja primaria por virus respiratorio sincicial grupos A y B Rev chil pediatr [Internet]. 2004 feb 2016; 75:[18-24 pp.].
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51. Sweetman LL, Ng YT, Butler IJ, Bodensteiner JB. Neurologic complications associated with respiratory syncytial virus. Pediatr Neurol. 2005;32(5):307-10.
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53. Hanna S, Tibby SM, Durward A, Murdoch IA. Incidence of hyponatraemia and hyponatraemic seizures in severe respiratory syncytial virus bronchiolitis. Acta Paediatr. 2003;92(4):430-4.
54. van Steensel-Moll HA, Hazelzet JA, van der Voort E, Neijens HJ, Hackeng WH. Excessive secretion of antidiuretic hormone in infections with respiratory syncytial virus. Arch Dis Child. 1990;65(11):1237-9.
55. Tasker RC, Roe MF, Bloxham DM, White DK, Ross-Russell RI, O'Donnell DR. The neuroendocrine stress response and severity of acute respiratory syncytial virus bronchiolitis in infancy. Intensive Care Med. 2004;30(12):2257-62.
56. Fujishima H, Okamoto Y, Saito I, Tsubota K. Respiratory syncytial virus and allergic conjunctivitis. J Allergy Clin Immunol. 1995;95(3):663-7.
57. Englund JA, Piedra PA, Jewell A, Patel K, Baxter BB, Whimbey E. Rapid diagnosis of respiratory syncytial virus infections in immunocompromised adults. J Clin Microbiol. 1996;34(7):1649-53.
58. Chartrand C, Tremblay N, Renaud C, Papenburg J. Diagnostic Accuracy of Rapid Antigen Detection Tests for Respiratory Syncytial Virus Infection: Systematic Review and Meta-analysis. J Clin Microbiol. 2015;53(12):3738-49.
59. Puppe W, Weigl JA, Aron G, Grondahl B, Schmitt HJ, Niesters HG, et al. Evaluation of a multiplex reverse transcriptase PCR ELISA for the detection of nine respiratory tract pathogens. J Clin Virol. 2004;30(2):165-74.
60. Willson DF, Jiao JH, Hendley JO, Donowitz L. Invasive monitoring in infants with respiratory syncytial virus infection. J Pediatr. 1996;128(3):357-62.
61. Hall CB. Respiratory syncytial virus and parainfluenza virus. N Engl J Med. 2001;344(25):1917-28.
62. Eisenhut M. Extrapulmonary manifestations of severe respiratory syncytial virus infection--a systematic review. Crit Care. 2006;10(4):R107.
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69. Herrera-Rodríguez DH, De la Hoz F, Mariño C, Ramírez E. Virus Respiratorios en Menores de Diez Años con Infección Respiratoria en el Hospital Militar Central de Bogotá. Revista de Salud Pública. 2007;9(4):576-86.
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instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/16532021-06-03T00:46:43Zcom_10336_925com_10336_562col_10336_926
Dosis ideal de relajación neuromuscular: evitar desacondicionamiento físico en niños críticamente enfermos
Olier Serra, Tatiana María
Restrepo Vélez, Nora
Ochoa Silva, Cristina
Beltrán Rodríguez, Johnny Adalber
Vecuronio
Desacondicionamiento Físico
2010-02-19T20:48:39Z
2010-02-19T20:48:39Z
2010-02-19T20:48:39Z
2010
masterThesis
https://doi.org/10.48713/10336_1653
TEME 0045 2009
http://repository.urosario.edu.co/handle/10336/1653
spa
info:eu-repo/semantics/openAccess
Abierto (Texto completo)
Atribución-NoComercial-SinDerivadas 2.5 Colombia
EL 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.
PARÁGRAFO: 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.
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/141922021-06-03T00:48:27Zcom_10336_925com_10336_562col_10336_926
Asociación LACHT con hipoplasia de la vía aérea superior. Caso clínico
Ardila Gomez, Iván Jose
Pardo Carrero, María Rosalba
Ruiz Rodriguez, Diana Alejandra
Asociación Mardini-Nyhan
Asociación LACTH
Agenesia pulmonar
Introduction: The Mardini-Nyhan or LACHT association is a clinical condition of low prevalence that presents with pulmonary, cardiac and limb abnormalities, in which genetic etiology is not clearly documented to date. Objective: To describe the case of a 4-month-old child and the literature review of cases reported on this association, with the purpose of exposing the alterations found and thus guide the early diagnosis of this entity. Clinical case: 4 months old girl, who admitted to intensive care in mixed respiratory failure, with pulmonary, cardiac and limb disorders that meet criteria for LACHT association, additionally documents hypoplasia of the upper airway, which worsens the evolution, increases the difficulty in mechanical ventilation and favors the fatal outcome at 7 days of hospitalization. Conclusions: LACTH association is a rare pathology in which the clinical findings make it
possible to suspect the diagnosis, this is the first case diagnosed in the Americas and the number 11 case in the world literature and brings as a new finding the association with hypoplasia of the upper airway.
2018-01-15T14:34:55Z
2018-01-15T14:34:55Z
2018-01-15T14:34:55Z
2017
masterThesis
https://doi.org/10.48713/10336_14192
http://repository.urosario.edu.co/handle/10336/14192
spa
info:eu-repo/semantics/openAccess
Abierto (Texto completo)
EL 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.
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
Atik T, Torun HO, Cogulu O, Ozkinay F. A new patient with LACHT syndrome (Mardini-Nyhan association). Am J Med Genet Part A. 2015;167(2):400-2. doi:10.1002/ajmg.a.36832.
Jaiman S, Surampudi K, Gundabattula SR, Nalluri HB. Mardini-Nyhan association (LACHT syndrome) with intrauterine fetal demise. Clin Dysmorphol. 2016;25(1):27-30. doi:10.1097/ MCD.0000000000000103.
Sawardekar KP. Is there a link between Holt-Oram Syndrome and “Mardini- Nyhan” association? – need for further research. Clin Genet. 2016:1-4. doi:10.1111/cge.12777.
Hastings R, Harding D, Donaldson A, et al. Mardini-Nyhan Association (Lung Agenesis, Congenital Heart, and Thumb Anomalies): Three New Cases and Possible Recurrence in a Sib-Is There a Distinct Recessive Syndrome? Am J Med Genet. 2009;(November):2838-42. doi:10.1002/ajmg.a.33124.
Mardini MNW. Agenesis of the lung: report of four patients with unusual anomalies. Chest. 1985;87(4):522-7. doi:10.1378/chest.87.4.522.
Kayemba-kay S, Goua V, Podevin G. Case Report Unilateral Pulmonary Agenesis: A Report of Four Cases , Two Diagnosed Antenatally and Literature Review. Pediatr Pulmonol. 2014;102(October 2013):96- 102. doi:10.1002/ppul.22920
Xie L, Zhao J, Shen J. Clinical diagnostic approach to congenital agenesis of right lung with dextrocardia: a case report with review of literature. Clin Respir J. 2015:1- 4. doi:10.1111/crj.12282.
Tansir G, Sasmal G, Dixit J, Sahoo R. Left Pulmonary Agenesis with Right Lung Bronchiectasis in an Adult. J Clin Diagnostic Res. 2016;10(9):15-17. doi:10.7860/JCDR/2016/21623.8547.
He H, Sun F, Ren W, Ph D, Wang Y, Xu S. Diagnostic Value of Echocardiography in Isolated Congenital Unilateral Lung Agenesis Combined with Different Anomalies: Two Rare Cases in Children. J Clin ultrasound. 2016;0(0):1- 4. doi:10.1002/jcu.22340
Vanessa P, Dinamarco V, Cilento C. Pulmonary agenesis and respiratory failure in childhood. Autops Case Reports. 2015;5(1):29-32.
De A. Agenesis of the Lung-a Rare Congenital Anomaly of the Lung. Acta Med Iran. 2012;51(Figure 2): 2011-4.
Hentati A, Neifar C, Abid W, Sameh M. Case Report Left lung agenesis discovered by a spontaneous pneumothorax in a 20‑year‑old girl. Lung india. 2016:205-7. doi:10.4103/0970-2113.177443.
Yu Y, Zhu C, Qian X, Gao Y, Zhang Z. Adult patient with pulmonary agenesis: focusing on one-lung ventilation during general anesthesia. J Thorac Dis. 2016;8(1):124-9. doi:10.3978/j.issn.2072- 1439.2016.01.23.
Nandan D, Bhatt GC, Dewan V, Pongener I. Complete Right Lung Agenesis with Dextrocardia : An Unusual Cause of Respiratory Distress. J Clin Imaging Sci. 2016;2(4):6-8. doi:10.4103/2156- 7514.105140
Nguyen LN, Parks WT. Bilateral Pulmonary Agenesis : A Rare and Unexpected Finding in a Newborn. Am J Perinatol Rep. 2016;1(212):246-9.
Malcon MC, Malcon CM, Cavada MN, Eduardo P, Caruso M, Real LF. Agenesia pulmonar unilateral. Relato de Caso. J Bras Pneumol. 2012;38(4):526-9.
Sumsam M, Khurram A, Rao SP, Vamshipriya A. Pulmonary agenesis : A case report with review of literature. Qatar Med J. 2013;2013:38-40.
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/475982026-03-04T03:03:04Zcom_10336_925com_10336_562col_10336_926
Uso de una herramienta de valoración sistemática de lectura de radiografía de tórax en estudiantes de último año de medicina de la Universidad de los Andes en rotación clínica en la Fundación Santa Fe de Bogotá entre septiembre de 2024 y abril de 2025
Solano Rivera, Andrés Camilo
Hernández Aranda, Jorge Mario
Yepes Velasco, Andrés Felipe
Carrizosa, Jorge Armando
Radiografía de tórax
Educación en cuidado crítico
Enseñanza entre pares
Estudiantes de medicina
Aprendizaje guiado por listas de verificación
Habilidades de interpretación
Background: Chest radiography remains a cornerstone in the evaluation and daily management of critically ill patients. However, accurate interpretation continues to challenge trainees due to overlapping structures, variable image quality, and frequent perceptual errors. Near-peer teaching and structured checklists have shown potential to improve diagnostic accuracy, yet few randomized studies have evaluated their combined educational impact. Objective: To assess the effectiveness of a resident-led, checklist-guided educational intervention in improving systematic chest radiograph (CXR) interpretation among final-year medical students. Methods: A randomized educational trial was conducted between September 2024 and April 2025 at Universidad de los Andes (Bogotá, Colombia). All participants attended a standardized lecture on CXR interpretation led by intensive care residents. Students were then randomized into two groups: a control group (lecture-only) and an experimental group (lecture plus checklist-guided training). Performance was measured through a 16-item online test (8 interpretation, 8 diagnosis questions). Scores were compared using nonparametric tests, and internal consistency was assessed with Cronbach’s alpha. Results: Fifty students completed the study. The experimental group achieved significantly higher median scores across all domains: interpretation (6 vs. 3; p<0.05), diagnosis (4 vs. 3; p<0.05), and total score (10 vs. 6; p<0.05). Strong correlations were observed between interpretation and total scores (ρ=0.78, p<0.01) and between diagnosis and total scores (ρ=0.69, p<0.01). Internal consistency was moderate (α=0.59). Nine items demonstrated excellent discrimination (D≥0.40). Conclusions: A brief, resident-led, checklist-guided intervention significantly enhanced CXR interpretation performance in senior medical students. This near-peer model provides a low-cost, feasible, and scalable approach to strengthen perceptual and analytical skills essential for critical care training. While interpretation improved markedly, diagnostic integration remained limited, suggesting the need for complementary strategies linking perceptual findings with clinical reasoning.
2026-03-03T22:38:09Z
2026-03-03T22:38:09Z
2026-03-03T22:38:09Z
masterThesis
https://doi.org/10.48713/10336_47598
https://repository.urosario.edu.co/handle/10336/47598
spa
info:eu-repo/semantics/openAccess
Abierto (Texto Completo)
EL 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.
http://creativecommons.org/licenses/by-nc-nd/4.0/
Attribution-NonCommercial-NoDerivatives 4.0 International
Universidad del Rosario
Escuela de Medicina y Ciencias de la Salud
Especialización en Medicina Crítica y Cuidado Intensivo
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/201672025-08-06T15:28:56Zcom_10336_925com_10336_562col_10336_926
Asociación entre uso de soluciones balanceadas y lesión renal durante la reanimación hídrica en niños con sepsis
Alcalá Lozano, Silvia Catalina
Erazo Vargas, Sofia Camila
Gómez Cortes, Laura Bibiana
Fernández Sarmiento, Jaime
Reyes Casas, Martha Cecilia
Sepsis severa
Solución balanceada
Aacidosis metabólica
Hipercloremia
Lesión renal
Niños
Objective. To establish the association between the administration of balanced an unbalanced crystalloid with different results such as acute kidney injury, metabolic acidosis and hyperchloremia, in children with severe sepsis and septic shock hospitalized in the PICU and in the cardiovascular PICU of the Fundación CardioInfantil. Type of study. Retrospective observational cohort. Patients. A cohort of patients from 1 month to 17 years of age, with severe sepsis and septic shock, who are hospitalized in the PICU and in the C-PICU of the Fundación CardioInfantil, from April 1/2018 to April 30/2019, and that received balanced and unbalanced crystalloids for hemodynamic stabilization, was collected. The association between the crystalloid type (balanced and unbalanced) and different outcome (acute kidney injury metabolic acidosis and hyperchloremia) was evaluated. Interventions. None. Results. Of 1074 patients hospitalized in the PICU and the C-PICU in the observation period, were included 103 patients with severe sepsis and septic shock, with an average age of 15 months old and a greater percentage of males. The mean length of stay in the PICU was 7.5 days. The most frequent infections were the respiratory, and secondly, the gastrointestinal ones (54.4% and 24.3%, respectively). It was found that 47.2% of patients who received unbalanced crystalloids developed acute renal injury (p<0.003), and of them, 16.7% required extracorporeal renal support (p<0.002). The mortality to the day 28 was significantly lower (7.6% vs 25.7%; p=0.02 respectively). There were no differences in the development of metabolic acidosis (p=0.84) and hyperchloremia (p=0.12) between the groups. Conclusion. The administration of balanced crystalloids was associated with a lower rate of acute kidney injury in children with severe sepsis and septic shock, and secondly, with a lower need for extracorporeal renal support and mortality rate.
2019-08-27T12:26:26Z
2019-08-27T12:26:26Z
2019-08-27T12:26:26Z
2018
masterThesis
https://doi.org/10.48713/10336_20167
http://repository.urosario.edu.co/handle/10336/20167
spa
info:eu-repo/semantics/openAccess
Abierto (Texto Completo)
EL 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.
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
Atribución-NoComercial-SinDerivadas 2.5 Colombia
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
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Remick DG. Pathophysiology of sepsis. Am J Pathol. 2007; 170(5):1435–44.
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Vincent JL, Orbegozo Cortés D, Acheampong A. Current haemodynamic management of septic shock. Press Medicale. 2016;45(4):99–103.
Silva JM, Oliveira AMRR, de Morais SZ, de Araújo LS, Victoria LGF, Marubayashi LY. Influence of central venous oxygen saturation on in-hospital mortality of surgical patients. Rev Bras Anestesiol. 2010;60(6):593–602, 329–34.
Fernández-sarmiento J, Carcillo JA, Salinas CM, Galvis EF, López PA, Jagua-gualdrón A. Effect of a Sepsis Educational Intervention on Hospital Stay. 2018; 19(6):321-328.
Hanna W, Wong HR. Pediatric Sepsis: Challenges and Adjunctive Therapies. Crit Care Clin. 2013;29(2):203–22.
Hartmann AF, Senn MJ. Studies in the metabolism of sodium r-Lactate. Response of normal human subjects to the intravenous injection of sodium r-Lactate. J Clin Invest. 1932;11(2):327–335.
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Hoorn EJ. Intravenous fluids: balancing solutions. J Nephrol. 2017;30(4):485–92.
Mendes PV, Zampieri FG, Park M. Is There a Role for Balanced Solutions in Septic Patients?. Shock. 2017;47(1):30–4.
De Backer D, Cortés DO. Characteristics of fluids used for intravascular volume replacement. Best Pract Res Clin Anaesthesiol. 2012;26(4):441–51.
Zampieri FG, Azevedo LCP, Corrêa TD, Falavigna M, Machado FR, De Assunção MSC, et al. Study protocol for the Balanced Solution versus Saline in Intensive Care Study (BaSICS): A factorial randomised trial. Crit Care Resusc. 2017;19(2):175–82.
Song JW, Shim JK, Kim NY, Jang J, Kwak YL. The effect of 0.9% saline versus plasmalyte on coagulation in patients undergoing lumbar spinal surgery; a randomized controlled trial. Int J Surg. 2015;20:128–34.
Awad S, Allison SP, Lobo DN. The history of 0.9% saline. Clin Nutr. 2008;27(2):179–88.
Yunos NM, Bellomo R, Hegarty C, Story D, Ho L, Bailey M. Association Between a Chloride-Liberal vs Chloride-Restrictive Intravenous Fluid Administration Strategy and Kidney Injury in Critically Ill Adults. Jama. 2012;308(15):1566.
Friedman JN, Beck CE, DeGroot J, Geary DF, Sklansky DJ, Freedman SB. Comparison of Isotonic and Hypotonic Intravenous Maintenance Fluids. JAMA Pediatr. 2015;169(5):445-51.
Handy JM, Soni N. Physiological effects of hyperchloraemia and acidosis. Br J Anaesth. 2008;101(2):141–50.
González-Castro A, Peñasco Martin Y, Ortiz-Lasa M. Reanimación con fluidos: perspectiva actual. Med Clin (Barc). 2016;146(3):128–32.
Miller DJ. Sydney Ringer; physiological saline, calcium and the contraction of the heart. J Physiol . 2004;555(3):585–7.
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Aksu U, Bezemer R, Yavuz B, Kandil A, Demirci C, Ince C. Balanced vs unbalanced crystalloid resuscitation in a near-fatal model of hemorrhagic shock and the effects on renal oxygenation, oxidative stress, and inflammation. Resuscitation. 2012;83(6):767–73.
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instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/87842021-06-03T00:45:50Zcom_10336_925com_10336_562col_10336_926
Diferencia venoarterial de Pco2 como predictor de disfunción miocárdica en niños con sepsis severa y choque séptico.
Orozco Marun, Rafael Jose
Fernández Sarmiento, Jaime
Morón Duarte, Lina Sofía
Fernández Sarmiento, Jaime
Sepsis
Cardiomiopatía
Diferencia venoarterial de pCO2
Disfunción miocárdica
Introduction: Sepsis is a major cause of morbidity and mortality in the pediatric population worldwide. It is widely known that low cardiac output is one of the main factors associated with mortality in pediatric sepsis. It has been suggested venoarterial pCO2 difference as predictor of myocardial function in patients with sepsis, however, to date no studies in children have been done to asses it. Objective: The aim of this study was to determine the predictive capacity and operational characteristics of venoarterial pCO2 difference as predictor of myocardial dysfunction in pediatric patients with severe sepsis and septic shock. Methods: In order to achieve the objectives of the study, it was performed a prospective study of diagnostic tests. Echocardiogram and venoarterial pCO2 difference were done to each patient, then the operating characteristics of the venoarterial difference of pCO2 were calculated, to determine its usefulness. Results: 71 patients were included. The median venoarterial pCO2 difference was not significantly higher in patients who had cardiac dysfunction on echocardiography compared with those with no dysfunction. A statistically significant relationship of values from 1. 5 to 2. 1 mmHg, as a negative predictor of myocardial dysfunction with a sensitivity of 100% and a specificity of 88% was found. Conclusions: The difference venoarterial pCO2 is not yet a good predictor of myocardial dysfunction in pediatric patients with severe sepsis and septic shock, even when other biomarkers are within normal limits. More clinical essays are requerided
2014-08-12T13:19:17Z
2014-08-12T13:19:17Z
2014-08-12T13:19:17Z
2014
masterThesis
https://doi.org/10.48713/10336_8784
http://repository.urosario.edu.co/handle/10336/8784
spa
info:eu-repo/semantics/openAccess
Abierto (Texto Completo)
Atribución-NoComercial-SinDerivadas 2.5 Colombia
EL 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.
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
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23. Casserly B, Read R, Levy M. Hemodynamic Monitoring in Sepsis. Crit Care Clin 2009; 25 : 803–823
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25. Allen, Hugh D.; Driscoll, David J.; Shaddy, Robert E.; Feltes, Timothy F. Moss and Adam’s Heart Disease in Infants, Children and Adolescents: Including the fetus and Young Adults. 7th Ed. Lippincott Williams & Wilkins. 2008
26. Rivers E, Guyen R, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M. Early Goal-Directed Therapy In The Treatment Of Severe Sepsis And Septic Shock. N Engl J Med 2001;345:1368-77
27. Maddirala S, Khan A. Optimizing Hemodynamic Support in Septic Shock Using Centraland Mixed Venous Oxygen Saturation. Crit Care Clin 2010; 26: 323–333
28. Rivers EP, Ander DS, Powell D. Central venous oxygen saturation monitoring in the critically ill patient. Curr Opin Crit Care 2001; 7(3):204-11
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/407542023-08-26T03:02:38Zcom_10336_925com_10336_562col_10336_926
Cambios en la microcirculación asociados al uso de infusiones de Milrinona en niños con choque séptico
Sarta Mantilla, Carlos Mauricio
Fernández-Sarmiento, Jaime
Acevedo Sedano, Lorena
Mulett Hoyos, Hernando
Fernandez-Sarmiento, Jaime
Choque séptico
Sepsis
Microcirculacion
Milrinone
Endotelio
Objectives: To evaluate changes in microcirculation (capillary density - blood flow) and the endothelial glycocalyx associated with using milrinone in children with sepsis. Sublingual videomicroscopy was used to assess capillary density (DC4-6 microns and DC7-25 microns), microvascular flow index, and perfused blood region (perfusion boundary region (PBR), inverse parameter of glycocalyx thickness - abnormal > 2.0 microns). The primary outcome was the association between changes in microcirculation and the endothelial glycocalyx related to milrinone use. Design: Prospective cohort study from February 2021 - January 2022. Place: 12-bed pediatric intensive care unit (PICU) in a university hospital. Patients: Children with sepsis/septic shock with and without milrinone infusion. Intervention: None Methods and Main Results: 140 children with a mean age of 2 years (IQR 0.58-12.1) were included. Fifty-eight percent (81/140) of patients received milrinone infusion. The main focus of infection was respiratory (43/140;30.7%). After 24 hours of administering milrinone, it was observed that capillary density (4-6 microns) was maintained only in this group (p<0.01). Children younger than two years who received milrinone had better DC4-6 than older ones (OR 0.33; CI 95% 0.12-0.89;p=0.02). In milrinone patients, capillary blood flow was more homogeneous and capillary recruitment capacity was maintained (p<0.05). Additionally, these children had less endothelial glycocalyx degradation (aOR 0.34 CI 95% 0.11-0.99; p=0.04), which was maintained despite elevated ferritin and C-reactive protein (aOR 0.41; CI 95% 0.18-0.93;p=0.03). The group without milrinone had more organ failure associated with microcirculation dysfunction, glycocalyx degradation (p<0.01) and a lower number of functional recruited capillaries (p<0.01). Elevated PBR was associated with mortality in both groups (p=0.04). Conclusions: in this investigation of children with sepsis, we found that milrinone was associated with changes in microcirculation. We found persistence of capillary recruitment of 4-6 microns after 24 hours of its administration, and maintenance and less heterogeneity of capillary blood flow as well as less degradation of the glycocalyx, particularly in children under two years of age.
2023-08-25T12:29:10Z
2023-08-25T12:29:10Z
2023-08-25T12:29:10Z
bachelorThesis
https://doi.org/10.48713/10336_40754
https://repository.urosario.edu.co/handle/10336/40754
spa
info:eu-repo/semantics/embargoedAccess
Restringido (Temporalmente bloqueado)
EL 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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http://creativecommons.org/licenses/by-nc-sa/4.0/
Attribution-NonCommercial-ShareAlike 4.0 International
Universidad del Rosario
Escuela de Medicina y Ciencias de la Salud
Especialización en Cuidado Intensivo Pediátrico
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Weiss SL, Peters MJ, Alhazzani W, Agus MSD, Flori HR, Inwald DP, Nadel S, Schlapbach LJ, Tasker RC, Argent AC, Brierley J, Carcillo J, Carrol ED, Carroll CL, Cheifetz IM, Choong K, Cies JJ, Cruz AT, De Luca D, Deep A, Faust SN, De Oliveira CF, Hall MW, Ishimine P, Javouhey E, Joosten KFM, Joshi P, Karam O, Kneyber MCJ, Lemson J, MacLaren G, Mehta NM, Møller MH, Newth CJL, Nguyen TC, Nishisaki A, Nunnally ME, Parker MM, Paul RM, Randolph AG, Ranjit S, Romer LH, Scott HF, Tume LN, Verger JT, Williams EA, Wolf J, Wong HR, Zimmerman JJ, Kissoon N, Tissieres P. Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children. Pediatr Crit Care Med. 2020 Feb;21(2):e52-e106.
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instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/37442021-06-03T00:46:56Zcom_10336_925com_10336_562col_10336_926
Correlación SO2/FiO2 con PaO2/FiO2 en niños en ventilación mecánica a grandes alturas : estudio multicéntrico
González Vélez, Claudia Liliana
Fernández Sarmiento, Jaime
SDRA
Índices de oxigenación
SO/FiO2
Pa/FiO2
Pediatría
Grandes alturas
Introduction: changes in the PaO2 correlate positively with changes in the SO2 allowing to determine the severity of hypoxemia. The search for a predictor, which in a noninvasive way detects patients with greater lung involvement has been gaining acceptance; establishing levels of moderate or severe hypoxemia as criteria for ALI and ARDS, based on the values of PaO2/FiO2 and its correlation with SO2/FiO2 in adults. The values of SO2/ FiO2 that identify the severity of the hypoxemia in Pediatrics are not known for heights over 2.500 m.a.s.l.
Methodology: study of correlation and prediction in patients from one month to 18 years of age admitted to PICU, with mechanical ventilatory support and serial blood gas analysis in two referral hospitals. Analysis of linear relationship and determination of the SOFiO2 and POFiO2 correlation from 430 measurements.
Results: the study showed a mean of 192,12 (DS 75.62) for PaO2/FiO2 and a mean of 208,61 (DS 62,79) for SO2/FiO2. The SO2/FiO2 and Pa2/FiO2 correlation was positive and moderately high (r = 0.702; p < 0.01). From the linear regression between the variables was obtained the equation for determining PaO2/FiO2 = (0.92xSO2/FIO2) - 12, with a 76% sensitivity and specificity for detecting severe hypoxemia (SO2/FiO2 <231), and 74% sensitivity and specificity of 71% for moderate hypoxemia (SO2/FiO2 <340).
Discussion: the findings obtained are very useful from a clinical point of view to quickly detect patients with moderate and severe hypoxemia, with a potential risk of deterioration, when there is no arterial line or arterial gases.
2012-08-21T18:46:04Z
2012-08-21T18:46:04Z
2012-08-21T18:46:04Z
2012
masterThesis
https://doi.org/10.48713/10336_3744
http://repository.urosario.edu.co/handle/10336/3744
spa
info:eu-repo/semantics/closedAccess
Bloqueado (Texto referencial)
Atribución-NoComercial-SinDerivadas 2.5 Colombia
EL 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.
PARÁGRAFO: 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.
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
Acevedo LE, Solarte I. Gasimetría arterial en adultos sanos a nivel de Bogotá. Acta Med Colomb. 1984; 9: 7-14.
Bernard GR, Artigas A, Brigham, Carlet J, Falke K, Hudson L et al. Report of the American-European consensus conference on ARDS: definitions, mechanisms, relevant outcomes and clinical trial coordination; the Consensus Committee. Intensive Care Med. 1994; 20:225–32.
Camargo JP, Gil. Comparación de la razón saturometría de pulso/fracción inspirada de oxígeno (SA/FIO2) y la razón presión arterial de oxígeno/fracción inspirada de oxígeno (PO2/FIO2) en pacientes con insuficiencia respiratoria aguda. Acta Colombiana de Cuidado Intensivo 2011; 11(2): 86-90.
Donahoe M. Acute respiratory distress syndrome: A clinical review. Pulm Circ. 2011 Apr-Jun; 1(2): 192–211. Doi: 10.4103/2045-8932.83454 PMCID: PMC3198645.
Fernández RO, Grilli MB, Arjona JC. Correlación saturometría de pulso / Fracción inspirada de oxígeno (SAFIO2) y razón presión arterial de oxígeno / fracción inspirada de oxígeno (PAFIO2) en una población general de pacientes críticos. Revista Hospital Español de Mendoza. Vol XII. No.1. ISSN 1668-9496.
Freishtat RJ, Mojgani B, Mathison DJ and Chamberlain JM. Toward early identification of acute lung injury in the emergency department. J Investig Med. 2007 December; 55 (8): 423-429
Fuhrman & Zimmerman: Pediatric Critical Care, 3rd ed. Copyright 2006 Mosby, Inc. MOSBY ELSEVIER. Software medico.
Guyton AC, Hall JE. Text Book of medical physiology. 11ed. Elsevier Saunders; 2006. P 471-480.
Hammer J, Newth CJ. Infant lung function testing in the intensive care unit. Intensive care medicine. 1995 sep; 21(9):744-52.
Hurtado JC, Salazar T, De la Peña M. Valores normales gases arteriales en Bogotá. Umbral científico Bogotá Colombia. 2007; Num10;93-101.
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/46182021-06-03T00:45:48Zcom_10336_925com_10336_562col_10336_926
Guía para el diagnóstico, atención integral y seguimiento de asma en niños y niñas
Godoy Collazos, Carol Yohanna
Dueñas, Elida
Velez Van Meerbeke, Alberto Francisco
Asthma
Bronchial Spasm
Inhaled Corticosteroids
2013-08-12T23:27:47Z
2013-08-12T23:27:47Z
2013-08-12T23:27:47Z
2013
masterThesis
https://doi.org/10.48713/10336_4618
http://repository.urosario.edu.co/handle/10336/4618
spa
info:eu-repo/semantics/openAccess
Abierto (Texto completo)
Atribución-NoComercial-SinDerivadas 2.5 Colombia
EL 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.
PARÁGRAFO: 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.
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
Castro-Rodríguez JA, Holberg CJ, Wright AL, Martinez FD. A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med. 2000;162(4 Pt 1):1403-6.
Galant SP, Crawford LJ, Morphew T, Jones CA, Bassin S. Predictive value of a cross-cultural asthma case-detection tool in an elementary school population. Pediatrics. 2004;114(3):e307-16.
Gerald LB, Grad R, Turner-Henson A, Hains C, Tang S, Feinstein R, et al. Validation of a multistage asthma case-detection procedure for elementary school children. Pediatrics. 2004;114(4):e459-68
Ly NP, Gold DR, Weiss ST, Celedón JC. Recurrent wheeze in early childhood and asthma among children at risk for atopy. Pediatrics. 2006;117(6):e1132-8
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/144192021-06-03T00:48:09Zcom_10336_925com_10336_562col_10336_926
Adaptación transcultural y validación psicométrica de la escala de Sedacion Comfort (Comfort Scale)
Leonor Alexandra, Monroy Cordoba
Pardo Carrero, María Rosalba
Escala de Sedación
COMFORT
Traducción
Equivalencia Lingüista
Approximately 2% of all children admitted to the hospital require management in the pediatric intensive care unit, and between 20 to 64% (1) requires the use of mechanical ventilation, therefore sedation is very important in order to provide them with well-being , relieve pain, reduce anxiety due to confinement and the presence of unknown persons, prevent discomfort caused by the high level of noise that can alter the sleep pattern and ensure adequate invasive monitoring. (2). In some circumstances, sedation and analgesia have therapeutic use. It should be remembered that high doses of sedation can increase morbidity and even affect the recovery of patients. The management of the critical patient focused on the disease cause of admission makes it tend to use multiple sedative drugs without considering the long-term consequences. This is why it is very important to objectively evaluate sedation goals in order to avoid excessive or deficient use of this, resulting in greater morbidity. The measurement is made by means of scales or instruments designed and validated to evaluate the sedation in intensive care units, based on the observation of clinical signs, allowing systematic sedation assessments, which must be interpreted in a similar way independently of the person of the team of health that uses it. There are multiple sedation scales, the COMFORT sedation scale is the most accepted due to its validity, reliability and ease of application (1); Ambuel and his collaborators (1990) developed the COMFORT Scale to assess the psychological distress of critically ill children; additionally, it was determined that the COMFORT scale is useful in determining whether a child is optimally sedated or not (3). This tool is considered a pain assessment instrument using the behavioral or physiological parameters often associated with pain. This was designed and validated in the United States (1994), has been translated and validated in Porto Alegre Brazil, (4); no validations were found for Spanish language in South America or Colombia. The purpose of this research is to perform the translation or linguistic equivalence of the scale from English to Spanish according to the international standards in force given by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), and the validation of the scale in Spanish for Colombia.
2018-02-20T12:05:38Z
2018-02-20T12:05:38Z
2018-02-20T12:05:38Z
2018
masterThesis
https://doi.org/10.48713/10336_14419
http://repository.urosario.edu.co/handle/10336/14419
spa
info:eu-repo/semantics/openAccess
Abierto (Texto Completo)
Atribución-SinDerivadas 2.5 Colombia
EL 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.
http://creativecommons.org/licenses/by-nd/2.5/co/
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
Szumita, P. (2011). Evaluation of a local ICU sedation guideline on goal-directed administration of sedatives and analgesics. Journal of Pain Research, 127. http://doi.org/10.2147/JPR.S18161
Vigg, A. (2011). Principles and Practice of Sedation in Intensive Care Unit (ICU). Apollo Medicine, 8(1), 13–23. http://doi.org/10.1016/S0976-0016(11)60044-6
Wild, D., Grove, A., Martin, M., Eremenco, S., McElroy, S., Verjee-Lorenz, A., & Erikson, P. (2005). Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value in Health : The Journal of the International Society for Pharmacoeconomics and Outcomes Research, 8(2), 94–104. http://doi.org/10.1111/j.1524-4733.2005.04054.x
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/16572021-06-03T00:46:57Zcom_10336_925com_10336_562col_10336_926
Suplementación de hormona tiroidea en pacientes pediátricos críticos con síndrome eutiroideo enfermo
Trigos Pallares, Paul Leonardo
Vega la Rotta, Gonzalo Gonzalo,
Beltrán Rodríguez, Johnny Adalber
Síndrome eutiroideo enfermo
Síndrome de t4 alto
Síndrome de t3 bajo
Background: The Euthyroid Sick Syndrome, and it has been considered as predicting factor of poor outcome . And the supplementation of thyroid hormone (T3) improves the myocardial contractility, stimulate the production of pulmonary surfactant. Nevertheless the hormone supplementation has been objet of controversy because the risk of secondary complications, lack of hemodynamic effects, or hospital stay. Objectives: determine the effect of the oral supplementation of thyroid hormones in critically ill patients with no response to crystalloids reanimation and need of two inotropic agents with respect to the arrhythmias, hemodynamic stability, requirements of inotropics, stay in pediatric intensive care, and mortality associated to the treatment. Methodology: descriptive, retroprospective of pediatric patients with refractory shock to cristaloides in the (PICU) Pediatric Intensive Care Unit. At Hospital Simon Bolivar of Bogota Colombia from 1 of January of the 2007 to 1 January of the 2009. Results: supplementation of thyroid hormone in euthyroid sick syndrome, is related with a significative decrease in needs of adrenergic agents: dopamine, epinephrine and norepinephrine with rangs of [4,78-2.4], [3.92 - 2.98] and [3.58- 2.24] (p <0.001) respectively without difference in diuretic, inodilators and vasodilators. Conclusion: thyroid hormone administration had a beneficial effect and allowed decrease inotropic support in patients with refractory shock and euthyroid sick syndrome
There is not relation between the presence of arrhythmias and the use of hormone thyroid.
2010-02-22T20:43:31Z
2010-02-22T20:43:31Z
2010-02-22T20:43:31Z
2009
masterThesis
https://doi.org/10.48713/10336_1657
TEME 0046 2009
http://repository.urosario.edu.co/handle/10336/1657
spa
info:eu-repo/semantics/openAccess
Abierto (Texto completo)
Atribución-NoComercial-SinDerivadas 2.5 Colombia
EL 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.
PARÁGRAFO: 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.
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/190422025-10-09T14:36:41Zcom_10336_925com_10336_562col_10336_926
Principales desenlaces clínicos en lactantes con insuficiencia respiratoria aguda tratados con cánula nasal de alto flujo
Piracoca Mejia, Jaime
Pardo, Rosalba
Ruiz, Diana
Canula nasal alto flujo
Oxigenoterapia
Insuficiencia respiratoria aguda
Bronquiolitis
Niños
The High Flow Nasal Cannula (HFNC) is a non-invasive ventilatory modality that is increasingly used in the pediatric population in which benefits are described on oxygenation, ventilation and comfort of the patient through mechanisms of action that have been studied and described in the medical literature, however there is still little evidence regarding the efficacy and safety of the high-flow nasal cannula, so through this study we will generate scientific information and know what the main outcomes of infants are. One month and up to 23 months of age were treated with acute respiratory failure with high flow nasal cannula in the pediatric intensive care unit of the Colsubsidio Children's Clinic between 2016 -2017.
2019-02-12T13:37:01Z
2019-02-12T13:37:01Z
2019-02-12T13:37:01Z
2019
masterThesis
https://doi.org/10.48713/10336_19042
http://repository.urosario.edu.co/handle/10336/19042
spa
info:eu-repo/semantics/openAccess
Abierto (Texto Completo)
EL 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.
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
Atribución-NoComercial-SinDerivadas 2.5 Colombia
Universidad del Rosario
Escuela de Medicina y Ciencias de la Salud
Especialización en Cuidado Intensivo Pediátrico
1. BE de Jongh. Work of breathing indices in infants with respiratory insufficiency receiving high-flow nasal cannula and nasal continuous positive airway pressure. J Perinatol. 34(1): 27–32. http://dx.doi.org/10.1038/jp.2013.120 (August 22, 2014).
2. Wegner A. A, et al. Cánula nasal de alto flujo en lactantes: experiencia en una unidad de paciente crítico. Revista Chilena de Pediatría. http://dx.doi.org/10.1016/j.rchipe.2015.06.003 (Febrero 11, 2015).
3. Schereiber, A. High flow nasal cannula oxygen therapy, work in progress in respiratory critical care. Minerva Medica 2016 December; 107(Suppl 1 to Nº 6): 14-20.
4. UNICEF. 2007. State of the World’s Children. New York: United Nations Children’s Fund
5. Principi, T. Complications of mechanical ventilation in the pediatric population. Pediatric Pulmonology 2011; 46(5): 452-7. doi 10.1002/ppul.21389
6. Programa Nacional de Prevención Manejo y Control de la Infección Respiratoria Aguda. Dirección de Promoción y Prevención, Subdirección de Enfermedades Transmisibles, Ministerio de Salud y Protección Social. Bogotá, D.C. Colombia 2014.
7. Estadísticas y datos epidemiológicos de la Organización Mundial de la Salud (OMS). 2010 ISBN 978 92 4 356398 5.
8. Iram Haq, Saikiran Gopalakaje et al. The evidence for high flow nasal cannula devices in infants. Paediatric Respiratory Reviews 124–134. http://dx.doi.org/10.1016/j.prrv.2013.12.002 (June, 2014).
9. Mikalsen, et al. High flow nasal cannula in children: A literature review. Scandinavian Journal of trauma, Resuscitation and Emergency Medicine 2016, 24:93 DOI 10.1186/s13049-016-0278-4
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11. Frat, Jean Pierre, et al. High flow nasal oxygen therapy and non-invasive ventilation in the management of acute hypoxemic respiratory failure. Annals of translation Medicine 2017; 5(14):297 DOI 10.21037
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13. Nedel, Wagner. High flow nasal cannula in critically ill subjects with or at risk for respiratory failure. A systematic review and Meta analysis. Respir Care 2017 Jan; 62(1): 123-132 DOI 10.4187/respcare.04831
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15. Abboud PA et al. “Predictors of failure in infants with viral bronchiolitis treated with high-flow, high-humidity nasal cannula therapy”. Pediatr Crit Care Med. https://www.ncbi.nlm.nih.gov/pubmed/22805160. 343-349. (Noviembre 2013).
Masclans, J.R. Papel de la oxigenoterapia de alto flujo en la insufiencia respiratoria aguda. Med Intensiva. 2015;39(8):505-515.
Christophe Milési. High flows nasal cannula: recommendations for daily practice in pediatrics. Annals of Intensive Care 4:29. http://dx.doi.org/10.1186/s13613-014-0029-5 (September 30, 2014)
A. García Figueruelo et al. “Utilización de cánulas nasales de alto flujo para la ventilación no invasiva en niños”. Anales de pediatría (Barc). http://www.analesdepediatria.org/es/utilizacion-canulas-nasales-alto-flujo/articulo. 182-17. (Septiembre 2011).
Randolph AG. “Management of acute lung injury and acute respiratory distress syndrome in children”. Crit. Care Med. https://www.ncbi.nlm.nih.gov/pubmed/19531940. 2448-54. (Agosto 2009).
Khemani RG, Patel NR, Bart RD, Newth CJ. “Comparison of the Pulse Oximetric Saturation/Fraction of Inspired Oxygen Ratio and the PaO2/Fraction of Inspired Oxygen Ratio in Children”. Chest. https://www.ncbi.nlm.nih.gov/pubmed/19029434. 662-668. (Marzo 2009).
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Amir Kugelman, Karine Raibin, Husein Dabbah, Irina Chistyakov, Isaac Srugo, Lea Even, Nurit Bzezinsky, Arieh Riskin. “Intravenous Fluids versus Gastric-Tube feeding in Hospitalized Infants with Viral Bronchiolitis: A Randomized, Prospective Pilot Study” The Journal of Pediatrics. http://www.jpeds.com/article/S0022-347. 640-642.(Marzo 2013)
Pallás, Argimon, and Jiménez Villa. 2013. “Estudios de Cohortes Tipos de esTudios de cohortes.” Métodos de investigación clínica y epidemiológica: 64–73. http://paginas.facmed.unam.mx/deptos/sp/wp-content/uploads/2013/12/Anexo-1B.-Argimon-PJ.-Estudios-de-cohortes.pdf (June 12, 2017).
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25. Masaji Nishimura et al. “High-flow nasal cannula oxygen therapy in adults”. Journal of Intensive Care. 3 – 15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393594, (Marzo 2015).
Pons Òdena M,Cambra Lasaosa FJ. “Ventilación mecánica en pediatría (III). Retirada de la ventilación, complicaciones y otros tipos de ventilación”. Ventilación no invasiva, An Pediatr (Barc), http://www.analesdepediatria.org/es/aplicacion-ventilacion-no-invasiva-una/articulo/13070175/. 165-72. (Enero 2005).
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Lee J, Rehder K, Willifor L, Cheifetz I, Turner D. Use of high flow nasal cannula in critically ill infants, children and adults: A critical review of literature. Int Care Med. 2013;39:247
Ward J. High flow oxygen administration by nasal cannula for adults and perinatal patients. Respir Care. 2013;58:98-122.
Dysart K, Miller T, Wolfson M, Shaffer T. Research in high flow therapy: Mechanism of action. Resp Med. 2009;103:1400-5.
Wettstein R, Shelley D, Peters J. Delivered oxygen concentrations using low-flow and high-flow nasal cannulas. Resp Care. 2005;50:604-9
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instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/449372025-10-09T09:27:22Zcom_10336_925com_10336_562col_10336_926
Caracterización del estado nutricional y evaluación del soporte nutricional en pacientes pediátricos críticamente enfermos en una UCI pediátrica de alta complejidad en Bogotá, Colombia
Vargas Morán, Carmen Helena
Bejarano Quintero, Ana María
Lamprea Pineda, Shirley Vanessa
Cárdenas, Adriana
Medina, Leonor
Bernal, Marcela
Baquero, Olga
Rojas, Sofia
Bejarano Quintero, Ana María
Rodríguez Hernández, Andrea Esperanza
Malnutrición hospitalaria
Pacientes pediátricos
Unidad de cuidado intensivo pediátrico
Soporte nutricional
Background: Hospital malnutrition was common among critically ill pediatric patients, with a negative impact on morbidity and mortality. Clínica Infantil Colsubsidio implemented a nutritional support team to address this issue. Objective: To describe patient demographics, nutritional status at the beginning and end of the intervention, nutrition-associated complications, type and route of nutrition administration used, and to evaluate significant variations in discharge weight and nutritional classification according to WHO criteria. Methodology: A retrospective cohort observational study was conducted on patients under 18 years of age admitted to the UCIP at Clínica Infantil Colsubsidio between January and December 2023. Patients receiving interventions from the nutritional support team were included, while cases with unreliable anthropometric data, short stays, deaths, or transfers were excluded. Results: This retrospective cohort study analyzed the intervention of the nutritional support team in pediatric patients, demonstrating a positive impact with improved nutritional status. An increase was observed in the proportion of patients classified as eutrophic and a decrease in patients with acute malnutrition and thinness, contrasting with international literature that often reports high rates of hospital malnutrition in critically ill patients. Conclusions: Structured nutritional intervention and continuous monitoring by a multidisciplinary team effectively prevented hospital malnutrition in critically ill patients. The results underscored the importance of implementing personalized nutritional support protocols tailored to each patient's needs, contributing to improved clinical outcomes and reduced nutritional risks in this population.
2025-02-06T15:39:58Z
2025-02-06T15:39:58Z
2025-02-06T15:39:58Z
masterThesis
https://doi.org/10.48713/10336_44937
https://repository.urosario.edu.co/handle/10336/44937
spa
info:eu-repo/semantics/openAccess
Abierto (Texto Completo)
EL 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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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.
http://creativecommons.org/licenses/by-nc-sa/4.0/
Attribution-NonCommercial-ShareAlike 4.0 International
Universidad del Rosario
Escuela de Medicina y Ciencias de la Salud
Especialización en Medicina Crítica y Cuidado Intensivo Pediátrico
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Zamberlan, Patrícia; Delgado, Artur Figueiredo; Leone, Cláudio; Feferbaum, Rubens; Okay, Thelma Suely (2011) Nutrition therapy in a pediatric intensive care unit: indications, monitoring, and complications. En: JPEN. Journal of parenteral and enteral nutrition. Vol. 35; No. 4; pp. 523 - 529; 1941-2444; Disponible en: 10.1177/0148607110386610.
WMA. Consultado en: 2024/03/10/03:20:55. Disponible en: https://www.wma.net/es/policies-post/declaracion-de-helsinki-de-la-amm-principios-eticos-para-las-investigaciones-medicas-en-seres-humanos/.
SAS, Redjurista; Resolución 8430 de 1993. En: www.redjurista.com. Consultado en: 2024/03/10/03:32:11. Disponible en: https://www.redjurista.com/Documents/resolucion_8430_de_1993.aspx.
Fieno, José Alberto Javier Tantaleán-da; Palomo-Luck, Olga Patricia; León-Paredes, Rosa Josefina (2022) Prácticas de soporte nutricional en unidad de cuidados intensivos pediátrica. En: Revista Cubana de Pediatría. Vol. 94; No. 1; pp. 1 - 13; 1561-3119; Consultado en: 2024/10/21/04:01:43. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=114621.
de León, María; Dotti, María; Duarte, Matías; Hoffman, María; López, María; Encuesta sobre prácticas nutricionales en pacientes críticos pediátricos en Uruguay durante julio de 2020.
Barrera, Isela; Osorio-Lechuga, Citlali; Torres-González, Karina; Chávez-López, Adrián (2022) Condición y abordaje nutricional del paciente crítico pediátrico: primeros días de hospitalización. En: Latin American Journal of Pediatric Gastroenterology and Nutrition. Vol. 1; Disponible en: 10.24875/LAJPGN.M22000001.
Etchegaray-Armijo, Karina; Bustos-Arriagada, Edson (2021) Evaluación y apoyo nutricional en el paciente pediátrico críticamente enfermo: Revisión de la literatura. En: Revista chilena de nutrición. Vol. 48; pp. 95 - 102; Disponible en: 10.4067/S0717-75182021000100095.
Galeano, Fernando; Sanabria-Báez, Gabriela (2018) DESCRIPTION OF THE COMPLICATIONS ASSOCIATED WITH PARENTERAL NUTRITION IN NEONATES OF HOSPITAL OF CLINICS OF SAN LORENZO. En: Revista del Instituto de Medicina Tropical. Vol. 13; No. 2; pp. 3 - 9; 19963696; Consultado en: 2024/10/21/17:06:57. Disponible en: http://scielo.iics.una.py/scielo.php?script=sci_arttext&pid=S1996-36962018000200003&lng=es&nrm=iso&tlng=es. Disponible en: 10.18004/imt/20181323-9.
Martínez-Costa, Cecilia; Giner, Consuelo (2017) Requerimientos en nutrición parenteral pediátrica. En: Nutrición Hospitalaria. Vol. 34; Disponible en: 10.20960/nh.1376.
Naing, Lin; Nordin, Rusli; Abdul Rahman, Hanif; Naing, Yuwadi (2022) Sample size calculation for prevalence studies using Scalex and ScalaR calculators. En: BMC Medical Research Methodology. Vol. 22; Disponible en: 10.1186/s12874-022-01694-7.
Theodoridis, Xenophon; Chrysoula, Lydia; Evripidou, Kleo; Kalaitzopoulou, Ioustini; Chourdakis, Michail (2023) Continuous versus Intermittent Enteral Feeding in Critically Ill Children: A Systematic Review. En: Nutrients. Vol. 15; pp. 288 Disponible en: 10.3390/nu15020288.
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/36182021-06-03T00:47:17Zcom_10336_925com_10336_562col_10336_926
Efectos de la ventilación mecánica con heliox en niños y adolescentes con patología bronquial obstructiva
Angarita Daza, Deicy
Fernández Sarmiento, Jaime
Godoy, Javier
Mullet, Hernando
Heliox
Ventilación mecánica
Falla respiratoria
Niños
Objective: To evaluate if the Heliox reduces the resistance in the airway in children and adolescents with obstructive bronchial pathology and mechanical ventilation.
Materials and Methods: An observational prospective descriptive study was made in children and adolescents with obstructive bronchial pathology and mechanical ventilation with Fi02 ≤ 0,5. Different variables were measured: resistance, pressure peak, mean airway pressure, pressure plateau, tidal volume, AutoPEEP, compliance, PetCO2, dead space ventilation, before heliox and after 30 minutes, 2, 4, 6, 12, 18 and 24 hours, and daily until heliox suspension by extubation or FiO2 > 0,5.
Results: This study with partial results included 9 patients finding significant reduction of expiratory resistance to 30 minutes (51.2 versus 32,3; p=0,0008), 2 hours (51.2 versus 33,4; p=0,0019) and 4 hours (51.2 versus 30,7; p=0,0012) as well as of the inspiratory resistance to hour 2 (48.6 versus 36,2; p = 0.013) and hour 4 (48.6 versus 30; p=0,004). PetCO2 no significant decreasing tendency was observed (52.3 versus 34,3: p=0,06). No changes in variables; autoPEEP, pressure peak, mean airway pressure, compliance, dead space, pressure plateau and tidal volume, before or after the Heliox were observed.
Conclusion: Mechanical ventilation with Heliox in Children with bronchial obstructive pathology appears to be that it reduce in a significant way the resistance of the airway, with tendency to the reduction of the PetC02. Prospective studies are needed at least observational analytic that corroborate these findings.
2012-07-23T14:04:30Z
2012-07-23T14:04:30Z
2012-07-23T14:04:30Z
2012
masterThesis
https://doi.org/10.48713/10336_3618
http://repository.urosario.edu.co/handle/10336/3618
spa
info:eu-repo/semantics/openAccess
Abierto (Texto completo)
Atribución-NoComercial-SinDerivadas 2.5 Colombia
EL 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.
PARÁGRAFO: 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.
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
Philippe Jolliet, Christine Watremez, Comparative effects of helium-oxygen and external positive end-expiratory pressure on respiratory mechanics, gas exchange, and ventilation-perfusion relationships in mechanically ventilated patients with chronic obstructive pulmonary disease Intensive Care Med (2003) 29:1442–1450
Claudio Migliori, The Effects of Helium/Oxygen Mixture (Heliox) Before and After Extubation in Long-term Mechanically Ventilated Very Low Birth Weight Infants Pediatrics 2009;123: 1524–1528
Fernández Jaime, Estrategias de ventilación mecánica y terapia coadyuvante en enfermedades pulmonares severas, El niño en estado crítico, 2 ed, 2011; 82-86
Matthew F Gross, Robert M Spear, Helium–oxygen mixture does not improve gas exchange in mechanically ventilated children with bronchiolitis, Crit Care 2000, 4:188–192
Martin CJ Kneyber, Marc van Heerde, Heliox reduces respiratory system resistance in respiratory syncytial virus induced respiratory failure, Critical Care 2009
Abd-Allah SA, Rogers MS, Terry M, et al. Helium-oxygen therapy for pediatric acute severe asthma requiring mechanical ventilation. Pediatr Crit Care Med 2003;4(3):353-7.
Martin C. J. Kneyber Mechanical ventilation with heliox decreases respiratory system resistance and facilitates CO2 removal in obstructive airway disease Intensive Care Med (2006) 32:1676–167
Tobias JD: Heliox in children with airway obstruction. Pediatr Emerg Care 1997; 13: 29–32
Kass JE, Castriotta RJ: Heliox therapy in acute severe asthma. Chest 1995; 107: 757–760
Wolfson MR, Bhutani VK, Shaffer TH, et al: Mechanics and energetics of breathing helium in infants with bronchopulmonary dysplasia. J Pediatr 1984; 104: 752–757
Macklem PT: The physiology of the small airway. Am J Respir Crit Care Med 1998; 157: 2181–2183
Martinon F. Heliox: Teorías y Prácticas pediátricas. En Manual de Cuidados Intensivos Pediátricos 3ra Ed. Ruza. 2001: 532-557
Martinon-Torres F. Current treatment for acute viral bronchiolitis in infants. Expert Opin Pharmacother. 2003 Aug;4(8):1355-71
Barach AL: The use of helium in the treatment of asthma and obstructive lesions in the larynx and trachea. Ann Intern Med 1935; 9: 739–765
Stein R, Canny GJ, Bohn DJ, et al: Severe acute asthma in a pediatric intensive care unit: Six years’ experience. Pediatrics 1989; 83: 1023–1028
Osundwa VM, Dawod S: Four-year experience with bronchial asthma in a pediatric intensive care unit. Ann Allergy 1992; 69: 518–520
Shugg AW, Kerr S, Butt WW: Mechanical ventilation of paediatric patients with asthma: Short and long term outcome. J Paediatr Child Health 1990; 26: 343–346
DeNicola LK, Monem GF, Gayle MO, et al: Treatment of critical status asthmaticus in children. Pediatr Clin North Am 1994; 41: 1293–1324
Schnitzler, Eduardo MD; Minces, Pablo MD. Is helium a better vehicle for aerosol therapy?. Ped Crit Care 2002;3;86-87
Paret G, Kornecki A, Szeinberg A, et al: Severe acute asthma in a community hospital pediatric intensive care unit: A ten years’ experience. Ann Allergy Asthma Immunol 1998; 80: 339–344
Dworkin G, Katton M: Mechanical ventilation for status asthmaticus in children. J Pediatr 1989; 114: 545–549
Shiue ST, Gluck EH: The use of helium-oxygen mixtures in the support of patients with status asthmaticus and respiratory acidosis. J Asthma 1989; 26: 177–180
Manthous CA, Morgan S, Pohlman A, et al: Heliox in the treatment of airflow obstruction: A critical review of the literature. Respir Care 1997; 42: 1034–1042
Gluck EH, Onorato DJ, Castriotta R: Helium-oxygen mixtures in intubated patients with status asthmaticus and respiratory acidosis. Chest 1990; 98: 693–698
Austan F: Heliox inhalation in status asthmaticus anrespiratory acidemia: A brief report. Heart Lung 1996; 25: 155–157
Duncan PG: Efficacy of helium-oxygen mixtures in the management of severe viral and postintubation croup. Can Anaesth Soc J 1979; 26: 206–212
Kemper KJ, Ritz RH, Benson MS, et al: Helium-oxygen mixture in the treatment of postextubation stridor in pediatric trauma patients. Crit Care Med 1991; 19: 356
Kemper KJ, Izenberg S, Marvin JA, et al: Treatment of postextubation stridor in a pediatric patient with burns: The role of heliox. J Burn Care Rehabil 1990; 11: 337–339
Weber JE, Chudnofsky CR, Younger JG, et al: A randomized comparison of helium-oxygen mixture (heliox) and racemic epinephrine for the treatment of moderate to severe croup. Pediatrics 2001; 107: e96
Piva JP, Menna Barreto S, Zelmanovitz F, et al: Heliox versus oxygen for nebulized aerosol therapy in children with lower airway obstruction. Pediatr Crit Care Med 2002; 3: 6–10
Polaner DM: The use of heliox and the laryngeal mask airway in a child with an anterior mediastinal mass. Anesth Analg 1996; 82: 208–210
Rodrigo G, Pollack C, Rodrigo C, Rowe B. Cochrane Database Syst Rev. 2003;4 Y Chest. 2003 Mar;123(3):891-6
Ho Anthony y cols. Heliox vs air-oxygen mixtures for the treatment of patients with acute asthma. Meta-análysis. Chest 2003:123;882-890
Manthous CA, Hall JB, Melmed A, et al: Heliox improves pulsus paradoxus and peak expiratory flow in nonintubated patients with severe asthma. Am J Respir Crit Care Med 1995; 151: 310–314
Kass J. Heliox redux. Chest 2003;123:673-4
Paret G, Dekel B, Vardi A, et al: Heliox in respiratory failure secondary to bronchiolitis: A new therapy. Pediatr Pulmonol 1996; 22: 322–323
Hollman G, Shen G, Zeng L, et al: Helium-oxygen improves clinical asthma scores in children with acute bronchiolitis. Crit Care Med 1998; 26: 1731–1736
Martinon F y cols. Heliox therapy in infants with acute bronchiolitis. Pediatrics 2002;109:68-73
Pizov R, Oppenheim A, Eidelman LA, et al: Helium versus oxygen for tracheal gas insufflation during mechanical ventilation. Crit Care Med 1998; 26: 290–295
Tsuno K, Prato P, Kolobow T: Acute lung injury from mechanical ventilation at moderately high airway pressures. J Appl Physiol 1990; 69: 956–961
Sauder RA, Rafferty JF, Bilenki AL, et al: Helium-oxygen and conventional mechanical ventilation in the treatment of large airway obstruction and respiratory failure in an infant. South Med J 1991; 84: 646–648
Habib DM, Garner SS, Brandeburg S: Effect of helium-oxygen on delivery of albuterol in a pediatric, volume-cycled, ventilated lung model. Pharmacotherapy 1999; 19: 143–149
Fernández Jaime, Ventilación mecánica con Heliox, Acta Colombiana de Cuidado Intensivo 2009; 9(4): 355-358
Tassaux D, Jolliet P, Thouret J, et al: Calibration of seven ICU ventilators for mechanical ventilation with helium-oxygen mixtures. Am J Respir Crit Care Med 1999; 160: 22–32
Berkenbosch, John W. MD; Grueber, Ryan E. Effect of helium-oxygen (heliox) gas mixtures on the function of four pediatric ventilators. Crit Care Med 2003;31:2052-58
Anderson M, Svartengren M, Gunnar B, et al: Deposition in asthmatics of particles inhaled in air or in helium-oxygen. Am Rev Respir Dis 1993; 147: 524–528
Michael JG, Blockage T, Tobias JD: Helium administration during mechanical ventilation in children with respiratory failure. J Intensive Care Med 1999; 14: 140–147
Svartengren M, Skogward P, Nerbrink O, et al: Regional deposition of inhaled Evans blue dye in mechanically ventilated rabbits with air or helium oxygen mixture. Exp Lung Res 1998; 24: 159–172
Ruben A, Harris A. Heliox for asthma in the emergency departament: a review of the literature. Emerg Med J 2004:21;131-135
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/12622021-06-03T00:47:03Zcom_10336_925com_10336_562col_10336_926
Factores de riesgo para mortalidad quirúrgica en menores de un año con cardiopatía congénita
Mojica Walteros, Carlos Manuel
Guerra Romero, Alberto Rafael
Cardiopatías congénitas
Complicaciones
Factores de riesgo
Mortalidad
OBJECTIVES Identify factors associated with mortality in patients under 1 year of age operated on for congenital heart disease at the Foundation Cardioinfantil IC, in a period from August 2004 to December 31, 2007. METHODS Descriptive analytical observational study of cases and controls in the period indicated. We reviewed 290 patients of which 60 were cases and 230 controls. A bivariate analysis with the risk ratio (Odds Ratio - OR) and confidence intervals 95% and subsequently performed unconditional logistic regression (multivariate) analysis of factors associated together.
2009-07-08T15:31:35Z
2009-07-08T15:31:35Z
2009-07-08T15:31:35Z
2009
masterThesis
https://doi.org/10.48713/10336_1262
TEME 0006 2009
http://repository.urosario.edu.co/handle/10336/1262
spa
info:eu-repo/semantics/openAccess
Abierto (Texto completo)
Atribución-NoComercial-SinDerivadas 2.5 Colombia
EL 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.
PARÁGRAFO: 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.
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/458642025-10-09T09:26:25Zcom_10336_925com_10336_562col_10336_926
Association Between Hyperprocalcitonemia and Endothelial and Microcirculatory Dysfunction and Outcomes in Children with Sepsis and Septic Shock
Beltrán Hernández, Briam
Fernandez-Sarmiento, Jaime
Cardenas, Carolina
Mulett Hoyos, Hernando
Sarta Mantilla, Mauricio
Fernández Sarmiento, Jaime
Sepsis
Choque séptico
Endotelio
Matriz extracelular
Glicocálix
Permeabilidad vascular
Proteoglicanos
Resultados clínicos
OBJECTIVES: To evaluate the association between hyperprocalcitonemia and endothelial and microcirculatory dysfunction in children with sepsis and septic shock, along with clinical outcomes. DESIGN: A prospective observational cohort study. SETTING: A tertiary care pediatric intensive care unit (PICU) with 15 medical-surgical beds in a university hospital. PATIENTS: We included children with sepsis and/or septic shock who had serum procalcitonin (PCT) measured at admission, 24 hours, and 48 hours, with simultaneous microcirculatory assessment using sublingual videomicroscopy and evaluation of endothelial injury biomarkers (syndecan-1, angiopoietin-2, [Ang-2] and endocan). Hyperprocalcitonemia (H-PCT) was defined as procalcitonin > 2 ng/mL. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 230 included patients, 43.9% (101/230) had H-PCT at PICU admission. After adjusting for confounders, children with H-PCT showed a greater reduction in capillary blood flow at 24 hours (aOR, 1.35 [95% CI, 1.08–1.72]) and 48 hours (aOR, 1.14 [95% CI, 1.04–1.24]) after admission, compared with patients with normal PCT. Children with H-PCT and elevated serum lactate had higher odds of glycocalyx damage (aOR, 1.31 [95% CI, 1.09–1.68]; p = 0.041). At 24 hours, children with H-PCT had higher syndecan-1 levels (125.87 [IQR, 49.56–224.30] vs. 107.71 [IQR, 62.82–156.55] ng/mL, respectively; p < 0.01) and higher odds of Ang-2 elevation (aOR, 2.28 [95% CI, 1.08–5.17]; p = 0.042). Hyperprocalcitonemia with severe endothelial/microcirculatory dysfunction was associated with >10% fluid overload (aOR, 2.01 [95% CI, 1.06–3.80]; p = 0.033), multiple organ dysfunction (aOR, 1.87 [95% CI, 1.01–3.57]; p = 0.041), and mortality (aOR, 1.66 [95% CI, 1.06–2.61]; p = 0.022). CONCLUSIONS: Hyperprocalcitonemia in children with sepsis and septic shock represents a phenotype characterized by endothelial and microvascular dysfunction, and is associated with worse clinical outcomes. Our study suggests that preserving microvascular integrity may be a therapeutic target to reduce microcirculatory damage and improve outcomes.
2025-07-14T15:00:44Z
2025-07-14T15:00:44Z
2025-07-14T15:00:44Z
masterThesis
https://doi.org/10.48713/10336_45864
https://repository.urosario.edu.co/handle/10336/45864
spa
info:eu-repo/semantics/openAccess
Abierto (Texto Completo)
EL 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.
http://creativecommons.org/licenses/by-nc-nd/4.0/
Attribution-NonCommercial-NoDerivatives 4.0 International
Universidad del Rosario
Escuela de Medicina y Ciencias de la Salud
Especialización en Medicina Crítica y Cuidado Intensivo Pediátrico
Dahabreh, Issa J.; Bibbins-Domingo, Kirsten (2024) Causal Inference About the Effects of Interventions From Observational Studies in Medical Journals. En: JAMA. Vol. 331; No. 21; pp. 1845 - 1845; Disponible en: 10.1001/jama.2024.7741.
Aldewereld, Zachary; Horvat, Christopher; Clermont, Gilles (2025) Pediatric Sepsis Phenotype in a Single-Center Cohort Covering 2010–2020: Evolution in Day 1–Day 3 Trajectory and Potential Prognostic Value. En: Pediatric Critical Care Medicine. Vol. 26; No. 7; pp. e909 - e914; Disponible en: 10.1097/PCC.0000000000003708.
Stanski, Natalja L.; Zhang, Bin; Cvijanovich, Natalie Z.; Fitzgerald, Julie C.; Bigham, Michael T.; Jain, Parag N.; Schwarz, Adam J.; Lutfi, Riad; Allen, Geoffrey L.; Thomas, Neal J.; Baines, Torrey; Haileselassie, Bereketeab; Weiss, Scott L.; Atreya, Mihir R.; Lautz, Andrew J.; Zingarelli, Basilia; Standage, Stephen W.; Kaplan, Jennifer; Goldstein, Stuart L. (2024) Diagnostic Validation of the Updated Pediatric Sepsis Biomarker Risk II for Acute Kidney Injury Prediction Model in Pediatric Septic Shock*. En: Pediatric Critical Care Medicine. Vol. 25; No. 11; pp. 1005 - 1016; Disponible en: 10.1097/PCC.0000000000003589.
Atreya, Mihir R.; Bennett, Tellen D.; Geva, Alon; Faustino, E. Vincent S.; Rogerson, Colin M.; Lutfi, Riad; Cvijanovich, Natalie Z.; Bigham, Michael T.; Nowak, Jeffrey; Schwarz, Adam J.; Baines, Torrey; Haileselassie, Bereketeab; Thomas, Neal J.; Luo, Yuan; Sanchez-Pinto, L. Nelson (2024) Biomarker Assessment of a High-Risk, Data-Driven Pediatric Sepsis Phenotype Characterized by Persistent Hypoxemia, Encephalopathy, and Shock. En: Pediatric Critical Care Medicine. Vol. 25; No. 6; pp. 512 - 517; Disponible en: 10.1097/PCC.0000000000003499.
Sanchez-Pinto, L. Nelson; Bennett, Tellen D.; Stroup, Emily K.; Luo, Yuan; Atreya, Mihir; Bubeck Wardenburg, Juliane; Chong, Grace; Geva, Alon; Faustino, E. Vincent S.; Farris, Reid W.; Hall, Mark W.; Rogerson, Colin; Shah, Sareen S.; Weiss, Scott L.; Khemani, Robinder G. (2023) Derivation, Validation, and Clinical Relevance of a Pediatric Sepsis Phenotype With Persistent Hypoxemia, Encephalopathy, and Shock*. En: Pediatric Critical Care Medicine. Vol. 24; No. 10; pp. 795 - 806; Disponible en: 10.1097/PCC.0000000000003292.
Branco, Ricardo G. (2023) Balancing Fluid Resuscitation in Pediatric Sepsis*. En: Pediatric Critical Care Medicine. Vol. 24; No. 3; pp. 257 - 259; Disponible en: 10.1097/PCC.0000000000003172.
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Duranteau, J.; De Backer, D.; Donadello, K.; Shapiro, N. I.; Hutchings, S. D.; Rovas, A.; Legrand, M.; Harrois, A.; Ince, C. (2023) The future of intensive care: the study of the microcirculation will help to guide our therapies. En: Critical Care. Vol. 27; No. 1; pp. 190 - 190; Disponible en: 10.1186/s13054-023-04474-x.
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instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR
oai:repository.urosario.edu.co:10336/88522021-06-03T00:45:32Zcom_10336_925com_10336_562col_10336_926
Morbimortalidad asociada a transfusiones de glóbulos rojos en una unidad de cuidados intensivos pediátricos de Bogotá
Alvarado Villarreal, Manuel Antonio
Tello Barceló, Montserrat Cristina
Pardo, Rosalba
Cárdenas Müller, Adriana
Morón Duarte, Lina Sofía
transfusión sanguínea
mortalidad
insuficiencia multiorgánica
tiempo de internación
respiración artificial
MORBIMORTALITY ASSOCIATED WITH RED BLOOD CELLS TRANSFUSION IN A PEDIATRIC CRITICAL CARE UNIT (PICU) IN BOGOTÁ. Objective: To determine if red blood cell transfusions in children hospitalized in a critical care unit are associated with an increase in morbimortality. Materials and Methods: An observational cohort analytical study including children with anemia from 1 month to 18 years that were admitted in PICU in a period of ten months. Results: 134 children with anemia were included. In 51. 5 % the anemia developed after admission. 66 children received a red blood cell transfusion and the median pretransfusion hemoglobin was 7. 5 g/dl. 6 % of the transfused patients had an adverse Reaction. Between transfused vs not trasfused children a significant difference exist in the admission hemoglobin, volumen of blood loss by extraction and age in the bivariate analysis. The transfused patients had major mortality than the not transfused ones (15. 2 % vs. 2. 9 %, p =0. 013). The development of multiorganic failure also was more frequent in the group transfused (62. 1 % vs. 16. 2 %, p 0. 001). The median of the days of stay in the PICU and time in mechanical ventilation was major in the transfused children than in the not transfused (8 vs 4 days p< 0. 001 and 6 vs 3 days p=0. 001 respectively). A mutivariate analysis showed association between red blood cell transfusions with mortality and multiorganic failure. Conclusion: Red blood cells transfusions are associated with an increase in the Mortality and in the development of Multiorganic Failure. The stay in the PICU and the time of Mechanical Ventilation was major in the children who received transfusion.
2014-09-02T21:06:16Z
2014-09-02T21:06:16Z
2014-09-02T21:06:16Z
2014
masterThesis
https://doi.org/10.48713/10336_8852
http://repository.urosario.edu.co/handle/10336/8852
spa
info:eu-repo/semantics/openAccess
Abierto (Texto completo)
Atribución-NoComercial-SinDerivadas 2.5 Colombia
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http://creativecommons.org/licenses/by-nc-nd/2.5/co/
Universidad del Rosario
Facultad de medicina
Especialización en Cuidado Intensivo Pediátrico
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instname:Universidad del Rosario
reponame:Repositorio Institucional EdocUR