Especialización en Medicina Crítica y Cuidado Intensivohttps://repository.urosario.edu.co/handle/10336/31182024-03-28T20:08:56Z2024-03-28T20:08:56Z461Actitud del médico de cuidado intensivo frente a la donación y transplate de órganos en institución de BogotáMartinez Vargas, Yennifer Samanthahttps://repository.urosario.edu.co/handle/10336/422232024-02-13T08:00:36Zdc.title: Actitud del médico de cuidado intensivo frente a la donación y transplate de órganos en institución de Bogotá
dc.description.abstract: Law 1805 of 2016 establishes crucial provisions regarding organ donation and transplants, with the purpose of satisfying the national demand for organs and tissues equitably and transparently. The law presumes organ donation for every adult Colombian citizen upon declaration of death, unless they have expressed prior refusal through a legal document. Healthcare personnel in Intensive Care Units (ICUs) play a fundamental role in the approach and management of organ donation, actively influencing the identification and maintenance of potential donors, as well as the initial contact with family members. Therefore, it is crucial to understand the attitude of intrahospital staff towards this issue. This descriptive observational cross-sectional study used a tool validated in Europe and Latin America. Demographic, occupational, socio-personal, knowledge, and religious variables were analyzed with the purpose of proposing strategies that strengthen institutional and governmental donation policies. The results reveal a favorable attitude in up to 92% of the surveyed individuals. However, deficiencies were identified in knowledge about the processes of reporting potential donors and the integrative role of the National Network for Organ and Tissue Donation and Transplantation (RDDTOT). Additionally, participants agree on the need to establish educational programs to promote awareness about organ donation and transplantation among healthcare personnel.
dc.description: La Ley 1805 de 2016 establece disposiciones cruciales sobre donación de órganos y trasplantes, con el propósito de satisfacer equitativa y transparentemente la demanda nacional de órganos y tejidos. La ley presume la donación de órganos para toda persona adulta de nacionalidad colombiana al declararse fallecida, a menos que haya expresado su negativa previa mediante un documento legal.
El personal de salud en las unidades de cuidado intensivo (UCI) juega un papel fundamental en el enfoque y gestión de la donación de órganos, influyendo activamente en la identificación y mantenimiento del potencial donante, así como en el primer contacto con los familiares. Por ende, es crucial comprender la actitud del personal intrahospitalario hacia esta temática.
Este estudio descriptivo observacional de corte transversal utilizó una herramienta validada en Europa y América Latina. Se analizaron variables demográficas, laborales, socio personales, conocimientos y religión con el propósito de proponer estrategias que fortalezcan las políticas institucionales y gubernamentales de donación.
Los resultados revelan una actitud favorable en hasta el 92% de los encuestados. Sin embargo, se identificaron deficiencias en el conocimiento sobre los procesos de reporte del potencial donante y en el rol integrativo de la Red Nacional de Donación y Trasplante de Órganos y Tejidos (RDDTOT). Además, los participantes coinciden en la necesidad de establecer programas educativos para fomentar el conocimiento sobre la donación y trasplante de órganos en el personal de salud.
Martinez Vargas, Yennifer SamanthaLaw 1805 of 2016 establishes crucial provisions regarding organ donation and transplants, with the purpose of satisfying the national demand for organs and tissues equitably and transparently. The law presumes organ donation for every adult Colombian citizen upon declaration of death, unless they have expressed prior refusal through a legal document. Healthcare personnel in Intensive Care Units (ICUs) play a fundamental role in the approach and management of organ donation, actively influencing the identification and maintenance of potential donors, as well as the initial contact with family members. Therefore, it is crucial to understand the attitude of intrahospital staff towards this issue. This descriptive observational cross-sectional study used a tool validated in Europe and Latin America. Demographic, occupational, socio-personal, knowledge, and religious variables were analyzed with the purpose of proposing strategies that strengthen institutional and governmental donation policies. The results reveal a favorable attitude in up to 92% of the surveyed individuals. However, deficiencies were identified in knowledge about the processes of reporting potential donors and the integrative role of the National Network for Organ and Tissue Donation and Transplantation (RDDTOT). Additionally, participants agree on the need to establish educational programs to promote awareness about organ donation and transplantation among healthcare personnel.Análisis de costos de pacientes con imitadores de ictus en la Fundación Santa Fe de BogotáVillalobos Ibarra, Juan Davidhttps://repository.urosario.edu.co/handle/10336/380612023-06-13T12:32:55Zdc.title: Análisis de costos de pacientes con imitadores de ictus en la Fundación Santa Fe de Bogotá
dc.description.abstract: 30% of patients with ischemic stroke symptoms are stroke mimics. This leads to performing paraclinical tests, imaging and in some cases thrombolysis, exposing these patients to unnecessary conditions, thus increasing health costs. Oobjectives: To analyze direct costs in mimicking stroke patients, compare costs based on Telestroke and FABS scores, and determine the frequency of thrombolysis. Methods: Cross-sectional observational study. Medical records of all patients admitted to the Fundación Santa Fe de Bogotá who were mimics of ischemic stroke were reviewed, thus characterizing the population studied, and an analysis was carried out to identify the costs of these patients. Results: 111 patients were included. The average age of mimic presentation was 65 +/- 19.4 years, with migraine being the most common cause of mimic among both sexes. Tissue plasminogen activator administration was performed in 0.9% of patients. The direct costs from the activation to the deactivation of the code was on average of US$1,098.72, with a cost of laboratory and imaging of US$773.95, and an average cost of total hospitalization of US$2,220.16 per patient. Conclusions: The most frequent cause of mimic is migraine and thrombolysis is performed in 0.9% of cases. The direct costs generated by the activation of the stroke code, the diagnostic tests, the treatment of these patients with intravenous thrombolysis and the hospitalization of patients with mimics are lower compared to other studies.
dc.description: 30% de los pacientes con síntomas de ictus isquémico son imitadores de ictus. Esto conduce a realizar paraclínicos, imágenes y en algunos casos trombólisis, exponiendo a estos pacientes a intervenciones innecesarias aumentando así los costos de salud. Objetivos: Analizar los costos directos en pacientes imitadores de ictus, comparar los costos según los puntajes Telestroke y FABS, y determinar la frecuencia de trombólisis. Métodos: Estudio observacional de corte transversal. Se revisaron las historias clínicas de todos los pacientes que ingresaron a la Fundación Santa Fe de Bogotá que fueron imitador de ictus isquémico, caracterizando así a la población estudiada y se realizó un análisis de identificación de costos en estos pacientes. Resultados: Se incluyeron 111 pacientes. La edad promedio de presentación del mimic fue 65 +/- 19.4 años, siendo la causa más común de mimic la migraña entre ambos sexos. La administración de activador de plasminógeno tisular fue realizada en 0.9% de los pacientes. Los costos directos desde la activación hasta la desactivación del código fue en promedio 1098.72 US, con un costo de laboratorio e imágenes de 773.95 US, y un costo promedio del total de la hospitalización 2220,16 US por paciente. Conclusiones: La causa más frecuente de mimic es la migraña y se realiza trombólisis en el 0.9% de los casos. Los costos directos que genera la activación de código de ictus, los exámenes diagnósticos, el tratamiento de estos pacientes con trombólisis intravenosa y la hospitalización de los pacientes con mimics son menores en comparación a otros estudios
Villalobos Ibarra, Juan David30% of patients with ischemic stroke symptoms are stroke mimics. This leads to performing paraclinical tests, imaging and in some cases thrombolysis, exposing these patients to unnecessary conditions, thus increasing health costs. Oobjectives: To analyze direct costs in mimicking stroke patients, compare costs based on Telestroke and FABS scores, and determine the frequency of thrombolysis. Methods: Cross-sectional observational study. Medical records of all patients admitted to the Fundación Santa Fe de Bogotá who were mimics of ischemic stroke were reviewed, thus characterizing the population studied, and an analysis was carried out to identify the costs of these patients. Results: 111 patients were included. The average age of mimic presentation was 65 +/- 19.4 years, with migraine being the most common cause of mimic among both sexes. Tissue plasminogen activator administration was performed in 0.9% of patients. The direct costs from the activation to the deactivation of the code was on average of US$1,098.72, with a cost of laboratory and imaging of US$773.95, and an average cost of total hospitalization of US$2,220.16 per patient. Conclusions: The most frequent cause of mimic is migraine and thrombolysis is performed in 0.9% of cases. The direct costs generated by the activation of the stroke code, the diagnostic tests, the treatment of these patients with intravenous thrombolysis and the hospitalization of patients with mimics are lower compared to other studies.Asociación de la concentración de material particulado en Bogotá con infarto agudo de miocardioAmorocho Barrera, JoseTorres Chaves, Maria Claudiahttps://repository.urosario.edu.co/handle/10336/44592021-06-03T05:46:12Z2013-01-01T00:00:00Zdc.title: Asociación de la concentración de material particulado en Bogotá con infarto agudo de miocardio
dc.description.abstract: Background: Air pollution has important effects on the respiratory and cardiovascular systems. The aim of this research is generate evidence that allow us to establish an association between the myocardial infarction and the environmental PM10 concentration, as a preliminary research for a set of patients in Bogotá.
Methods: The association between the particulate matter concentration (PM10 concentration registered on the closest monitor located from the place reported by patient as the place where the symptoms began) and the myocardial infarction was established using a case crossover design. Information from the medical record of patients with myocardial infarction diagnosis in the FSFB’s Emergency Room and the PM10 concentration registered on air quality monitor, was used.
Results: The association between PM10 concentration and the myocardial infarction diagnosis is statistically significant for three control moments: 2 hours before the event, 24 hours before the event and 48 hours before the event.
Discussion: This research suggests that high PM10 environmental concentrations increase the risk of developing myocardial infarction, especially on patients with previous coronary disease.
Moreover, it brings attention on the importance of generate policy actions that decrease air pollution in order to protect population health.
dc.description: Introducción: la contaminación atmosférica no solo tiene efectos sobre el sistema respiratorio sino también sobre el cardiovascular. El objetivo de este estudio es generar evidencia que permita establecer una asociación entre el infarto agudo del miocardio y la concentración de PM10 en el ambiente como un estudio preliminar para un grupo de pacientes en Bogotá. Metodología: la asociación entre la concentración del material particulado (en este caso PM10 medido en la estación más cercana del lugar reportado por el paciente) y el infarto agudo del miocardio se estableció utilizando el diseño case crossover. Se utilizó información de las historias clínicas de los pacientes con infarto agudo del miocardio que ingresaron al Servicio de Urgencias de la FSFB, y las concentraciones de PM10 medido en la estación más cercana al lugar de inicio de los síntomas de síndrome coronario agudo, reportado por el paciente. Resultados: se encontró que la asociación entre la concentración de PM10 y el diagnóstico de infarto agudo del miocardio es estadísticamente significativa teniendo en cuenta tres momentos de control: 2 horas antes del evento, 24 horas antes del evento y 48 horas antes del evento. Discusión: este estudio sugiere que las altas concentraciones de material particulado en el ambiente son un factor de riesgo para el desarrollo de infarto agudo del miocardio especialmente en personas con enfermedad coronaria subyacente. Con esta investigación se demuestra la importancia de generar acciones que disminuyan la contaminación de la ciudad y de esta forma proteger la salud de las personas.
2013-01-01T00:00:00ZAmorocho Barrera, JoseTorres Chaves, Maria ClaudiaBackground: Air pollution has important effects on the respiratory and cardiovascular systems. The aim of this research is generate evidence that allow us to establish an association between the myocardial infarction and the environmental PM10 concentration, as a preliminary research for a set of patients in Bogotá.
Methods: The association between the particulate matter concentration (PM10 concentration registered on the closest monitor located from the place reported by patient as the place where the symptoms began) and the myocardial infarction was established using a case crossover design. Information from the medical record of patients with myocardial infarction diagnosis in the FSFB’s Emergency Room and the PM10 concentration registered on air quality monitor, was used.
Results: The association between PM10 concentration and the myocardial infarction diagnosis is statistically significant for three control moments: 2 hours before the event, 24 hours before the event and 48 hours before the event.
Discussion: This research suggests that high PM10 environmental concentrations increase the risk of developing myocardial infarction, especially on patients with previous coronary disease.
Moreover, it brings attention on the importance of generate policy actions that decrease air pollution in order to protect population health.Asociación entre dominios disglucemicos y desenlaces de morbimortalidad en pacientes neurocríticosGuerra Quintero, Harold Fernandohttps://repository.urosario.edu.co/handle/10336/383412023-06-13T12:35:59Zdc.title: Asociación entre dominios disglucemicos y desenlaces de morbimortalidad en pacientes neurocríticos
dc.description.abstract: INTRODUCTION: Variation in glycemia in critically ill patients is associated with increased mortality, complications, ICU stay, and costs. Currently, the information related to glycemic control in neurocritical patients is insufficient. In this study, neurocritical patients were defined as those hospitalized in the ICU with: cerebrovascular accident, aneurysmal subarachnoid hemorrhage, intracranial hypertension, meningitis, encephalitis, hypoxic-ischemic encephalopathy, spinal compression, status epilepticus, traumatic brain or spinal injury, and/or death. cerebral. OBJECTIVE: To evaluate the association between the alteration of glycemic domains with in-hospital mortality and the requirement of ventilatory support in neurocritical patients hospitalized in the ICU of the Fundación Santa Fe de Bogotá between 2019 and 2020.
METHODS: Retrospective cohort study. A univariate analysis and a bivariate analysis and two logistic regression models were performed to determine the association between the alteration of the glycemic domains with intrahospital mortality and ventilatory support. RESULTS: 221 patients were included. 50.2% (n= 111) were men, the mean age was 60.2 (SD: 19.84) years. 30.8% (n= 68) required mechanical ventilation and 9% (n= 20) died in the ICU. CONCLUSIONS: The Odds of dying among patients with glucose values greater than 240mg/dL is 4.4 times to 1, the Odds of dying among patients who do not present glucose values greater than 240mg/dL, having adjusted for the other variables. The presence of hypoglycemia, glycemic variability greater than 20% or hyperglycemia are not associated with the requirement for ventilatory support.
dc.description: La variación en la glucemia en los pacientes críticamente enfermos se asocia con un aumento de mortalidad, complicaciones, estancia en UCI y costos. Actualmente, la información relacionada con control glucémico en los pacientes neurocríticos es insuficiente. En este estudio, los pacientes neurocríticos se definieron como aquellos hospitalizados en UCI con: accidente cerebrovascular, hemorragia subaracnoidea aneurismática, hipertensión intracraneal, meningitis, encefalitis, encefalopatía isquémica-hipóxica, compresión espinal, estatus epiléptico, lesión cerebral o espinal traumática y/o muerte cerebral.
Guerra Quintero, Harold FernandoINTRODUCTION: Variation in glycemia in critically ill patients is associated with increased mortality, complications, ICU stay, and costs. Currently, the information related to glycemic control in neurocritical patients is insufficient. In this study, neurocritical patients were defined as those hospitalized in the ICU with: cerebrovascular accident, aneurysmal subarachnoid hemorrhage, intracranial hypertension, meningitis, encephalitis, hypoxic-ischemic encephalopathy, spinal compression, status epilepticus, traumatic brain or spinal injury, and/or death. cerebral. OBJECTIVE: To evaluate the association between the alteration of glycemic domains with in-hospital mortality and the requirement of ventilatory support in neurocritical patients hospitalized in the ICU of the Fundación Santa Fe de Bogotá between 2019 and 2020.
METHODS: Retrospective cohort study. A univariate analysis and a bivariate analysis and two logistic regression models were performed to determine the association between the alteration of the glycemic domains with intrahospital mortality and ventilatory support. RESULTS: 221 patients were included. 50.2% (n= 111) were men, the mean age was 60.2 (SD: 19.84) years. 30.8% (n= 68) required mechanical ventilation and 9% (n= 20) died in the ICU. CONCLUSIONS: The Odds of dying among patients with glucose values greater than 240mg/dL is 4.4 times to 1, the Odds of dying among patients who do not present glucose values greater than 240mg/dL, having adjusted for the other variables. The presence of hypoglycemia, glycemic variability greater than 20% or hyperglycemia are not associated with the requirement for ventilatory support.Biopelículas bacterianas de tubo-orotraqueal y su sensibilidad antimicrobiana en dos ucis en Bogotá, ColombiaYepes Velasco, Andres Felipehttps://repository.urosario.edu.co/handle/10336/208732021-03-01T19:22:49Zdc.title: Biopelículas bacterianas de tubo-orotraqueal y su sensibilidad antimicrobiana en dos ucis en Bogotá, Colombia
dc.description.abstract: The use of antibiotics and invasive medical devices contributes to the emergence of drug-resistant microorganisms, making treatment difficult. Nosocomial pneumonia, especially that associated with mechanical ventilation, is one of the most frequent health care associated infections (HAI) in the intensive care unit (ICU). HAIs are linked to hospitalization mainly in ICUs, and are an important cause of morbidity and mortality. The microbiota of the airways in patients requiring mechanical ventilation is a serious problem because they rapidly colonize and form biofilms on the orotracheal tubes, where they persist and can contribute to the deterioration of the patient. These communities are composed of microorganisms from the normal flora of the patient as well as cross-contamination with the microbiota of the hospital environment. The most prevalent bacteria are Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumanii among others. Previous study of resistance mechanisms in planktonic state and in biofilm of K. pneumoniae from native isolates of Colombian patients, aware of the importance and the need to generate prevention strategies and alternative or new treatments specifically in infections generated around medical devices commonly used at the hospital level, this project aims to generate new knowledge and provide useful information for the outcome and prognosis of patients from microbial communities in biofilm on the orotracheal tube in two Medical-Surgical ICUs, a topic that Although it has been studied worldwide, in Colombia it would be one of the pioneers specifically in the area of biofilms on invasive medical devices used routinely at the hospital level. In this prospective study, the characterization of the microbial communities of the biofilms formed on the endotracheal tube obtained by culture and by sequencing the V3-V4 region of the 16S rRNA gene was carried out in patients from 2 intensive care units in Bogotá. - Colombia in the period between December 2016 and December 2017, collecting 116 samples of orotracheal tuos, Approximately half of the samples corresponded to microorganisms belonging to the ESKAPE group, K. pneumonia was the most prevalent microorganism in the two care units intensive in the evaluation of biofilm formation and is also the one with the highest capacity for biofilm formation, followed by P. aeruginosa. The evaluation of the minimum biofilm eradication concentration (MBEC) was carried out in 4 strains (2 from each ICU) and in the plantonic state they were sensitive to carbapenemic, however in the biofilm state they increase their resistance up to 8 times. The findings presented here generate an information base on the microbiota in ICU patients that contributes to the scientific community and to future studies aimed at generating improvements in antibiotic therapy that can benefit the patient`s quality of life and reduce the burden of the disease for the health system.
dc.description: El uso de antibióticos y de dispositivos médicos invasivos contribuye a la aparición de microorganismos resistentes a medicamentos, lo cual dificultan el tratamiento. La neumonía nosocomial, especialmente aquella asociada a ventilación mecánica, es una de las infecciones asociadas a la atención en salud (IAAS) más frecuente en la unidad de cuidado intensivo (UCI). Las IAAS están ligadas a la hospitalización principalmente en UCIs, y son causa importante de morbilidad y mortalidad. La microbiota de las vías aéreas en pacientes que requieren ventilación mecánica es un grave problema debido a que colonizan y forman biopelículas rápidamente sobre los tubos orotraqueales, donde persisten y pueden contribuir al deterioro del paciente. Dichas comunidades están compuestas por microorganismos de la flora normal del paciente así como de contaminación cruzada con la microbiota del ambiente hospitalario. Las bacterias más prevalentes se encuentran Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumanii entre otros. Previo estudio de los mecanismos de resistencia en estado planctónico y en biopelícula de K. pneumoniae a partir de aislados nativos de pacientes colombianos, conscientes de la importancia y la necesidad de generar estrategias de prevención y tratamientos alternativos o nuevos específicamente en las infecciones generadas alrededor de los dispositivos médicos de uso común a nivel hospitalario, en este proyecto se pretende generar conocimiento nuevo y brindar información útil para el desenlace y pronóstico de los pacientes de las comunidades microbianas en biopelícula sobre el tubo orotraqueal en dos UCIs Médico-Quirúrgicas, un tema que si bien ha sido estudiado a nivel mundial, en Colombia sería uno de los pioneros específicamente en el área de biopelículas sobre dispositivos médicos invasivos usados de rutina a nivel hospitalario. En este estudio de corte prospectiva se realizó la caracterización de las comunidades microbianas de las biopeliculas formadas sobre el tubo endotraqueal obtenidos por cultivo y por secuenciación de la región V3-V4 del gen 16S rRNA, en los pacientes de 2 unidades de cuidado intensivo en Bogotá- Colombia en el periodo comprendido entre diciembre de 2016 y diciembre de 2017, recolectándose 116 muestras de tuos orotraqueales, Aproximadamente la mitad de las muestras correspondieron a microorganismos pertencientes al grupo ESKAPE, K.pneumonia fue el microorganismo mas prevalente en las dos unidades de cuidado intensivo en la evaluación de formación de biopelicula y asi mismo es el de mayor capacidad de formación de la misma seguido por P. aeruginosa. Se realizó la evaluación de la concentración minima de erradicación en biopelicula (MBEC) en 4 cepas ( 2 de cada UCI) y en estado plantónico fueron sensibles a carbapenemico sin embargo en estado de biopelícula aumentan su resistencia hasta 8 veces . Los hallazgos aquí presentados generan un base de información sobe la microbiota en pacientes en UCI que aporta a la comunidad científica y a estudios futuros orientados a generar mejoras en la terapia antibiótica que pueda beneficiar la calidad de vida del paciente y reducir la carga de la enfermedad para el sistema de salud.
Yepes Velasco, Andres FelipeThe use of antibiotics and invasive medical devices contributes to the emergence of drug-resistant microorganisms, making treatment difficult. Nosocomial pneumonia, especially that associated with mechanical ventilation, is one of the most frequent health care associated infections (HAI) in the intensive care unit (ICU). HAIs are linked to hospitalization mainly in ICUs, and are an important cause of morbidity and mortality. The microbiota of the airways in patients requiring mechanical ventilation is a serious problem because they rapidly colonize and form biofilms on the orotracheal tubes, where they persist and can contribute to the deterioration of the patient. These communities are composed of microorganisms from the normal flora of the patient as well as cross-contamination with the microbiota of the hospital environment. The most prevalent bacteria are Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumanii among others. Previous study of resistance mechanisms in planktonic state and in biofilm of K. pneumoniae from native isolates of Colombian patients, aware of the importance and the need to generate prevention strategies and alternative or new treatments specifically in infections generated around medical devices commonly used at the hospital level, this project aims to generate new knowledge and provide useful information for the outcome and prognosis of patients from microbial communities in biofilm on the orotracheal tube in two Medical-Surgical ICUs, a topic that Although it has been studied worldwide, in Colombia it would be one of the pioneers specifically in the area of biofilms on invasive medical devices used routinely at the hospital level. In this prospective study, the characterization of the microbial communities of the biofilms formed on the endotracheal tube obtained by culture and by sequencing the V3-V4 region of the 16S rRNA gene was carried out in patients from 2 intensive care units in Bogotá. - Colombia in the period between December 2016 and December 2017, collecting 116 samples of orotracheal tuos, Approximately half of the samples corresponded to microorganisms belonging to the ESKAPE group, K. pneumonia was the most prevalent microorganism in the two care units intensive in the evaluation of biofilm formation and is also the one with the highest capacity for biofilm formation, followed by P. aeruginosa. The evaluation of the minimum biofilm eradication concentration (MBEC) was carried out in 4 strains (2 from each ICU) and in the plantonic state they were sensitive to carbapenemic, however in the biofilm state they increase their resistance up to 8 times. The findings presented here generate an information base on the microbiota in ICU patients that contributes to the scientific community and to future studies aimed at generating improvements in antibiotic therapy that can benefit the patient`s quality of life and reduce the burden of the disease for the health system. Calidad de vida de los pacientes que egresaron por patología neurocrítica en la unidad de cuidado intensivo en el año 2017Barrero, Jhon Alexanderhttps://repository.urosario.edu.co/handle/10336/310232021-03-03T08:03:15Zdc.title: Calidad de vida de los pacientes que egresaron por patología neurocrítica en la unidad de cuidado intensivo en el año 2017
dc.description.abstract: The main objective is to know the quality of life of patients who were discharged from the intensive care unit due to a neurocritical pathology in 2017. Also, to know the time to return to work or to usual daily activity. A descriptive cross-sectional study was carried out, patients who were discharged from the intensive care unit (ICU) with the diagnoses of: moderate or severe traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), ischemic stroke (ischemic stroke) or hemorrhagic stroke, subdural and epidural hematomas. Information form 60 patients were collected. An EQ-5D-5L survey was applied to them on quality of life, work activity prior to hospitalization in 2017 and current, time of re-entry to work or time to resume their usual activities. The respondents considered that the quality of life decreased with an average of 63.8%, the quality-of-life modules most affected according to the EQ-5D-5L survey were: mobility and pain or discomfort. 38.3% never resumed their work activities and 35% never resumed their usual activities to the date of this survey. Patients who were discharged from the ICU due to a neurocritical pathology have a quality-of-life compromise and a third of the patients will never resume their usual or work activities three years after discharge.
dc.description: El objetivo es conocer la calidad de vida de los pacientes que egresaron de la unidad de cuidados intensivos por una patología neurocrítica en el año 2017, también conocer el tiempo de reingreso a sus actividades laborales o usuales. Se realizo un estudio descriptivo de corte transversal, en pacientes que egresaron de la unidad de cuidado intensivo (UCI) con los diagnósticos de: trauma craneoencefálico moderado o severo (TCE), hemorragia subaracnoidea (HSA), accidente cerebrovascular isquémico (ACV isquémico) o hemorrágico, hematomas subdurales y epidurales. Se obtuvieron 60 pacientes, se les aplico la encuesta EQ5D-5L sobre la calidad de vida, adicionalmente se interrogo sobre actividad laboral previa hospitalización en 2017 y actual, tiempo de reingreso laboral o tiempo en retomar sus actividades usuales. Los encuestado consideraron que la calidad de vida disminuyo con una media de 63.8%, los módulos de la calidad de vida más afectados según la encuesta EQ-5D5L fueron: el de movilidad y el de dolor o malestar, el 38.3% nunca retomaron sus actividades laborales y el 35% nunca retomaron sus actividades usuales a los 3 años de su egreso. Los pacientes que egresaron de UCI por una patología neurocrítica tienen un compromiso de la calidad de vida y un tercio de los pacientes nunca retomaran sus actividades usuales o laborales a los tres años de su egreso
Barrero, Jhon AlexanderThe main objective is to know the quality of life of patients who were discharged from the intensive care unit due to a neurocritical pathology in 2017. Also, to know the time to return to work or to usual daily activity. A descriptive cross-sectional study was carried out, patients who were discharged from the intensive care unit (ICU) with the diagnoses of: moderate or severe traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), ischemic stroke (ischemic stroke) or hemorrhagic stroke, subdural and epidural hematomas. Information form 60 patients were collected. An EQ-5D-5L survey was applied to them on quality of life, work activity prior to hospitalization in 2017 and current, time of re-entry to work or time to resume their usual activities. The respondents considered that the quality of life decreased with an average of 63.8%, the quality-of-life modules most affected according to the EQ-5D-5L survey were: mobility and pain or discomfort. 38.3% never resumed their work activities and 35% never resumed their usual activities to the date of this survey. Patients who were discharged from the ICU due to a neurocritical pathology have a quality-of-life compromise and a third of the patients will never resume their usual or work activities three years after discharge.Calorimetría indirecta versus Harris-Benedict para determinar gasto energético basal en pacientes ventiladosEspinosa Durán, José Javierhttps://repository.urosario.edu.co/handle/10336/31682021-06-03T05:46:55Z2012-01-01T00:00:00Zdc.title: Calorimetría indirecta versus Harris-Benedict para determinar gasto energético basal en pacientes ventilados
dc.description.abstract: The Inadequate nutritional in the critical patients has led to the devel-opment of complications that increase mortality and costs of the health care. Many factors are involved in the consumption of nutrients by the body, such as transfers, surgery, use of vasopressors, mechanical ventilation, and others. If there errors in the determination of energy expenditure may causes an excess supply for nutrients for the patients, which can affect the evolution and prognosis.
It is universal knowledge that the costs of the health care increased every day, especially when there is requirement for management of a patient in the intensive care unit. To predict basal energy expenditure of the patient in the Intensive Care Unit, the tools must be economical, simple and easy, as the Harris-Benedict equation, other tool to calcu-lated de basal energy expenditure is the Indirect Calorimetry, but is more expensive and complex to manage.
The demand for new technology increase for the treatment in the ICU, the health personnel have to be more critical in the use of new technol-ogy, for that reason, we evaluated the correlation between the equations of Harris-Benedict and Indirect Calorimetry, the study results shows a good correlation between the equations, with a Pearson value = 0.700 and p= 0.002, and we concluded that the equations can be used to estimated basal energy expenditure of patients in the ICU for at the same time.
dc.description: El inadecuado aporte nutricional en los pacientes con enfermedades criticas, ha llevado al desarrollo de complicaciones que incrementan la mortalidad y los costos de la atención en salud. Muchos factores están involucrados en el consumo de los nutrientes por el organismo, como: los traslados, las intervenciones quirúrgicas, el uso de vasopresores, la ventilación mecánica, entre otros. Si se presenta imprecisión en la de-terminación del gasto energético, puede conllevar a un sobre aporte alimenticio en el paciente el cual puede afectar la evolución y pronosti-co del individuo.
Es de conocimiento universal que los costos en salud cada día se in-crementan, en especial cuando se presenta requerimiento del manejo de un paciente en la unidad de cuidados intensivos. Para predecir el gasto energético basal de los paciente en las UCI se cuentan con herramientas de evaluación sencillas, de fácil uso y económicas, como la ecuación de Harris-Benedict, o herramientas complejas y de difícil manejo como la Calorimetría Indirecta.
El incremento en la demanda de servicios con mayor tecnología en el tratamiento de los pacientes, enfrenta al personal de salud para ser más crítico en el uso de la nueva tecnología, por tal motivo, se evaluó la presencia de correlación entre las ecuaciones de Harris-Benedict y Calorimetría Indirecta, encontrando que se presenta una buena correlación entre las ecuaciones, con un valor de Pearson de 0,700 y una p = 0.002. Por lo que se puede concluir que las ecuaciones pueden ser utilizadas para estimar el gasto energético basal de los pacientes en la UCI.
2012-01-01T00:00:00ZEspinosa Durán, José JavierThe Inadequate nutritional in the critical patients has led to the devel-opment of complications that increase mortality and costs of the health care. Many factors are involved in the consumption of nutrients by the body, such as transfers, surgery, use of vasopressors, mechanical ventilation, and others. If there errors in the determination of energy expenditure may causes an excess supply for nutrients for the patients, which can affect the evolution and prognosis.
It is universal knowledge that the costs of the health care increased every day, especially when there is requirement for management of a patient in the intensive care unit. To predict basal energy expenditure of the patient in the Intensive Care Unit, the tools must be economical, simple and easy, as the Harris-Benedict equation, other tool to calcu-lated de basal energy expenditure is the Indirect Calorimetry, but is more expensive and complex to manage.
The demand for new technology increase for the treatment in the ICU, the health personnel have to be more critical in the use of new technol-ogy, for that reason, we evaluated the correlation between the equations of Harris-Benedict and Indirect Calorimetry, the study results shows a good correlation between the equations, with a Pearson value = 0.700 and p= 0.002, and we concluded that the equations can be used to estimated basal energy expenditure of patients in the ICU for at the same time.Caracterización de los pacientes con catéter venoso central en un hospital universitario de cuarto nivel en Bogotá 2011 - 2013Villota Eraso, EstherBarranco Carvajal, Elderhttps://repository.urosario.edu.co/handle/10336/106162021-06-03T05:45:42Z2015-01-01T00:00:00Zdc.title: Caracterización de los pacientes con catéter venoso central en un hospital universitario de cuarto nivel en Bogotá 2011 - 2013
dc.description.abstract: Introduction: The use of central venous catheters (CVC) in the intensive care unit has great importance and wide use, they are a source of support for the realization of various activities, but with a great potential for complications, so it is essential to know all aspects related to its use, in order to control them.
Methods: A descriptive cross-sectional study aimed to characterize patients requiring CVC at University Hospital Fundación Santa Fe de Bogotá in June 2011 and May 2013, describe their associated mechanical and infectious complications, determine the rate of bacteremia, causative organisms and their resistance patterns.
Results: 2.286 CVC were placed, 52,9% in men, the average age was 58,9 years. Total complications amount to 4.5%, 4.0% mechanical and infectious 0.6%. Only we find immediate mechanical complications, no late. Within infectious complications we find insertion site infection and bacteremia. The bacteremia rate was of 3,4 per 1.000 catheter-days in 2013, decreased compared to 2012 (3,9) and 2011 (4,4). The most frequently isolated microorganism was Staphylococcus Coagulase Negative with usual pattern of resistance.
Conclusion: Complications associated with CVC in HUFSFB, occur less frequently than those described internationally; the rate of CVC-associated bacteremia has decreased year by year, possibly associated with the strictest care after the implementation of management protocols.
dc.description: Introducción: La utilización de catéteres venosos centrales (CVC) en la unidad de cuidado intensivo tiene gran importancia y amplio uso, son fuente de apoyo para la realización de varia actividades, pero con un gran potencial de complicaciones, por lo cual es fundamental conocer todos los aspectos relacionados con su uso, para así poder controlarlas.
Métodos: Realizamos un estudio descriptivo de corte transversal con el objetivo de caracterizar los pacientes que requirieron CVC en el Hospital Universitario Fundación Santa Fe de Bogotá durante junio de 2011 y mayo de 2013, describimos sus complicaciones asociadas tanto mecánicas como infecciosas, determinamos la tasa de bacteriemia, gérmenes causales y sus patrones de resistencia.
Resultados: Se colocaron 2.286 CVC, el 52,9% en hombres, la media de edad fue 58,9 años. El total de las complicaciones ascienden al 4,5%, infecciosas 4,0% y mecánicas 0,6%. Dentro de las mecánicas solo encontramos inmediatas, no tardías. Con respecto a las infecciosas encontramos infección del sitio de inserción y bacteriemia. Se documentó una tasa de bacteriemia de 3,4 por 1000-días catéter en 2013, en disminución con respecto a 2012 (3,9) y 2011 (4,4). El microorganismo mas frecuentemente aislado fue el Staphylococcus Coagulasa Negativo con patrón usual de resistencia.
Conclusión: Las complicaciones asociadas al uso de CVC en el HUFSFB, se presentan en menor frecuencia a las descritas internacionalmente; la tasa de bacteriemia asociada al CVC ha disminuido año tras año, posiblemente asociado al cuidado mas estricto posterior a la implementación de protocolos de manejo.
2015-01-01T00:00:00ZVillota Eraso, EstherBarranco Carvajal, ElderIntroduction: The use of central venous catheters (CVC) in the intensive care unit has great importance and wide use, they are a source of support for the realization of various activities, but with a great potential for complications, so it is essential to know all aspects related to its use, in order to control them.
Methods: A descriptive cross-sectional study aimed to characterize patients requiring CVC at University Hospital Fundación Santa Fe de Bogotá in June 2011 and May 2013, describe their associated mechanical and infectious complications, determine the rate of bacteremia, causative organisms and their resistance patterns.
Results: 2.286 CVC were placed, 52,9% in men, the average age was 58,9 years. Total complications amount to 4.5%, 4.0% mechanical and infectious 0.6%. Only we find immediate mechanical complications, no late. Within infectious complications we find insertion site infection and bacteremia. The bacteremia rate was of 3,4 per 1.000 catheter-days in 2013, decreased compared to 2012 (3,9) and 2011 (4,4). The most frequently isolated microorganism was Staphylococcus Coagulase Negative with usual pattern of resistance.
Conclusion: Complications associated with CVC in HUFSFB, occur less frequently than those described internationally; the rate of CVC-associated bacteremia has decreased year by year, possibly associated with the strictest care after the implementation of management protocols.Caracterización de los pacientes críticos ventilados en la Fundación Santa Fe de Bogotá 2009 a 2013Gómez Cortés, Leonardo AndrésBernal Ramírez, OmarMoreno Duarte, IngridCarrizosa, Jorge Armandohttps://repository.urosario.edu.co/handle/10336/46332021-08-27T14:09:30Z2013-01-01T00:00:00Zdc.title: Caracterización de los pacientes críticos ventilados en la Fundación Santa Fe de Bogotá 2009 a 2013
dc.description.abstract: Objective: To characterize patients on mechanical ventilation at the Intensive Care Units from Fundación Santa Fe de Bogotá between 2009 and 2013.
Methods: We performed a retrospective analysis of a cohort of patients admitted to Intensive Care Units (ICU) that required mechanical ventilatory regardless of the cause of respiratory failure.
Results: The mean age of the patients was 63.83 years, the most frequent diagnosis at admission was myocardial revascularization, followed by pneumonia and aortic valve replacement; on 43% of cases the cause of respiratory failure was the postoperative state; the most frequently used ventilation modes were SIMV (27.5%) and assisted control (26.12%). 50% of patients were ventilated with PEEP <6 cmH2O. Crude mortality at the ICU was 15%. 22% of patients had prolonged ICU hospitalization. Weaning protocol was applied to 77% of patients. The duration of mechanical ventilation is increased with increasing age between 60 and 80 years. Mortality is about 50% at 50 years and more than 80% at 80 years. Ventilatory support lasting five or more days increased mortality to 80% or greater.
Discussion and Conclusions: These results are comparable to previous studies. This study can be considered as the first step to generate a proper record of mechanical ventilation on ICU in the country.
dc.description: Objetivo: Caracterizar a los pacientes que recibieron ventilación mecánica en las unidades de cuidado intensivo (UCI) de la Fundación Santa Fe de Bogotá entre los años 2009 y 2013.
Metodología: Se analizó una cohorte retrospectiva de los pacientes en UCI que requirieron soporte ventilatorio mecánico al ingreso a la unidad independientemente de la causa.
Resultados: La media de edad de los pacientes fue 63,83 años; el diagnóstico más frecuente de ingreso fue revascularización miocárdica, seguido por neumonía y recambio valvular aórtico; en el 43% de los casos la causa de la falla fue el estado postoperatorio. Los modos ventilatorios más frecuentemente utilizados fueron SIMV (27,5%) y ventilación asistida controlada (26,12%). El 50% de los pacientes fueron ventilados con PEEP < 6 cmH2O. La mortalidad bruta fue del 15%. 22% de los pacientes tuvieron estancia prolongada en UCI. Se aplicó protocolo de retiro de ventilación mecánica en el 77% de los pacientes. La duración de la ventilación mecánica es mayor a medida que aumenta la edad del paciente entre los 60 y los 80 años. La mortalidad es cercana al 50% alrededor de los 50 años y mayor a 80% después de los 80 años. El soporte ventilatorio por cinco o más días aumentó la mortalidad a 80% o más.
Discusión y Conclusiones: Estos resultados son comparables a los encontrados en estudios previos. Este estudio puede ser considerado como el primer paso para generar un registro adecuado de la ventilación de la mecánica de las unidades de cuidado intensivo del país.
2013-01-01T00:00:00ZGómez Cortés, Leonardo AndrésBernal Ramírez, OmarMoreno Duarte, IngridCarrizosa, Jorge ArmandoObjective: To characterize patients on mechanical ventilation at the Intensive Care Units from Fundación Santa Fe de Bogotá between 2009 and 2013.
Methods: We performed a retrospective analysis of a cohort of patients admitted to Intensive Care Units (ICU) that required mechanical ventilatory regardless of the cause of respiratory failure.
Results: The mean age of the patients was 63.83 years, the most frequent diagnosis at admission was myocardial revascularization, followed by pneumonia and aortic valve replacement; on 43% of cases the cause of respiratory failure was the postoperative state; the most frequently used ventilation modes were SIMV (27.5%) and assisted control (26.12%). 50% of patients were ventilated with PEEP <6 cmH2O. Crude mortality at the ICU was 15%. 22% of patients had prolonged ICU hospitalization. Weaning protocol was applied to 77% of patients. The duration of mechanical ventilation is increased with increasing age between 60 and 80 years. Mortality is about 50% at 50 years and more than 80% at 80 years. Ventilatory support lasting five or more days increased mortality to 80% or greater.
Discussion and Conclusions: These results are comparable to previous studies. This study can be considered as the first step to generate a proper record of mechanical ventilation on ICU in the country.Caracterización y perfiles de pacientes con morbilidad materna extrema, Unidad de Cuidados Intensivos, Hospital La Samaritana, 2008 -2014Solarte Palacios, Mercedeshttps://repository.urosario.edu.co/handle/10336/136462021-06-03T05:48:18Z2017-01-01T00:00:00Zdc.title: Caracterización y perfiles de pacientes con morbilidad materna extrema, Unidad de Cuidados Intensivos, Hospital La Samaritana, 2008 -2014
dc.description.abstract: The intensive care unit (ICU) admission of patients with extreme maternal morbidity (MME) in developing countries is 0. 2 to 10%, with low mortality rates despite clinical involvement; The study of this indicator has been promoted for three decades as a tool to reduce maternal mortality. The present study describes clinical, sociodemographic and profile characteristics of women with MME treated for 7 years in the ICU of a third level Hospital with coverage of more than two million inhabitants. The average age was 24. 3 years, the majority had low schooling, stable union, low burden of previous morbidity; 57% presented severe preeclampsia, we found the simultaneous involvement of two or more organs, of which the most affected was the cardiovascular, elevated transaminases and thrombocytopenia were the main abnormal paraclinics. ICU stay was longer than described in Colombia and other countries, the use of central venous catheter, transfusions and mechanical ventilation were the most performed interventions. A group of patients admitted to the ICU did not present greater organic compromise or alterations in signs vital or paraclinical, their stay in the ICU was justified by the potential risk in their health status, on the other hand patients with worse clinical conditions, prolonged stays and the requirement of a greater number of interventions. Due to the low number of mortality cases, it was not possible to determine prognostic factors and differences between survivors and non-survivors.
dc.description: El ingreso a la unidad de cuidados intensivos (UCI) de pacientes con morbilidad materna extrema (MME) en países en desarrollo es de 0,2 a 10%, con tasas de mortalidad baja a pesar del compromiso clínico; desde hace tres décadas se ha promovido el estudio de este indicador como una herramienta para disminuir la mortalidad materna.
El presente estudio describe características clínicas, sociodemográficas y perfiles de mujeres con MME atendidas durante 7 años en la UCI de un Hospital de tercer nivel con cobertura de más de dos millones de habitantes.
La edad promedio fue 24,3 años, la mayoría tenían escolaridad baja, unión estable, baja carga de morbilidad previa; el 57% presentaron preeclampsia severa, se encontró el compromiso simultáneo de dos o más órganos, de estos el más afectado fue el cardiovascular, la elevación de transaminasas y la trombocitopenia fueron los principales paraclínicos anormales
El tiempo de estancia en la UCI fue superior al descrito en Colombia y otros países, el uso de catéter venoso central, transfusiones y ventilación mecánica fueron las intervenciones más realizadas.
Un grupo de pacientes ingresan a la UCI no presentan mayor compromiso orgánico ni alteraciones en signos vitales o paraclínicos, su estancia en UCI se justifica por el potencial riesgo en su estado de salud, por otro lado pacientes con peores condiciones clínicas, compromiso multiorgánico, tienen estancias prolongadas y requerimiento de mayor número de intervenciones. Por el bajo número de casos de mortalidad no fue posible determinar los factores pronósticos y las diferencias entre supervivientes y no sobrevivientes.
2017-01-01T00:00:00ZSolarte Palacios, MercedesThe intensive care unit (ICU) admission of patients with extreme maternal morbidity (MME) in developing countries is 0. 2 to 10%, with low mortality rates despite clinical involvement; The study of this indicator has been promoted for three decades as a tool to reduce maternal mortality. The present study describes clinical, sociodemographic and profile characteristics of women with MME treated for 7 years in the ICU of a third level Hospital with coverage of more than two million inhabitants. The average age was 24. 3 years, the majority had low schooling, stable union, low burden of previous morbidity; 57% presented severe preeclampsia, we found the simultaneous involvement of two or more organs, of which the most affected was the cardiovascular, elevated transaminases and thrombocytopenia were the main abnormal paraclinics. ICU stay was longer than described in Colombia and other countries, the use of central venous catheter, transfusions and mechanical ventilation were the most performed interventions. A group of patients admitted to the ICU did not present greater organic compromise or alterations in signs vital or paraclinical, their stay in the ICU was justified by the potential risk in their health status, on the other hand patients with worse clinical conditions, prolonged stays and the requirement of a greater number of interventions. Due to the low number of mortality cases, it was not possible to determine prognostic factors and differences between survivors and non-survivors.