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Relación entre estrategias de manejo perioperatorio y desenlaces clínicos en pacientes pediátricos llevados a cirugía abdominal mayor electiva en el Hospital Infantil Rafael Henao Toro entre enero del 2016 y diciembre del 2022
dc.contributor.advisor | Trujillo Mejia, Alexander | |
dc.contributor.author | Daniela Ocampo Arboleda | |
dc.date.accessioned | 2024-03-22T18:58:13Z | |
dc.date.available | 2024-03-22 | |
dc.date.available | 2024-03-22T18:58:13Z | |
dc.date.issued | 2024-03-22 | |
dc.identifier.uri | https://repositorio.ucaldas.edu.co/handle/ucaldas/19834 | |
dc.description | Tablas | spa |
dc.description.abstract | spa: Introducción: Cada vez existe más evidencia que respalda los beneficios de los programas de recuperación acelerada después de cirugía abdominal mayor. Sin embargo, es limitada en la población pediátrica. Para la elaboración de una guía de manejo basada en estos programas, deben conocerse las características propias de la población a intervenir, desenlaces clínicos que han tenido al ser manejados con estrategias de cuidado tradicionales y qué factores críticos pueden influir en la génesis de complicaciones y estancia hospitalaria prolongada. Métodos: se realizó un estudio de prevalencia tipo observacional, retrospectivo, longitudinal, con alcance analítico en pacientes de cirugía abdominal mayor (0.1 a 17 años) intervenidos entre 2016-2022 en un Hospital pediátrico de Manizales, para su caracterización sociodemográfica y clínica. Además, se realizaron análisis bivariados y regresiones lineales múltiples para determinar si existía relación entre las variables clínicas y complicaciones respiratorias, infecciosas, náuseas y vómito, íleo, dolor severo y estancia hospitalaria prolongada. Resultados: Se incluyeron 104 pacientes. Se encontraron puntos críticos a intervenir como intervención nutricional y prehabilitación, tromboprofilaxis, tiempos de ayuno y método de ansiolisis. Hubo relación estadísticamente significativa entre el antecedente de patología neurológica y aparición de íleo posoperatorio (p = 0.017), y entre la duración de estancia hospitalaria con el inicio temprano de la dieta líquida (p = 0.015) y la suspensión temprana de los líquidos endovenosos (p = 0.005). Conclusiones: En la institución, se continúan realizando prácticas alejadas de la evidencia científica actual y se requiere diseñar un protocolo de recuperación acelerada en cirugía abdominal mayor pediátrica ajustado a las necesidades propias del hospital, enfocándose en la mejoría de los factores clave identificados. | spa |
dc.description.abstract | eng: Introduction: There is increasing evidence supporting the benefits of accelerated recovery programs after major abdominal surgery. However, this evidence is limited in the pediatric population. To develop a management guideline based on these programs, it is necessary to understand the characteristics of the population to be intervened, the clinical outcomes they have had when managed with traditional care strategies, and which critical factors may influence the genesis of complications and prolonged hospital stay. Methods: An observational, retrospective, longitudinal prevalence study with analytical scope was conducted on patients undergoing major abdominal surgery (0.1 to 17 years old) between 2016-2022 at a pediatric hospital in Manizales, for their sociodemographic and clinical characterization. Additionally, bivariate analyses and multiple linear regressions were performed to determine if there was a relationship between clinical variables and respiratory and infectious complications, nausea and vomiting, ileus, severe pain, and prolonged hospital stay. Results: 104 patients were included. Critical points were found to intervene, such as nutritional intervention and prehabilitation, thromboprophylaxis, fasting times, and anxiolysis method. There was a statistically significant relationship between a history of neurological pathology and the occurrence of postoperative ileus (p = 0.017), and between the duration of hospital stay and the early initiation of liquid diet (p = 0.015) and early discontinuation of intravenous fluids (p = 0.005). Conclusions: In the institution, practices continue to be performed that are distant from current scientific evidence, and there is a need to design an accelerated recovery protocol in major pediatric abdominal surgery tailored to the hospital's specific needs, focusing on improving the identified key factors. | eng |
dc.description.tableofcontents | Introducción/Antecedentes/Evolución de los Protocolos de Recuperación Acelerada Después de Cirugía/Evolución de los Programas de Recuperación Acelerada en Cirugía Abdominal Pediátrica/Planteamiento del problema/Pregunta de investigación/Objetivos/Justificación/Consideraciones/éticas/Metodología/Resultados/Caracterización sociodemográfica y clínica de los pacientes/Variables/sociodemográficas/Variables clínicas preoperatorias/clínicas del día de cirugía/Variables clínicas postoperatorias/Tiempos de estancia/Metas de recuperación POP/Complicaciones presentadas/Seguimiento ambulatorio/Relación entre variables clínicas y sociodemográficas con complicaciones/posoperatorias/Náuseas y vómito POP/Íleo/Complicaciones respiratorias/Complicaciones infecciosas/Dolor no controlado/Relación entre variables clínicas y sociodemográficas con mayor duración de estancia hospitalaria/Discusión/Conclusiones/Recomendaciones/Anexos/¡Error! Marcador no definido/Anexo 1: Códigos CUPS utilizados para la identificación de los pacientes/ ¡Error! Marcador no definido/Bibliografía. | spa |
dc.format.mimetype | application/pdf | spa |
dc.language.iso | spa | spa |
dc.title | Relación entre estrategias de manejo perioperatorio y desenlaces clínicos en pacientes pediátricos llevados a cirugía abdominal mayor electiva en el Hospital Infantil Rafael Henao Toro entre enero del 2016 y diciembre del 2022 | spa |
dc.type | Trabajo de grado - Especialización | spa |
dc.contributor.educationalvalidator | Arango Gómez, Fernando | |
dc.description.degreelevel | Especialización médico - quirúrgica | spa |
dc.identifier.instname | Universidad de Caldas | spa |
dc.identifier.reponame | Repositorio Institucional Universidad de Caldas | spa |
dc.identifier.repourl | https://repositorio.ucaldas.edu.co | spa |
dc.publisher.faculty | Facultad de Ciencias para la Salud | spa |
dc.publisher.place | Manizales | spa |
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dc.rights.accessrights | info:eu-repo/semantics/closedAccess | spa |
dc.rights.accessrights | info:eu-repo/semantics/openAccess | spa |
dc.rights.accessrights | info:eu-repo/semantics/openAccess | spa |
dc.rights.accessrights | info:eu-repo/semantics/closedAccess | spa |
dc.rights.accessrights | info:eu-repo/semantics/openAccess | spa |
dc.rights.accessrights | info:eu-repo/semantics/openAccess | spa |
dc.subject.proposal | Cirugía abdominal | spa |
dc.subject.proposal | Cirugía pediátrica | spa |
dc.subject.proposal | Recuperación acelerada | spa |
dc.subject.proposal | Recuperación intensificada | spa |
dc.subject.unesco | Anestesiología | |
dc.type.content | Text | spa |
dc.type.driver | info:eu-repo/semantics/masterThesis | spa |
dc.type.version | info:eu-repo/semantics/publishedVersion | spa |
oaire.version | http://purl.org/coar/version/c_ab4af688f83e57aa | spa |
oaire.accessrights | http://purl.org/coar/access_right/c_abf2 | spa |
dc.description.degreename | Especialista en Anestesiología | spa |
dc.publisher.program | Especialización en Anestesiología | spa |
dc.rights.coar | http://purl.org/coar/access_right/c_14cb | spa |