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Relación entre el balance hídrico y grado de congestión venosa medido por protocolo VEXUS en pacientes hospitalizados en unidad de cuidados intensivos del Hospital Universitario Nacional de Colombia
dc.rights.license | Reconocimiento 4.0 Internacional |
dc.contributor.advisor | Espinosa Almansa, Carmelo José |
dc.contributor.advisor | Ruiz Ávila, Héctor Andrés |
dc.contributor.author | Gomez Tobar, Juan Esteban |
dc.date.accessioned | 2023-02-03T20:53:03Z |
dc.date.available | 2023-02-03T20:53:03Z |
dc.date.issued | 2023-02-03 |
dc.identifier.uri | https://repositorio.unal.edu.co/handle/unal/83300 |
dc.description.abstract | Introducción: La evaluación del estado de volemia y la sobrecarga de volumen, son consideraciones importantes en el manejo del paciente críticamente enfermo. Esta última condición ha sido reconocida como un problema con desenlaces adversos asociados. El auge del ultrasonido, ha llevado a crear nuevos índices de monitoreo hemodinámico; uno de los más destacados recientemente, ha sido el sistema VEXUS usado para evaluar la congestión venosa Objetivo principal: Evaluar si existe relación entre el grado de sobrecarga de volumen de los pacientes críticos y el nivel de congestión demostrado por sistema VEXUS en las primeras 72 horas de inicio de tratamiento en UCI y establecer factores asociados a la presencia de grados mayores de VEXUS. Materiales y métodos: Estudio descriptivo de corte transversal, realizado en pacientes críticamente enfermos hospitalizados en UCI del Hospital Universitario Nacional de Colombia en el periodo comprendido entre noviembre 2021- julio 2022. Resultados: Se incluyeron 123 pacientes, 73 (59.3%) fueron hombres, el promedio de edad en años fue 60,7 (RIQ 30). El volumen de fluidos acumulado al tercer día de hospitalización fue -151.5 ml (DE ± 2713). Los pacientes con congestión venosa sistémica catalogados con un puntaje de VEXUS ≥ 2 correspondieron al 22% (n=27) de la población. la edad mostró ser un factor protector con un (OR) de 0,97 (IC 95% 0.94 - 0,99; p: 0.02). La hipertensión pulmonar resultó ser un factor asociado a congestión con un OR de 6.55 (IC 95% 2,02 - 21,2; p.0.02); al igual que el balance acumulado de fluidos medido en litros al tercer día de la evaluación OR de 1.29 (Por cada litro de balance positivo - IC 95% 1.06 - 1,59; p. 0.008). Conclusión. La prevalencia de congestión venosa en una unidad de cuidados intensivos fue del 22.8%. El edema clínicamente evaluado al examen físico, no se asoció a grados de congestión venosa medidos por ecografía. Los factores asociados a congestión fueron la edad la hipertensión arterial pulmonar y el balance acumulado de 1 litro a las 72 horas de manejo. (Texto tomado de la fuente) |
dc.description.abstract | Background The evaluation of the state of volemia and volume overload are important considerations in the management of the critically ill patient. This last condition has been recognized as a problem with associated adverse outcomes. The rise of ultrasound has led to the creation of new hemodynamic monitoring indices; one of the most prominent recently has been the VEXUS system used to assess venous congestion. Primary objective: To assess whether there is a relationship between the degree of volume overload in critically ill patients and the level of congestion demonstrated by the VEXUS system in the first 72 hours of treatment initiation in the ICU and to establish factors associated with the presence of higher degrees of VEXUS. Materials and methods: Descriptive cross-sectional study, carried out in critically ill patients hospitalized in the ICU of the National University Hospital of Colombia in the period between November 2021- July 2022. Results: 123 patients were included, 73 (59.3%) were men, the mean age in years was 60.7 (IQR 30). The accumulated fluid volume on the third day of hospitalization was -151.5 ml (SD ± 2713). Patients with systemic venous congestion classified as having a VEXUS score ≥ 2 corresponded to 22% (n=27) of the population. Age was shown to be a protective factor with an (OR) of 0.97 (95% CI 0.94 - 0.99; p: 0.02). Pulmonary hypertension turned out to be a factor associated with congestion with an OR of 6.55 (95% CI 2.02 - 21.2; p.0.02); as well as the accumulated balance of fluids measured in liters on the third day of the evaluation OR of 1.29 (For each liter of positive balance - 95% CI 1.06 - 1.59; p. 0.008). Conclusions. The prevalence of venous congestion in an intensive care unit was 22.8%. The clinically assessed edema on physical examination was not associated with degrees of venous congestion measured by ultrasound. The factors associated with congestion were age, pulmonary arterial hypertension, and the accumulated balance of 1 liter after 72 hours of treatment. |
dc.format.mimetype | application/pdf |
dc.language.iso | spa |
dc.publisher | Universidad Nacional de Colombia |
dc.subject.ddc | 610 - Medicina y salud |
dc.title | Relación entre el balance hídrico y grado de congestión venosa medido por protocolo VEXUS en pacientes hospitalizados en unidad de cuidados intensivos del Hospital Universitario Nacional de Colombia |
dc.type | Trabajo de grado - Especialización |
dc.type.driver | info:eu-repo/semantics/masterThesis |
dc.type.version | info:eu-repo/semantics/acceptedVersion |
dc.publisher.program | Bogotá - Medicina - Especialidad en Medicina Interna |
dc.coverage.country | Colombia |
dc.description.degreelevel | Especialidades Médicas |
dc.description.degreename | Especialista en Medicina Interna |
dc.description.methods | Estudio de corte transversal. |
dc.identifier.instname | Universidad Nacional de Colombia |
dc.identifier.reponame | Repositorio Institucional Universidad Nacional de Colombia |
dc.identifier.repourl | https://repositorio.unal.edu.co/ |
dc.publisher.faculty | Facultad de Administración |
dc.publisher.place | Bogotá, Colombia |
dc.publisher.branch | Universidad Nacional de Colombia - Sede Bogotá |
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dc.rights.accessrights | info:eu-repo/semantics/opendAccess |
dc.subject.decs | Cuidados Críticos |
dc.subject.decs | Critical Care |
dc.subject.decs | Métodos |
dc.subject.decs | Methods |
dc.subject.proposal | Sobrecarga de fluidos |
dc.subject.proposal | Enfermo crítico |
dc.subject.proposal | Lesión renal aguda |
dc.subject.proposal | Edema |
dc.subject.proposal | Fluid overload |
dc.subject.proposal | Critical illness |
dc.subject.proposal | Acute kidney injury |
dc.subject.proposal | Edema |
dc.title.translated | Relationship between fluid balance and degree of venous congestion measured by the VEXUS protocol in patients hospitalized in the intensive care unit of the National University Hospital of Colombia |
dc.type.coar | http://purl.org/coar/resource_type/c_bdcc |
dc.type.coarversion | http://purl.org/coar/version/c_ab4af688f83e57aa |
dc.type.content | DataPaper |
dc.type.redcol | http://purl.org/redcol/resource_type/TM |
oaire.accessrights | http://purl.org/coar/access_right/c_14cb |
oaire.awardtitle | Relación entre el balance hídrico y grado de congestión venosa medido por protocolo VEXUS en pacientes hospitalizados en unidad de cuidados intensivos del Hospital Universitario Nacional de Colombia |
dcterms.audience.professionaldevelopment | Investigadores |
dc.contributor.orcid | 0000-0002-2762-6455 |