Depuración de procalcitonina en pacientes con sepsis neonatal del Hospital Abel Gilbert entre 2014-2015
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2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
La sepsis neonatal es una causa importante de muerte en pacientes críticamente enfermos, sobre todo en países en vías de desarrollo. En América Latina la incidencia de sepsis neonatal se encuentra entre 3.5 y 8.9 por ciento. En el Ecuador, según el INEC, en 2010, la sepsis en el período neonatal ocupó la sexta causa de morbilidad infantil y la quinta causa de mortalidad, sin contar sus problemas asociados como la enterocolitis necrotizante o la neumonía connatal. Y a nivel del Hospital Abel Gilbert Pontón en el área de UCIN ocupo la segunda causa de morbi-mortalidad.
Actualmente no contamos con una técnica rápida, que comparada con los cultivos, puede influir negativamente en la mortalidad de pacientes con sepsis neonatal. Este estudio pretendo determinar la depuración de procalcitonina como biomarcador de pronóstico de Sepsis.
Objetivos: Determinar la frecuencia en que actuó como valor predictivo la depuración de procalcitonina en pacientes con Sepsis neonatal.
Metodología:Se trata de un estudio con enfoque cuantitativo que requiere de un diseño epidemiológico descriptivo observacional de casos con cohorte histórica, de tipo transversal aplicado a 52 historias clínicas de pacientes con diagnóstico definitivo de ingreso de Sepsis Neonatal, en el área de UCIN. En este estudio utilizamos los valores seriados de PCT de inicio y al 3er día para realizar la fórmula de aclaramiento.
Resultados: La población estudiada de 53 pacientes de los cuales el 57.6% (n=30) fue sexo masculino, 42.4% (n=23) sexo femenino. La mediana de edad 4 días, la mediana de días de hospitalización 12 días, pero los pacientes con mayor tiempo de internación en cuidados intensivos neonatales fue el 38% de la población total. Los cultivos positivos u 44.2%. Siendo la klebsiella pneumoniae y E.coli los más frecuentes con el 20.8%. Los niveles de PCT al inicio medina 1.2ng/ml, y PCT 3er dia 1.3ng/ml y el punto de corte de PCTc fue mayor de 22%.
Conclusión: Se ha observado que el uso de la seriado de PCT como de apoyo óptimo en la admisión nos permitió realizar la depuración de esta misma y podemos concluir que es un buen predictor de mayor estancia hospitalaria en cuidados intensivos neonatales y se ve reflejado que los niveles elevados de PCTc se presentaron en mayor porcentaje en la pacientes con mortalidad
Neonatal sepsis is an important cause of death in critically ill patients, especially in developing countries. In Latin America, the incidence of neonatal sepsis is between 3.5 and 8.9 percent. In Ecuador, according to the INEC, in 2010, sepsis in the neonatal period occupied the sixth cause of infant morbidity and the fifth cause of mortality, not counting its associated problems such as necrotizing enterocolitis or congenital pneumonia. And at the level of the Abel Gilbert Pontón Hospital in the NICU area, I was the second cause of morbidity and mortality. Currently we do not have a rapid technique, which compares with the cultures, can negatively influence the mortality of patients with neonatal sepsis. This study aims to determine the clearance of procalcitonin as a prognostic biomarker of Sepsis. Objectives: To determine the frequency of performance as predictive value of procalcitonin clearance in patients with neonatal sepsis. Establish the association between positive cultures and clearance of procalcitonin. Association between days of hospitalization and clearance of procalcitonin Methodology: This is a study with a quantitative approach that requires a descriptive epidemiological design of clinical and clinical cases of a transverse type applied to 52 clinical records of patients with definitive diagnosis of neonatal sepsis in the NICU area. Abel Gilbert Pontón Hospital with retrospective follow-up between 2014-2015. In this study we used the serial values of PCT onset and on the 3rd day to perform the clearing formula. RESULTS: The studied population of 53 patients (57.6%) (n = 30) was male, 42.4% (n = 23) female. The median age was 4 days, median days of hospitalization 12 days, but the patients with the longest stay in neonatal intensive care were 38% of the total population. Positive cultures or 44.2%. Klebsiella pneumoniae and E.coli being the most xiv frequent with 20.8%. The PCT levels at the beginning medina 1.2ng / ml, and PCT 3er diameter 1.3ng / ml and the PCTc cutoff was greater than -22%. Conclusion: It has been observed that the use of the PCT series as an optimal support in the admission and allowed to perform the same treatment and can conclude that it is a good predictor of the main hospital stay in neonatal intensive care and is reflected Elevated PCT levels were higher in patients with mortality
Neonatal sepsis is an important cause of death in critically ill patients, especially in developing countries. In Latin America, the incidence of neonatal sepsis is between 3.5 and 8.9 percent. In Ecuador, according to the INEC, in 2010, sepsis in the neonatal period occupied the sixth cause of infant morbidity and the fifth cause of mortality, not counting its associated problems such as necrotizing enterocolitis or congenital pneumonia. And at the level of the Abel Gilbert Pontón Hospital in the NICU area, I was the second cause of morbidity and mortality. Currently we do not have a rapid technique, which compares with the cultures, can negatively influence the mortality of patients with neonatal sepsis. This study aims to determine the clearance of procalcitonin as a prognostic biomarker of Sepsis. Objectives: To determine the frequency of performance as predictive value of procalcitonin clearance in patients with neonatal sepsis. Establish the association between positive cultures and clearance of procalcitonin. Association between days of hospitalization and clearance of procalcitonin Methodology: This is a study with a quantitative approach that requires a descriptive epidemiological design of clinical and clinical cases of a transverse type applied to 52 clinical records of patients with definitive diagnosis of neonatal sepsis in the NICU area. Abel Gilbert Pontón Hospital with retrospective follow-up between 2014-2015. In this study we used the serial values of PCT onset and on the 3rd day to perform the clearing formula. RESULTS: The studied population of 53 patients (57.6%) (n = 30) was male, 42.4% (n = 23) female. The median age was 4 days, median days of hospitalization 12 days, but the patients with the longest stay in neonatal intensive care were 38% of the total population. Positive cultures or 44.2%. Klebsiella pneumoniae and E.coli being the most xiv frequent with 20.8%. The PCT levels at the beginning medina 1.2ng / ml, and PCT 3er diameter 1.3ng / ml and the PCTc cutoff was greater than -22%. Conclusion: It has been observed that the use of the PCT series as an optimal support in the admission and allowed to perform the same treatment and can conclude that it is a good predictor of the main hospital stay in neonatal intensive care and is reflected Elevated PCT levels were higher in patients with mortality
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Polipéptido alfa relacionado con calcitonina, Sepsis neonatal, Epidemiología descriptiva, Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón, Cantón Guayaquil, Ecuador