Eficacia de la luminofototerapia en neonatos con ictericia por incompatibilidad ABO en la Unidad de Cuidados Intensivos de Neonatología del Hospital de Especialidades Dr. Abel Gilbert Pontón desde mayo a octubre del 2016
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2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
La fototerapia es el tratamiento estándar para el control de la hiperbilirrubinemia neonatal, disminuye la bilirrubina plasmática por reacciones fotoquímicas que se producen en la piel. El objetivo del estudio fue determinar la eficacia de la Luminofototerapia en neonatos con ictericia por incompatibilidad ABO en la Unidad de Cuidados Intensivos de Neonatología del Hospital de Especialidades Abel Gilbert Pontón. La investigación fue de tipo descriptiva, observacional, transversal y retrospectiva que analizó 54 registros médicos de recién nacidos ingresados por ictericia patológica en el Hospital de Especialidades Abel Gilbert Pontón del 1 de mayo hasta el 31 de octubre del 2016. Los resultados del estudio demostraron que predominó mayor porcentaje de RN con peso entre 2500-4000 gramos (81,5%) que se consideran dentro del rango de la normalidad. El peso promedio fue de 2.894,48 gramos. En el presente estudio el 96,3% (52) de las madres tenía grupo sanguíneo O+. Además solo se observó 1 caso materno con grupo B+ (1,9%) y 1 caso con grupo AB+ (1,9%), lo cual sugiere hiperinmunización. El promedio de bilirrubina al ingreso fue de 19,29 mg/dl (Rango: 14,4-27,4 mg/dl y se encontró riesgo de neurotoxicidad con bilirrubina mayor o igual de 25 mg/dl en el 7,4% (4). La mayor parte de los RN, la ictericia alcanzo las piernas y los pies, que se corresponden con la zona 4 ( 9%) y 5 (91%) de Kramer. El promedio de duración de la fototerapia fue de 3,51 días. Hubo disminución de bilirrubina y cambio en las zonas de Kramer a zona 3 y 4 en el momento del egreso. Después de 24 horas de la fototerapia se encontró que el 83% (45) de los recién nacidos disminuyeron los niveles de bilirrubina a menos de 20 mg/dl, lo cual sugiere que la fototerapia es un
método confiable para disminuir la hiperbilirrubinemia neonatal, aunque solo 2 pacientes (4%) reingresaron para fototerapia después del egreso hospitalario.
Phototherapy is the standard treatment for the control of neonatal hyperbilirubinemia, decreases plasma bilirubin by photochemical reactions that occur in the skin. The objective of the study was to determine the efficacy of Luminofototerapia in neonates with jaundice due to ABO incompatibility in the Intensive Care Unit of Neonatology of the Abel Gilbert Pontón Specialty Hospital. The research was descriptive, observational, cross-sectional and retrospective, which analyzed 54 medical records of newborns hospitalized for pathological jaundice at the Abel Gilbert Pontón Specialty Hospital from May 1 to October 31, 2016. The results of the study showed that A greater percentage of newborns with a weight between 2500-4000 grams (81.5%) were considered to be within the normal range. The average weight was 2,894.48 grams. In the present study, 96.3% (52) of the mothers had an O + blood group. In addition, only 1 maternal case was observed with B + group (1.9%) and 1 case with AB + group (1.9%), which suggests hyperimmunization. The average bilirubin on admission was 19.29 mg / dl (Range: 14.4-27.4 mg / dl and a neurotoxicity risk was found with bilirubin greater than or equal to 25 mg / dl in 7.4% ( The average length of phototherapy was 3, 9, and 9, respectively, and the average duration of phototherapy was 3, After 24 hours of phototherapy, 83% (45) of the newborns were found to have decreased bilirubin levels To less than 20 mg / dl, which suggests that phototherapy is a reliable method to reduce neonatal hyperbilirubinemia, although only 2 patients (4%) re-admitted for phototherapy after hospital discharge.
Phototherapy is the standard treatment for the control of neonatal hyperbilirubinemia, decreases plasma bilirubin by photochemical reactions that occur in the skin. The objective of the study was to determine the efficacy of Luminofototerapia in neonates with jaundice due to ABO incompatibility in the Intensive Care Unit of Neonatology of the Abel Gilbert Pontón Specialty Hospital. The research was descriptive, observational, cross-sectional and retrospective, which analyzed 54 medical records of newborns hospitalized for pathological jaundice at the Abel Gilbert Pontón Specialty Hospital from May 1 to October 31, 2016. The results of the study showed that A greater percentage of newborns with a weight between 2500-4000 grams (81.5%) were considered to be within the normal range. The average weight was 2,894.48 grams. In the present study, 96.3% (52) of the mothers had an O + blood group. In addition, only 1 maternal case was observed with B + group (1.9%) and 1 case with AB + group (1.9%), which suggests hyperimmunization. The average bilirubin on admission was 19.29 mg / dl (Range: 14.4-27.4 mg / dl and a neurotoxicity risk was found with bilirubin greater than or equal to 25 mg / dl in 7.4% ( The average length of phototherapy was 3, 9, and 9, respectively, and the average duration of phototherapy was 3, After 24 hours of phototherapy, 83% (45) of the newborns were found to have decreased bilirubin levels To less than 20 mg / dl, which suggests that phototherapy is a reliable method to reduce neonatal hyperbilirubinemia, although only 2 patients (4%) re-admitted for phototherapy after hospital discharge.
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Fototerapia, Ictericia neonatal, Incompatibilidad ABO, Unidades de Cuidado Intensivo Neonatal, Epidemiología descriptiva, Estudios retrospectivos, Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón, Cantón Guayaquil, Ecuador, Recién nacido