Sepsis en pacientes pediátricos quemados y propuesta de cirugía temprana en el paciente pediátrico quemado
Fecha
2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La sepsis en quemaduras en una grave complicación que genera gastos hospitalarios y aumenta la mortalidad. El objetivo general fue diseñar un modelo de atención de emergencia de la sepsis por quemaduras dirigido a pacientes atendidos en el Hospital del Niño Dr. Francisco de Icaza Bustamante. El estudio fue observacional, cuantitativo y transversal que analizó y que comprendió el periodo del 1 de enero hasta el 30 de junio del 2016. Los datos fueron obtenidos de las historias clínicas y procesados en forma de frecuencias y porcentajes. Se evaluaron un total de 57 niños entre 1 y 15 años, el sexo masculino (73,7%) y el grupo etario de 2-5 años de edad fueron los más afectados (50,9%). Las quemaduras térmicas (94,7%) fueron la etiología más frecuente. Las extremidades superiores (50,9%) e inferiores (56,1%) fueron las regiones anatómicas más lesionadas. Las lesiones en la región genital se encontraron en poca frecuencia representando el 7% (4) del total de pacientes analizados. El porcentaje de pacientes con lesiones críticas > 15% fue de 26,3% y las lesiones de 3º grado de profundidad (68,4%) fueron las lesiones más comunes. Hubo 13 pacientes con sepsis (22,8%). La infección de la herida por quemadura (19,3%) fue la más común. El 38,6% (22) se asoció a factores de riesgo, los cuales se presentaron en la siguiente proporción: desnutrición (10,5%); neoplasias (1,8%); vía central (35,1%); ventilación mecánica (21,1%); inmunodeficiencia, trisomía, malformaciones congénitas y diabetes mellitus con el 3,5% (2) cada una respectivamente. Las principales complicaciones clínicas secundarias a sepsis fueron: alteraciones hidroelectrolíticas 7%(4), shock séptico 5.3% (3), disfunción multiorgánica 3.5% (2), insuficiencia renal aguda 1,8% (1).
Sepsis in burns in a serious complication that overall hospital costs and increases mortality. The overall objective was to design a model of emergency care of burns directed sepsis patients treated at the Children's Hospital Dr. Francisco de Icaza Bustamante. The study was observational, quantitative and transverse analyzed that covered the period from 1 January to 30 June 2016. Data were obtained from medical records and processed as frequencies and percentages. A total of 57 children aged 1 to 15 years, males (73.7%) and the age group 2-5 years old were evaluated were the most affected (50.9%). Thermal burns (94.7%) were the most frequent cause. Higher (50.9%) and lower (56.1%) were the most injured limb anatomical regions. Lesions in the genital region were found in infrequently representing 7% (4) of the total patients analyzed. The percentage of patients with critical lesions> 15% was 26.3% and grade 3 lesions deep (68.4%) were the most common injuries. There were 13 patients with sepsis (22.8%). Infection of the burn wound (19.3%) was the most common. 38.6% (22) was associated with risk factors, which are presented in the following proportion: malnutrition (10.5%); neoplasms (1.8%); central line (35.1%); mechanical ventilation (21.1%); immunodeficiency, trisomy, congenital malformations and diabetes mellitus with 3.5% (2) each respectively. The main clinical complications secondary to sepsis were: electrolyte disturbances 7% (4), septic shock 5.3% (3), multiorgan dysfunction 3.5% (2), 1.8% acute renal failure (1).
Sepsis in burns in a serious complication that overall hospital costs and increases mortality. The overall objective was to design a model of emergency care of burns directed sepsis patients treated at the Children's Hospital Dr. Francisco de Icaza Bustamante. The study was observational, quantitative and transverse analyzed that covered the period from 1 January to 30 June 2016. Data were obtained from medical records and processed as frequencies and percentages. A total of 57 children aged 1 to 15 years, males (73.7%) and the age group 2-5 years old were evaluated were the most affected (50.9%). Thermal burns (94.7%) were the most frequent cause. Higher (50.9%) and lower (56.1%) were the most injured limb anatomical regions. Lesions in the genital region were found in infrequently representing 7% (4) of the total patients analyzed. The percentage of patients with critical lesions> 15% was 26.3% and grade 3 lesions deep (68.4%) were the most common injuries. There were 13 patients with sepsis (22.8%). Infection of the burn wound (19.3%) was the most common. 38.6% (22) was associated with risk factors, which are presented in the following proportion: malnutrition (10.5%); neoplasms (1.8%); central line (35.1%); mechanical ventilation (21.1%); immunodeficiency, trisomy, congenital malformations and diabetes mellitus with 3.5% (2) each respectively. The main clinical complications secondary to sepsis were: electrolyte disturbances 7% (4), septic shock 5.3% (3), multiorgan dysfunction 3.5% (2), 1.8% acute renal failure (1).
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PEDIATRIA, SEPSIS, QUEMADURAS, MORTALIDAD, HOSPITAL DEL NIÑO FRANCISCO DE ICAZA BUSTAMANTE, CANTON GUAYAQUIL, ECUADOR