Sepsis neonatal temprana diagnóstico clínico y de laboratorio. Algoritmo diagnóstico
Fecha
2016
Autores
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Introducción.- La Sepsis Neonatal Temprana, es un Síndrome de Respuesta Inflamatoria Sistémica debido a infección probada o sospechada, durante los primeros 3 días de vida. El diagnóstico oportuno es difícil debido a lo inespecífico de los signos y escasos métodos diagnósticos de detección precoz para iniciar el manejo, incrementando la morbimortalidad. Objetivos.- Disminuir la morbimortalidad neonatal, identificar los signos clínicos y de laboratorio y proponer un algoritmo diagnóstico de detección oportuna de sepsis neonatal temprana. Metodología.- La investigación es de tipo cualitativa, en su forma estratégica de estudio de caso, teniendo como instrumento el análisis documental. Resultados.- El diagnóstico de Sepsis neonatal Temprana se realiza en mayor proporción en neonatos de sexo masculino, las tres cuartas partes de neonatos con este diagnóstico son obtenidos por cesárea. Los factores de riesgo asociados más frecuentemente con la Sepsis Neonatal Temprana son las infecciones del tracto urinario y genitales maternos, la ruptura prematura de membrana y la presencia de líquido amniótico meconial entre otros. Los signos más frecuentes que se observaron, en las primeras horas de vida son la dificultad respiratoria, la distermia, el llenado capilar mayor a 3 segundos y la letargia. El hemocultivo, la proteína C reactiva y la procalcitonina, no son métodos diagnósticos útiles para la detección precoz. Conclusiones.- Debido a que el hemocultivo tiene una baja sensibilidad para confirmar los casos de sospecha de sepsis y no existe método diagnóstico de detección oportuna de sepsis neonatal ideal, se propone el uso de un algoritmo diagnóstico como recurso auxiliar
Introduction.- Early Neonatal Sepsis is a systemic inflammatory response syndrome in the presence of proven or suspected infection during the first 3 days of life. Its timely diagnosis is difficult because of the nonspecific signs it presents and the shortage of diagnostic methods of early detection to start the management and antimicrobial therapy, increasing the morbidity and mortality. Objectives.- Decrease the newborn morbidity and mortality rate, identify the clinic and laboratory signs and propose a diagnostic algorithm for timely detection of early neonatal sepsis. Methodology.- The research is qualitative type, in its strategic form of case study , having as instrument a documental analysis. Results.- The diagnosis of Early Neonatal Sepsis is done in a greater proportion in male infants, tree-quarters of infants with this diagnosis are obtained by cesarean section. The most frequently associated risk factors with Early Neonatal Sepsis are maternal genitourinary infections, premature rupture of membranes, dyed amniotic fluid and others. The most common signs that were observed in the first hours of life are breathlessness, the dysthermia, the capillary refill higher than 3 seconds and lethargy. Blood culture, C-reactive protein and procalcitonine are not useful diagnostic methods for early detection. Conclusions.- Because the blood culture has low sensitivity to confirm suspected cases of sepsis and there doesn’t exist an ideal diagnostic method for timely detection of neonatal sepsis, the use of a diagnostic algorithm is proposed as an auxiliary resource
Introduction.- Early Neonatal Sepsis is a systemic inflammatory response syndrome in the presence of proven or suspected infection during the first 3 days of life. Its timely diagnosis is difficult because of the nonspecific signs it presents and the shortage of diagnostic methods of early detection to start the management and antimicrobial therapy, increasing the morbidity and mortality. Objectives.- Decrease the newborn morbidity and mortality rate, identify the clinic and laboratory signs and propose a diagnostic algorithm for timely detection of early neonatal sepsis. Methodology.- The research is qualitative type, in its strategic form of case study , having as instrument a documental analysis. Results.- The diagnosis of Early Neonatal Sepsis is done in a greater proportion in male infants, tree-quarters of infants with this diagnosis are obtained by cesarean section. The most frequently associated risk factors with Early Neonatal Sepsis are maternal genitourinary infections, premature rupture of membranes, dyed amniotic fluid and others. The most common signs that were observed in the first hours of life are breathlessness, the dysthermia, the capillary refill higher than 3 seconds and lethargy. Blood culture, C-reactive protein and procalcitonine are not useful diagnostic methods for early detection. Conclusions.- Because the blood culture has low sensitivity to confirm suspected cases of sepsis and there doesn’t exist an ideal diagnostic method for timely detection of neonatal sepsis, the use of a diagnostic algorithm is proposed as an auxiliary resource
Descripción
PDF
Palabras clave
SEPSIS NEONATAL, DIAGNOSTICO CLINICO, DIAGNOSTICO DE LABORATORIO, ALGORITMO DE DIAGNOSTICO, BACTERIEMIA, HOSPITAL DE ESPECIALIDADES DR. TEODORO MALDONADO CARBO, CANTON GUAYAQUIL, ECUADOR