Indicadores de shock séptico oculto en pacientes que ingresan por emergencia al Hospital Abel Gilbert Pontón 2018
Fecha
2019
Autores
Título de la revista
ISSN de la revista
Título del volumen
Editor
Resumen
La sepsis es una de las pocas condiciones médicas que ataca por igual y con gran ferocidad tanto a poblaciones en zonas de escasos recursos como a las del mundo de altos ingresos. A nivel mundial, se estima que entre 20 y 30 millones de pacientes son afectados por esta grave entidad. La sepsis no tiene un cuadro clínico característico y su diagnóstico está basado en una elevada sospecha clínica y la verificación de algunos parámetros generales, inflamatorios, perfusión tisular, lactato y disfunción orgánica. Aproximadamente, el 10% de los pacientes que son ingresados al hospital a través del servicio de urgencias presentan un cuadro de sepsis. Después del diagnóstico y la administración debida de medicamentos en estos pacientes, la mortalidad disminuye significativamente. Sin embargo, dichos pacientes podrían llegar a ser valorados con “hipoperfusión tisular” si son tratados fuera de la sala de terapia intensiva. Debido a que solo recurren a parámetros como: presión arterial (PA) para evaluar perfusión tisular. Por otra parte, el ácido láctico (AL) ha sido empleado en el cuarto de urgencias para ayudar a identificar la mortalidad en pacientes con sospecha de infección. Asimismo, ha evidenciado ser útil en reportes previos. No obstante, debido a variables no claras en estas interpretaciones, este estudio buscara evaluar el uso del lactato en combinación con la presión arterial como predictor de esta patología. Esta investigación incluye a pacientes del Hospital Abel Gilbert Pontón que fueron ingresados al servicio de urgencia con sospecha de infección cuyos niveles de lactato y presión arterial fueron obtenidos al momento del ingreso.
Sepsis is one of the few medical conditions that attacks all social classes: under class, middle class and upper class. Worldwide, it is estimated that between 20 and 30 million patients are affected by this serious entity. Sepsis does not have a unique characteristic to follow and it diagnosis is based on diagnosis of exclusion. However, some general parameters can be used: inflammatory perfusion of the tissue, lactate and organic dysfunction. Approximately 10% of patients admitted to the emergency area are diagnosed with sepsis.After the diagnosis and the proper administration of medications in these patients, the mortality decreases significantly. Notwithstanding, these patients could be misdiagnosed with “tissue hypo-perfusion” if treated outside of the intensive care unit. Because they solely make use of parameters such as, blood pressure (BP) to evaluate tissue perfusion. Furthermore, lactic acid (LA) has been used in the emergency room to help identify mortality in patients with suspected infection. Likewise, it has proven to be useful in previous reports and studies. However, due to unclear variable in these interpretations, this study will seek to evaluate the use of lactate in combination with blood pressure as a predictor of this pathology. This study includes patients from Abel Gilbert Pontón Hospital who were admitted to the emergency department with suspected infection, whose lactate levels and blood pressure were obtained at the time of admission
Sepsis is one of the few medical conditions that attacks all social classes: under class, middle class and upper class. Worldwide, it is estimated that between 20 and 30 million patients are affected by this serious entity. Sepsis does not have a unique characteristic to follow and it diagnosis is based on diagnosis of exclusion. However, some general parameters can be used: inflammatory perfusion of the tissue, lactate and organic dysfunction. Approximately 10% of patients admitted to the emergency area are diagnosed with sepsis.After the diagnosis and the proper administration of medications in these patients, the mortality decreases significantly. Notwithstanding, these patients could be misdiagnosed with “tissue hypo-perfusion” if treated outside of the intensive care unit. Because they solely make use of parameters such as, blood pressure (BP) to evaluate tissue perfusion. Furthermore, lactic acid (LA) has been used in the emergency room to help identify mortality in patients with suspected infection. Likewise, it has proven to be useful in previous reports and studies. However, due to unclear variable in these interpretations, this study will seek to evaluate the use of lactate in combination with blood pressure as a predictor of this pathology. This study includes patients from Abel Gilbert Pontón Hospital who were admitted to the emergency department with suspected infection, whose lactate levels and blood pressure were obtained at the time of admission
Descripción
PDF
Palabras clave
Presión arterial, Sepsis, Mortalidad, Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón, Cantón Guayaquil, Ecuador, Shock séptico