Factores asociados a la limitación del esfuerzo terapeutico (LET) en la Unidad de Cuidados Intensivos. Hospital Regional IESS Dr. Teodoro Maldonado Carbo 2009-2010
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2010
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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El médico frente a un enfermo sin esperanza de vida puede seguir obstinado en tratarlo 0 parar el esfuerzo terapéutico. Esta última aptitud se ha denominado “limitación del esfuerzo terapéutico” también conocida por sus siglas “LET”. Esta decisión, frecuente en las UCI, puede ser tomada en función de varios factores. Muchos de estos pueden causar conflictos éticos por lo que estos deben ser identificados y analizados. En la UCI del hospital Regional del IESS “Dr. Teodoro Maldonado Carbo” no se ha identificado estos factores y el análisis no ha podido efectuarse. Con el objetivo de conocer los factores que se asocian a la limitación del esfuerzo terapéutico en pacientes atendidos en esta unidad se presenta a continuación el proyecto para realizar un estudio de tipo observacional, descriptivo, de diseño no experimental, transversal en el que se incluirán los pacientes atendidos en la UCI de esta casa da salud en el periodo comprendido entre el 1 de septiembre de 2009 a 30 de agosto de 2010 en los cuales se limitó el esfuerzo terapéutico. Para la descripción de las características de la población se utilizarán estadígrafos, histogramas, tasas, porcentajes e índices, considerando una dispersión de la media de 1 DE. Los resultados mostraron que el grupo de 70 a 79 años fue el más numeroso (20%). La proporción de pacientes críticos masculinos y femeninos fue similar (51,7% y 48,3%). La estancia hospitalaria en la mayoría fue de 1 a 7 días (73,3%). La presencia de comorbilidad se observó en el 68%. El más frecuente de los procesos comórbidos fue la Hipertensión arterial (18%). La puntuación de SOFA fue en todos los casos superior a 15 (100%). Gran parte de la decisión de LET se tomó entre las 00 y las 089 horas (80.0%). Los familiares participaron en la toma de decisión de LET en el60% de los casos. La patología que determinó la toma de decisión de LET en la mayoría fue la falla multiorgánica.
A doctor facing a patient without hope can follow in treating obstinate 0 stop therapeutic efforts. The latter ability is called "withholding treatment" also known by its initials "LT." This decision, often in ICUs may be taken depending on several factors. Many of these can cause ethical conflicts as they should be identified and analyzed. In the hospital ICU Regional del IESS "Dr Teodoro Maldonado Carbo "has not identified these factors and analysis has not taken place. In order to understand the factors that are associated with the limitation of treatment in patients treated in this unit are presented below the project to conduct a study, observational, descriptive, nonexperimental, cross-sectional study will include patients treated in the ICU of this house gives health in the period from 1 September 2009 to August 30, 2010 in which limited the therapeutic effort. For a description of the characteristics of the population used statisticians, histograms, rates, percentages and indices, whereas the average dispersion of 1 SD. The results showed that the group of 70 to 79 years was the most numerous (20%). The critical proportion of male and female patients was similar (51.7% and 48.3%). Hospital stay in the majority was from 1 to 7 days (73.3%). The presence of comorbidity was observed in 68%. The most frequent comorbid conditions were: hypertension (18%). The SOFA score was in all cases greater than 15 (100%). Much of the LT decision was taken between 00 and 089 hours (80.0%). Family members participated in the LT decision making in EL60% of cases. The condition that determined the LT decision making in the majority was multiple organ failure.
A doctor facing a patient without hope can follow in treating obstinate 0 stop therapeutic efforts. The latter ability is called "withholding treatment" also known by its initials "LT." This decision, often in ICUs may be taken depending on several factors. Many of these can cause ethical conflicts as they should be identified and analyzed. In the hospital ICU Regional del IESS "Dr Teodoro Maldonado Carbo "has not identified these factors and analysis has not taken place. In order to understand the factors that are associated with the limitation of treatment in patients treated in this unit are presented below the project to conduct a study, observational, descriptive, nonexperimental, cross-sectional study will include patients treated in the ICU of this house gives health in the period from 1 September 2009 to August 30, 2010 in which limited the therapeutic effort. For a description of the characteristics of the population used statisticians, histograms, rates, percentages and indices, whereas the average dispersion of 1 SD. The results showed that the group of 70 to 79 years was the most numerous (20%). The critical proportion of male and female patients was similar (51.7% and 48.3%). Hospital stay in the majority was from 1 to 7 days (73.3%). The presence of comorbidity was observed in 68%. The most frequent comorbid conditions were: hypertension (18%). The SOFA score was in all cases greater than 15 (100%). Much of the LT decision was taken between 00 and 089 hours (80.0%). Family members participated in the LT decision making in EL60% of cases. The condition that determined the LT decision making in the majority was multiple organ failure.
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PACIENTE CRITICO, LIMITACION DEL ESTUDIO TERAPEUTICO, UNIDADES DE CIUDADANOS INTENSIVOS, HOSPITAL DE ESPECIALIDADES DR. TEODORO MALDONADO CARBO, CANTON GUAYAQUIL, ECUADOR, COMORBILIDAD