Factores asociados al desarrollo de insuficiencia renal aguda en el postoperatorio de cirugía cardiovascular en la Unidad de Cuidados Intensivos del Hospital Luis Vernaza durante el año 2015
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2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Introducción: En la cirugía cardiaca actual, los pacientes intervenidos presentan un perfil de riesgo elevado, por su edad y mayor número de enfermedades asociadas. La insuficiencia renal aguda es una complicación importante en el postoperatorio de los pacientes sometidos a cirugía cardiovascular, aumentando así la estancia hospitalaria, los costos, la morbilidad y la mortalidad en este grupo de pacientes. Objetivos: El objetivo general fue identificar los factores de riesgo asociados a insuficiencia renal aguda en el post operatorio de cirugía cardiovascular. Los específicos fueron: Definir la frecuencia y gravedad de cada uno de los factores de riesgo asociados a insuficiencia renal aguda. Establecer la incidencia de insuficiencia renal aguda en el post operatorio de cirugía cardiovascular. Establecer el uso de soporte vasopresor como variante independiente de riesgo y pronóstico para insuficiencia renal aguda. Determinar la incidencia de requerimiento de terapia de reemplazo renal. Materiales y métodos: Proyecto de investigación descriptivo, de corte transversal, retrospectivo, no experimental realizado a los pacientes del Hospital Luis Vernaza sometidos a cirugía cardiovascular en el Servicio de Terapia Intensiva. El universo lo constituyo los pacientes ingresados al área de Terapia Intensiva. La población fue de 48 pacientes sometidos cirugía cardiovascular, no se usó muestra porque se estudió toda la población. Se analizó la presencia de insuficiencia renal mediante el sistema de clasificación de RIFLE. Resultados: Del total 48(100%) pacientes del estudio, 46(96%) presentaron función renal normal, 2(4%) Insuficiencia renal aguda postoperatoria. Entre los pacientes con IRA, 1(50%) recibió terapia dialítica, 2(100%) eran HTA, 1(50%) era Diabético, 2(100%) recibieron vasopresores, 2(100%) fueron cirugías electivas, ninguno tenía cirugías previas, la Fracción de eyección fue superior a 40 % en los dos casos. Conclusiones:El porcentaje de Insuficiencia renal aguda en pacientes sometidos a cirugía cardiovascular es bajo, dentro de los factores de riesgo, la Diabetes y el uso de vasopresores fueron los más relevantes, no así la fracción de eyección. La mitad de los pacientes que presentaron IRA recibió terapia de reemplazo renal.
Introduction: In the current cardiac surgery, the surgery patients have a high risk profile, their age and greater number of associated diseases. Acute renal failure is an important complication in postoperative patients undergoing cardiovascular surgery, thus increasing hospital stay, costs, morbidity and mortality in this patient group. Objectives: The objective was to identify risk factors associated with acute renal failure in the postoperative period of cardiovascular surgery. Specific were: Define the frequency and severity of each of the risk factors associated with acute renal failure. Establish the incidence of acute renal failure in the postoperative period of cardiovascular surgery. Establish the use of vasopressor support as an independent variant of risk and prognosis for acute renal failure. To determine the incidence of requirement for renal replacement therapy.Materials and methods: research, cross-sectional, retrospective project not carried out experimental Luis Vernaza patients undergoing cardiovascular surgery Hospital in the Intensive Therapy. The universe constituted patients admitted to intensive care area. The population was 48 patients undergoing cardiovascular surgery, no sample was used for the entire population studied. the presence of renal failure was analyzed by the RIFLE classification system. Results: Of the total of 48 (100%) patients in the study, 46 (96%) had normal renal function, 2 (4%) Acute renal failure. Among patients with ARF, 1 (50%) received dialysis therapy, 2 (100%) were hypertension, 1 (50%) had diabetes, 2 (100%) received vasopressors, 2 (100%) were elective surgeries, none had previous surgeries, his ejection fraction was higher than 40% in both cases. Conclusions: The percentage of acute renal failure in patients undergoing cardiovascular surgery is low in risk factors, diabetes and vasopressors were the most relevant, but not the ejection fraction. Half of the patients who received IRA renal replacement therapy
Introduction: In the current cardiac surgery, the surgery patients have a high risk profile, their age and greater number of associated diseases. Acute renal failure is an important complication in postoperative patients undergoing cardiovascular surgery, thus increasing hospital stay, costs, morbidity and mortality in this patient group. Objectives: The objective was to identify risk factors associated with acute renal failure in the postoperative period of cardiovascular surgery. Specific were: Define the frequency and severity of each of the risk factors associated with acute renal failure. Establish the incidence of acute renal failure in the postoperative period of cardiovascular surgery. Establish the use of vasopressor support as an independent variant of risk and prognosis for acute renal failure. To determine the incidence of requirement for renal replacement therapy.Materials and methods: research, cross-sectional, retrospective project not carried out experimental Luis Vernaza patients undergoing cardiovascular surgery Hospital in the Intensive Therapy. The universe constituted patients admitted to intensive care area. The population was 48 patients undergoing cardiovascular surgery, no sample was used for the entire population studied. the presence of renal failure was analyzed by the RIFLE classification system. Results: Of the total of 48 (100%) patients in the study, 46 (96%) had normal renal function, 2 (4%) Acute renal failure. Among patients with ARF, 1 (50%) received dialysis therapy, 2 (100%) were hypertension, 1 (50%) had diabetes, 2 (100%) received vasopressors, 2 (100%) were elective surgeries, none had previous surgeries, his ejection fraction was higher than 40% in both cases. Conclusions: The percentage of acute renal failure in patients undergoing cardiovascular surgery is low in risk factors, diabetes and vasopressors were the most relevant, but not the ejection fraction. Half of the patients who received IRA renal replacement therapy
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Insuficiencia renal, Posoperatorio, Cirugía cardiovascular, Estudios retrospectivos, Epidemiología descriptiva, Hospital Luis Vernaza, Cantón Guayaquil, Ecuador