Reanimación hídrica y lesión renal aguda en quemaduras eléctricas. Experiencia de 7 años en Hospital Simon Bolivar

En los pacientes quemados, la reanimación inicial de volumen en forma excesiva o insuficiente se asocian a lesión renal aguda (LRA) e incluso a un aumento en la mortalidad. Sin embargo, los pacientes con quemaduras eléctricas se excluyen sistemáticamente de los estudios clínicos. El objetivo del pre...

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2024
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Universidad del Rosario
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Palabra clave:
Lesión renal aguda
Rabdomiolisis
Quemadura Eléctrica
Reanimación Hídrica
Electrical injuries
Electrical burn
Acute kidney injury
Rhabdomyolysis
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network_name_str Repositorio EdocUR - U. Rosario
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dc.title.none.fl_str_mv Reanimación hídrica y lesión renal aguda en quemaduras eléctricas. Experiencia de 7 años en Hospital Simon Bolivar
dc.title.TranslatedTitle.none.fl_str_mv Fluid resuscitation and acute kidney injury in electrical burns. 7 years of experience at Hospital Simón Bolívar
title Reanimación hídrica y lesión renal aguda en quemaduras eléctricas. Experiencia de 7 años en Hospital Simon Bolivar
spellingShingle Reanimación hídrica y lesión renal aguda en quemaduras eléctricas. Experiencia de 7 años en Hospital Simon Bolivar
Lesión renal aguda
Rabdomiolisis
Quemadura Eléctrica
Reanimación Hídrica
Electrical injuries
Electrical burn
Acute kidney injury
Rhabdomyolysis
title_short Reanimación hídrica y lesión renal aguda en quemaduras eléctricas. Experiencia de 7 años en Hospital Simon Bolivar
title_full Reanimación hídrica y lesión renal aguda en quemaduras eléctricas. Experiencia de 7 años en Hospital Simon Bolivar
title_fullStr Reanimación hídrica y lesión renal aguda en quemaduras eléctricas. Experiencia de 7 años en Hospital Simon Bolivar
title_full_unstemmed Reanimación hídrica y lesión renal aguda en quemaduras eléctricas. Experiencia de 7 años en Hospital Simon Bolivar
title_sort Reanimación hídrica y lesión renal aguda en quemaduras eléctricas. Experiencia de 7 años en Hospital Simon Bolivar
dc.contributor.advisor.none.fl_str_mv Navarrete Aldana, Norberto
dc.subject.none.fl_str_mv Lesión renal aguda
Rabdomiolisis
Quemadura Eléctrica
Reanimación Hídrica
topic Lesión renal aguda
Rabdomiolisis
Quemadura Eléctrica
Reanimación Hídrica
Electrical injuries
Electrical burn
Acute kidney injury
Rhabdomyolysis
dc.subject.keyword.none.fl_str_mv Electrical injuries
Electrical burn
Acute kidney injury
Rhabdomyolysis
description En los pacientes quemados, la reanimación inicial de volumen en forma excesiva o insuficiente se asocian a lesión renal aguda (LRA) e incluso a un aumento en la mortalidad. Sin embargo, los pacientes con quemaduras eléctricas se excluyen sistemáticamente de los estudios clínicos. El objetivo del presente estudio es describir la reanimación hídrica inicial y evaluar la asociación entre la administración de líquidos subóptima o excesiva y la incidencia de LRA. Metodología: Estudio de cohorte retrospectivo. Se evaluaron pacientes adultos atendidos en las primeras 48 horas posterior a lesión eléctrica en la unidad de quemados del Hospital Simón Bolívar, entre 2007 y 2013. El resultado primario fue LRA temprana. Se evaluaron diferencias en género, edad, Área de superficies corporal quemada, CPK y volumen de líquidos administrados como posibles factores relacionados al desarrollo de LRA. Resultados: Se evaluaron 456 pacientes. La mediana de ASCQ fue del 5% (2%-12%). 25 pacientes (5,5%) desarrollaron LRA. Ninguno requirió terapia de reemplazo renal. No existen diferencias significativas en edad, sexo, CPK o valor de CPKmax entre pacientes con LRA y sin LRA, excepto para CPK3 (p = 0,0483). Aunque el volumen infundido en 0-2 días fue menor en el grupo de LRA, no hubo diferencias significativas respecto a la reanimación insuficiente o excesiva y el volumen de reanimación con líquidos por hora. Conclusiones: El volumen de reanimación con líquidos no está asociado con el desarrollo de LRA en pacientes con lesiones eléctricas.
publishDate 2024
dc.date.accessioned.none.fl_str_mv 2024-08-26T20:27:25Z
dc.date.available.none.fl_str_mv 2024-08-26T20:27:25Z
dc.date.created.none.fl_str_mv 2024-04-19
dc.date.embargoEnd.none.fl_str_mv info:eu-repo/date/embargoEnd/2024-11-29
dc.type.none.fl_str_mv bachelorThesis
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_7a1f
dc.type.document.none.fl_str_mv Trabajo de grado
dc.type.spa.none.fl_str_mv Trabajo de grado
dc.identifier.uri.none.fl_str_mv https://repository.urosario.edu.co/handle/10336/43340
url https://repository.urosario.edu.co/handle/10336/43340
dc.language.iso.none.fl_str_mv spa
language spa
dc.rights.*.fl_str_mv Attribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.acceso.none.fl_str_mv Abierto (Texto Completo)
dc.rights.uri.*.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
rights_invalid_str_mv Attribution-NonCommercial-NoDerivatives 4.0 International
Abierto (Texto Completo)
http://creativecommons.org/licenses/by-nc-nd/4.0/
http://purl.org/coar/access_right/c_abf2
dc.format.extent.none.fl_str_mv 40 PP
dc.format.mimetype.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidad del Rosario
dc.publisher.department.none.fl_str_mv Escuela de Medicina y Ciencias de la Salud
dc.publisher.program.none.fl_str_mv Especialización en Medicina de Emergencias
publisher.none.fl_str_mv Universidad del Rosario
institution Universidad del Rosario
dc.source.bibliographicCitation.none.fl_str_mv 1. Rong Xiang Xu, Bradford S. Weeks. Burns. Regenerative medicine and therapy. Karger Publishers. 2004 2. Burn injuries. P.A.Markoa, J. Layona, L.Carusoa, D.W. Mozingob, A.Gabriellia. Curr Opin Anaesthesiol, 2003; 16:183–191. 3. Lund T, Onarheim H, Reed RK. Pathogenesis of edema formation in burn injuries. World J Surg. 1992 Jan-Feb;16(1):2-9. Review. PubMed PMID: 1290261. 4. Vertel RM, Knochel JP. Nonoliguric acute renal failure. JAMA 1967;200:598–602. 5. Cameron JS. Disturbances of renal function in burnt patients. Proc R Soc Med 1969;62:49–50. 6. Davies DM, Pusey CD, Rainford DJ, et al. Acute renal failure in burns. Scand J Plast Reconstr Surg 1979;13:189–92. 7. Aikawa N, Wakabayashi G, Ueda M, et al. Regulation of renal function in thermal injury. J Trauma 1990;30:S174–S178. 8. Leblanc M, Thibeault Y, Querin S. Continuous haemofiltration and haemodiafiltration for acute renal failure in severely burned patients. Burns 1997;23:160–5. 9. Jeschke MG, Barrow RE, Wolf SE, et al. Mortality in burned children with acute renal failure. Arch Surg 1998;133:752–6. 10. Holm C, Horbrand F, von Donnersmarck GH, et al. Acute renal failure in severely burned patients. Burns 1999;25:171–8. 11. Tremblay R, Ethier J, Querin S, et al. Veno-venous continuous renal replacement therapy for burned patients with acute renal failure. Burns 2000;26:638–43. 12. Chrysopoulo MT, Jeschke MG, Dziewulski P, et al. Acute renal dysfunction in severely burned adults. J Trauma 1999;46:141–4. 13. Kim GH, Oh KH, Yoon JW, et al. Impact of burn size and initial serum albumin level on acute renal failure occurring in major burn. Am J Nephrol 2003;23:55–60. 14. Maull-Rodriguez. Electrical Injuries. Cap 47. Complicaciones in trauma and Critical Care. 15. Price T, Cooper MA: Electrical and Lightning Injuries, Rosen's Emergency Medicine, Concepts and Clinical Practices, 6th Edition, 2006 16. Koumbourlis CA. Electrical injuries. Crit Care Med 2002; 30(11), (suppl) S424 – s431 17. Faggiano G, De Donno G. High-tension electrical burns Annals of Burns and Fire Disasters Vol 11(3) sept 1998. 18. Hussman J, Kucan JO, Russell RC, Bradley T, Zamboni WA. Electrical injuriesmorbidity, outcome and treatment rationale. Burns 1995;21:530–5. 19. Haberal MA. An eleven-year survey of electrical burn injuries. J Burn Care Rehabil 1995;16:43–8. 20. Ferreiro I, Melendez J, Regalado J, Bejar FJ, Gabilondo FJ. Factor influencing the sequale of high-tension electrical injuries. Burns 1998;24:649–53. 21. Rai J, Jeschke M, Barrow RE, Herndon D. Electrical injuries: a 30-year review. J Trauma 1999;46:933–6. 22. Garcia-Sanchez V, Gomez-Morell P. Electrical burns: high and low tension injuries. Burns 1999;25:357–60. 23. Arnoldo BD, Purdue GF, Kowalske K, Helm PA, Burries A, Hunt JL. Electrical injuries: a 20-year review. J Burn Care Rehabil 2004;25:479–84. 24. Cancio LC, Jimenez-Reyna JF, Barillo DJ, Walker SC, Mc-Manus AT, Vaughan GM. One hundred ninety-five cases of high-voltage electrical injury. J Burn Care Rehabil 2005;26:331–40. 25. Maghsoudi H, Adyani Y, Ahmadian N. Electrical and lightning injuries. J Burn Care Res 2007;28:255–61. 26. Handschin AE, Jung FJ, Guggenheim M, et al. Surgical treatment of high-voltage electrical injuries. Handchir Mikrochir. Plast Chir 2007;39:345–9. 27. Noble J, Gomez M, Fish JS, Quality of life and return to work following electrical burns. Burns 2006, 32:159–62. 28. Ahrenholz DH, Schubert W, Solem LD. Creatine kinase as a prognostic indicator in electrical injury. Surgery. 1988 Oct;104(4):741-7. 29. Kopp J., Loos B., Spilker G., Horch R.E. Correlation between serum creatinine kinase levels and extent of muscle damage in electrical burns. Burns 2004;30(7):680- 683 . 30. Bosch X, Poch E, Grau JM. Rhabdomyolysis and acute kidney injury. N Engl J Med. 2009 Jul 2;361(1):62-72. 31. Steinvall I, Bak Z, Sjoberg F: Acute kidney injury is common, parallels organ dysfunction or failure, and carries appreciable mortality in patients with major burns: a prospective exploratory cohort study. Crit Care 2008, 12:R124. 32. Navarrete-Aldana N, Rodriguez N. Epidemiologic Characteristics of death by burn injury from 2000 to 2009. Population-based study in a middle-income country. In: Proceedings of the american burn association 47th annual meeting. J Burn Care Res. 2015 Jul-Aug;36 Suppl 1:S242. 33. Lopes JA, Jorge S, Neves FC, Caneira M, da Costa AG, Ferreira AC, Prata MM: An assessment of the RIFLE criteria for acute renal failure in severely burned patients [letter]. Nephrol Dial Transplant 2007, 22:285. 34. Culnan DM, Farner K, Bitz GH, Capek KD, Tu Y, Jimenez C, Lineaweaver WC. Volume Resuscitation in Patients With High-Voltage Electrical Injuries. Ann Plast Surg. 2018 Mar;80(3 Suppl 2):S113-S118 35. Handschin AE, Vetter S, Jung FJ, Guggenheim M, Künzi W, Giovanoli P. A casematched controlled study on high-voltage electrical injuries vs thermal burns. J Burn Care Res. 2009 May-Jun;30(3):400-7. PubMed PMID: 19349896. 36. Chertow GM, Burdick E, Honour M, et al. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol 2005; 16:3365–3370. 37. Hoste EA, Kellum JA. Acute renal failure in the critically ill: impact on morbidity and mortality. Contrib Nephrol 2004; 144: 1–11. 38. Klenzak J, Himmelfarb J. Sepsis and the kidney. Crit Care Clin 2005; 21:211–222. 39. Lameire N. The pathophysiology of acute renal failure. Crit Care Clin 2005;21: 197– 210. 40. Colpaert K, Hoste EA. Acute kidney injury in burns: a story of volume and inflammation. Crit Care. 2008;12:192. doi: 10.1186/cc7106 41. Coca SG, Bauling P, Schifftner T, Howard CS, Teitelbaum I, Parikh CR: Contribution of acute kidney injury toward morbidity and mortality in burns: a contemporary analysis. Am J Kidney Dis 2007, 49:517-523 42. Kellum JA, Levin N, Bouman C, et al. Developing a consensus classification system for acute renal failure. Curr Opin Crit Care 2002; 8: 509–514. 43. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney inter., Suppl. 2012; 2: 1–138. 4. Bellomo R, Ronco C, Kellum JA, et al. Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004; 8:R204–212 45. Uchino S, Bellomo R, Goldsmith D, et al. An assessment of the RIFLE criteria for acute renal failure in hospitalized patients. Crit Care Med 2006;34: 1913–1917 46. Mehta RL, Kellum JA, Shah SV, et al. Acute kidney injury network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007;11:R31. 47. Praught ML, Shlipak MG: Are small changes in serum creatinine an important risk factor? Curr Opin Nephrol Hypertens 2005, 14:265-270 48. Bache SE, Taggart I, Gilhooly C. Late-onset rhabdomyolysis in burn patients in the intensive care unit. Burns. 2011 Nov;37(7):1241-7. Epub 2011 Jun 23. 49. Mustonen KM, Vuola J. Acute renal failure in intensive care burn patients (ARFin burn patients). J Burn Care Res. 2008 Jan-Feb;29(1):227-37. 50. Mosier MJ, Pham TN, Klein MB, Gibran NS, Arnoldo BD, Gamelli RL, Tompkins RG, Herndon DN. Early acute kidney injury predicts progressive renal dysfunction and higher mortality in severely burned adults. J Burn Care Res. 2010 JanFeb;31(1):83-92 51. Sandor BJ. Electrical Burn injuries. Ann Burns Fire Disasters. 1998 Sept:11(3) 52. Melli G, Chaudhry V, Cornblath DR. Rhabdomyolysis: an evaluation of 475 hospitalized patients. Medicine (Baltimore). 2005 Nov;84(6):377-85. 53. Oda J, Tanaka H, Yoshioka T, Iwai A, Yamamura H, Ishikawa K, et al. Analysis of 372 patients with Crush syndrome caused by the Hanshin-Awaji earthquake. J Trauma. 1997 Mar;42(3):470-5; discussion 475-6. PubMed PMID: 9095115. 54. Sever MS, Vanholder R, Lameire N. Management of crush-related injuries after disasters. N Engl J Med. 2006 Mar 9;354(10):1052-63. Review. 55. Homsi E, Fernanda M, Barreiro L, et al. Prophylaxis of acute renal failure in patients with rhabdomyolysis. Ren Fail. 1997;19:283–288. 56. Feinfeld DA, Cheng JT, Beysolow TD, Briscoe AM. A prospective study of urine and serum myoglobin levels in patients with acute rhabdomyolysis. Clin Nephrol. 1992;38:193–195. 57. Brown CV, Rhee P, Chan L, Evans K, Demetriades D, Velmahos GC. Preventing renal failure in patients with rhabdomyolysis: do bicarbonate and mannitol make a difference? J Trauma. 2004 Jun;56(6):1191-6. PubMed PMID: 15211124. 58. Ward MM. Factors predictive of acute renal failure in rhabdomyolysis. Arch Intern Med. 1988 Jul;148(7):1553-7. PubMed PMID: 3382301. 59. Fernandez WG, Hung O, Bruno GR, Galea S, Chiang WK. Factors predictive of acute renal failure and need for hemodialysis among ED patients with rhabdomyolysis. Am J Emerg Med. 2005 Jan;23(1):1-7. PubMed PMID: 15672329. 60. Walsh MB, Miller SL, Kagen LJ. Myoglobinemia in severely burned patients: correlations with severity and survival. J Trauma 1982;22(1):6–10. 61. Kasaoka S, Todani M, Kaneko T, Kawamura Y, Oda Y, Tsuruta R, et al. Peak value of blood myoglobin predicts acute renal failure induced by rhabdomyolysis. J Crit Care. 2010 Dec;25(4):601-4. PubMed PMID: 20537502. 62. Lappalainen H, Tiula E, Uotila L, Manttari M. Elimination kinetics of myoglobin and creatine kinase in rhabdomyolysis: implications and follow up. Crit Care Med. 2002;30:2212–2215. 63. Stollwerck PL, Namdar T, Stang FH, Lange T, Mailänder P, Siemers F. Rhabdomyolysis and acute renal failure in severely burned patients. Burns. 2011 Mar;37(2):240-8. Epub 2010 Oct 20. PubMed PMID: 20965664 64. Rodríguez-Capote K, Balion CM, Hill SA, Cleve R, Yang L, El Sharif A. Utility of urine myoglobin for the prediction of acute renal failure in patients with suspected rhabdomyolysis: a systematic review. Clin Chem. 2009 Dec;55(12):2190-7. 65. Grover DS, Atta MG, Eustace JA, Kickler TS, Fine DM. Lack of clinical utility of urine myoglobin detection by microconcentrator ultrafiltration in the diagnosis of rhabdomyolysis. Nephrol Dial Transplant. 2004;19:2634–2638. 66. Total Burn Care. Editor: Herndon D. Fifth Edition. Elsevier. 2018 67. Advanced burn life support providers manual. Chicago, IL: American Burn Association; 2018 8;26(1):43. 69. Luz DP, Millan LS, Alessi MS, Uguetto WF, Paggiaro A, Gomez DS, Ferreira MC. Electrical burns: a retrospective analysis across a 5-year period. Burns. 2009 Nov;35(7):1015-9 70. González-Castro LF, Ávila-Vargas SV , Quezada-Rueda JT , Vivas-García SM. Fisiopatología de las quemaduras eléctricas: artículo de revisión. Rev Chil Anest 2019; 48: 115-122 71. ISBI Practice Guidelines Committee; Steering Subcommittee; Advisory Subcommittee. ISBI Practice Guidelines for Burn Care. Burns. 2016 Aug;42(5):953- 1021. 72. Gentges J, Schieche C. Electrical injuries in the emergency department: an evidencebased review. Emerg Med Pract. 2018 Nov;20(11):1-20. 73. National Kidney Foundation: K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification and Stratification. Am J Kidney Dis 2002, 39: 2 Suppl 1:S76-S92. 74. Hsueh YY, Chen CL, Pan SC. Analysis of factors influencing limb amputation in high-voltage electrically injured patients. Burns. 2011 Jun;37(4): 673-7. 75. Little RJA , Rubin DB . Statistical analysis with missing data . 2nd ed. Hoboken, NJ : Wiley, 2002 . 76. Nguyen NL, Gun RT, Sparnon AL, et al. The importance of initial management: a case series of childhood burns in Vietnam. Burns. 2002;28(2):167-172. 77. Jeschke MG, Barrow RE, Wolf SE, et al. Mortality in burned children with acute renal failure. Arch Surg. 1998;133(7):752-756. 78. Barrow RE, Jeschke MG, Herndon DN. Early fluid resuscitation improves outcomes in severely burned children. Resuscitation. 2000 Jul;45(2):91-6 79. Laura Lindahl et al. Initial fluid resuscitation guided by the Parkland formula leads to high fluid volumes in the first 72 h, increasing mortality and the risk for kidney injury. Burns Open 2023; 7(3):51-58 80. Navarrete N. Schulz J.T. Electrical burn injuries in Colombia, South America: A major source of morbidity and mortality. Ann Burns Fire Disasters. Accepted 21/12/2023.
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spelling Navarrete Aldana, Norbertobc9b5cb4-0399-4558-99af-17be7251b634-1Nasiff Cabrales, Laura SofiaBernal Salazar, Sandra JimenaEspecialista en Medicina de EmergenciasMaestríaFull timeab9f8a6a-fd7f-482b-84e7-c0e198600d47-148202e5e-b983-461f-b6f6-1ded08e6ea18-12024-08-26T20:27:25Z2024-08-26T20:27:25Z2024-04-19info:eu-repo/date/embargoEnd/2024-11-29En los pacientes quemados, la reanimación inicial de volumen en forma excesiva o insuficiente se asocian a lesión renal aguda (LRA) e incluso a un aumento en la mortalidad. Sin embargo, los pacientes con quemaduras eléctricas se excluyen sistemáticamente de los estudios clínicos. El objetivo del presente estudio es describir la reanimación hídrica inicial y evaluar la asociación entre la administración de líquidos subóptima o excesiva y la incidencia de LRA. Metodología: Estudio de cohorte retrospectivo. Se evaluaron pacientes adultos atendidos en las primeras 48 horas posterior a lesión eléctrica en la unidad de quemados del Hospital Simón Bolívar, entre 2007 y 2013. El resultado primario fue LRA temprana. Se evaluaron diferencias en género, edad, Área de superficies corporal quemada, CPK y volumen de líquidos administrados como posibles factores relacionados al desarrollo de LRA. Resultados: Se evaluaron 456 pacientes. La mediana de ASCQ fue del 5% (2%-12%). 25 pacientes (5,5%) desarrollaron LRA. Ninguno requirió terapia de reemplazo renal. No existen diferencias significativas en edad, sexo, CPK o valor de CPKmax entre pacientes con LRA y sin LRA, excepto para CPK3 (p = 0,0483). Aunque el volumen infundido en 0-2 días fue menor en el grupo de LRA, no hubo diferencias significativas respecto a la reanimación insuficiente o excesiva y el volumen de reanimación con líquidos por hora. Conclusiones: El volumen de reanimación con líquidos no está asociado con el desarrollo de LRA en pacientes con lesiones eléctricas.In burn patients, acute kidney injury (AKI) and mortality had been attributed to both under or over-volume resuscitation. Nonetheless, electrical burns patients are systematically excluded from these studies. Recommendations regarding volume management remain controversial. The aim is to describe fluid resuscitation while concurrently evaluating its association between sub-optimal or excessive fluid and the incidence of early AKI (eAKI). Methods: Retrospective cohort study. Patient chart review was conducted in Hospital Simón Bolívar. Adult patients admitted to the Burn ICU were included during the first 48 hours after electrical injury, between 2007 to 2013 was analyzed. Results: A total of 456 patients were included. Median TBSA was 5% (2%-12%). 27 patients (5,9%) developed eAKI. None of the patients underwent renal replacement therapy. There were no significant differences in age, sex, CPK, or CPKmax value between eAKI and NoneAKI patients, except for CPK3 (p=0.0483). Although volume infused in 0-2 days was lower in the eAKI group, there were no significant differences regarding under or over-resuscitation frequency and the hourly fluid resuscitation volume. Conclusions: Fluid resuscitation volume is not associated with the development of AKI in patients with electrical injuries40 PPapplication/pdfhttps://repository.urosario.edu.co/handle/10336/43340spaUniversidad del RosarioEscuela de Medicina y Ciencias de la SaludEspecialización en Medicina de EmergenciasAttribution-NonCommercial-NoDerivatives 4.0 InternationalAbierto (Texto Completo)EL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.http://creativecommons.org/licenses/by-nc-nd/4.0/http://purl.org/coar/access_right/c_abf21. Rong Xiang Xu, Bradford S. Weeks. Burns. Regenerative medicine and therapy. Karger Publishers. 2004 2. Burn injuries. P.A.Markoa, J. Layona, L.Carusoa, D.W. Mozingob, A.Gabriellia. Curr Opin Anaesthesiol, 2003; 16:183–191. 3. Lund T, Onarheim H, Reed RK. Pathogenesis of edema formation in burn injuries. World J Surg. 1992 Jan-Feb;16(1):2-9. Review. PubMed PMID: 1290261. 4. Vertel RM, Knochel JP. Nonoliguric acute renal failure. JAMA 1967;200:598–602. 5. Cameron JS. Disturbances of renal function in burnt patients. Proc R Soc Med 1969;62:49–50. 6. Davies DM, Pusey CD, Rainford DJ, et al. Acute renal failure in burns. Scand J Plast Reconstr Surg 1979;13:189–92. 7. 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Accepted 21/12/2023.instname:Universidad del Rosarioreponame:Repositorio Institucional EdocURLesión renal agudaRabdomiolisisQuemadura EléctricaReanimación HídricaElectrical injuriesElectrical burnAcute kidney injuryRhabdomyolysisReanimación hídrica y lesión renal aguda en quemaduras eléctricas. Experiencia de 7 años en Hospital Simon BolivarFluid resuscitation and acute kidney injury in electrical burns. 7 years of experience at Hospital Simón BolívarbachelorThesisTrabajo de gradoTrabajo de gradohttp://purl.org/coar/resource_type/c_7a1fEscuela de Medicina y Ciencias de la SaludBogotáLICENSElicense.txtlicense.txttext/plain1483https://repository.urosario.edu.co/bitstreams/f94aa8e9-7696-4834-9526-f2ae6fb23f04/downloadb2825df9f458e9d5d96ee8b7cd74fde6MD52CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8899https://repository.urosario.edu.co/bitstreams/e575180c-fd3d-4b05-9023-c7004c6db8ed/download3b6ce8e9e36c89875e8cf39962fe8920MD53ORIGINALReanimacion_hidrica_lesion_renal_Bernal_Salazar_Sandra_Jimena.pdfReanimacion_hidrica_lesion_renal_Bernal_Salazar_Sandra_Jimena.pdfapplication/pdf746490https://repository.urosario.edu.co/bitstreams/5d7347ab-5fb2-4d15-a085-cb5269519272/downloadfbb848d08bdbdb26cefbef9050d21dd4MD54TEXTReanimacion_hidrica_lesion_renal_Bernal_Salazar_Sandra_Jimena.pdf.txtReanimacion_hidrica_lesion_renal_Bernal_Salazar_Sandra_Jimena.pdf.txtExtracted texttext/plain72039https://repository.urosario.edu.co/bitstreams/e227e0e8-1320-4d0b-b703-a7ae3ac6468d/downloadc3f406281cb1bfa26faac88269f8f514MD55THUMBNAILReanimacion_hidrica_lesion_renal_Bernal_Salazar_Sandra_Jimena.pdf.jpgReanimacion_hidrica_lesion_renal_Bernal_Salazar_Sandra_Jimena.pdf.jpgGenerated Thumbnailimage/jpeg2683https://repository.urosario.edu.co/bitstreams/a1f22798-4c70-4878-b7c1-748c707bf178/downloadea7fe6992253f79fea978ea05e21e22aMD5610336/43340oai:repository.urosario.edu.co:10336/433402024-08-28 07:47:09.529http://creativecommons.org/licenses/by-nc-nd/4.0/Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttps://repository.urosario.edu.coRepositorio institucional EdocURedocur@urosario.edu.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