Secuelas neurológicas post-reanimación según el tiempo de anoxia en la población adulta del Hospital Tunal desde Diciembre 2018 Abril 2019
72 páginas : gráficas
- Autores:
-
Puentes Granados, Angie Katherine
Monje Ortiz, Juan Carlos
Torres Sánchez, Christian Andrés
- Tipo de recurso:
- Trabajo de grado de pregrado
- Fecha de publicación:
- 2019
- Institución:
- Universidad de Ciencias Aplicadas y Ambientales U.D.C.A
- Repositorio:
- Repositorio Institucional UDCA
- Idioma:
- spa
- OAI Identifier:
- oai:repository.udca.edu.co:11158/2670
- Acceso en línea:
- https://repository.udca.edu.co/handle/11158/2670
- Palabra clave:
- Manifestaciones Neurológicas
Paro Cardíaco
Hipoxia
- Rights
- embargoedAccess
- License
- Derechos Reservados - Universidad de Ciencias Aplicadas y Ambientales
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Secuelas neurológicas post-reanimación según el tiempo de anoxia en la población adulta del Hospital Tunal desde Diciembre 2018 Abril 2019 |
| title |
Secuelas neurológicas post-reanimación según el tiempo de anoxia en la población adulta del Hospital Tunal desde Diciembre 2018 Abril 2019 |
| spellingShingle |
Secuelas neurológicas post-reanimación según el tiempo de anoxia en la población adulta del Hospital Tunal desde Diciembre 2018 Abril 2019 Manifestaciones Neurológicas Paro Cardíaco Hipoxia |
| title_short |
Secuelas neurológicas post-reanimación según el tiempo de anoxia en la población adulta del Hospital Tunal desde Diciembre 2018 Abril 2019 |
| title_full |
Secuelas neurológicas post-reanimación según el tiempo de anoxia en la población adulta del Hospital Tunal desde Diciembre 2018 Abril 2019 |
| title_fullStr |
Secuelas neurológicas post-reanimación según el tiempo de anoxia en la población adulta del Hospital Tunal desde Diciembre 2018 Abril 2019 |
| title_full_unstemmed |
Secuelas neurológicas post-reanimación según el tiempo de anoxia en la población adulta del Hospital Tunal desde Diciembre 2018 Abril 2019 |
| title_sort |
Secuelas neurológicas post-reanimación según el tiempo de anoxia en la población adulta del Hospital Tunal desde Diciembre 2018 Abril 2019 |
| dc.creator.fl_str_mv |
Puentes Granados, Angie Katherine Monje Ortiz, Juan Carlos Torres Sánchez, Christian Andrés |
| dc.contributor.advisor.spa.fl_str_mv |
Caro Roa, Ivonne, dir. Suárez, Nelson, dir. Sánchez, Jhon, dir. |
| dc.contributor.author.spa.fl_str_mv |
Puentes Granados, Angie Katherine Monje Ortiz, Juan Carlos Torres Sánchez, Christian Andrés |
| dc.subject.mesh.spa.fl_str_mv |
Manifestaciones Neurológicas Paro Cardíaco Hipoxia |
| topic |
Manifestaciones Neurológicas Paro Cardíaco Hipoxia |
| description |
72 páginas : gráficas |
| publishDate |
2019 |
| dc.date.issued.spa.fl_str_mv |
2019 |
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2020-01-23T15:43:18Z |
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2020-01-23T15:43:18Z |
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Trabajo de grado - Pregrado |
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REGISTRO DE PARO CARDÍACO EN EL ADULTO. rev.fac.med. [Internet]. 2005 July [cited 2018 Apr 10] ; 53( 3 ): 196-203. Available from: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120- 00112005000300006&lng=en. Valencia, W. and Navarro, J. (2011). Implementación del registro de paro cardiorrespiratorio en un hospital de segundo nivel. Revista Colombiana de Anestesiología, 39(4), pp.478-487. Safar P. Resuscitation after Brain Ischemia, in Grenvik A and Safar P Eds: Brain Failure and Resuscitation, Churchill Livingstone, New York, 1981; 155-184. Schefold J, Storm C, Krüger A, Ploner C, Hasper D. The Glasgow coma score is a predictor of good outcome in cardiac arrest patients treated with therapeutic hypothermia. Resuscitation [Internet]. 2009 [cited 3 April 2018];80(6):658-661. Available from: https://www.sciencedirect.com/science/article/pii/S0300957209001257 Rafael Burgos Rodríguez. -3ªed Metodología de investigación y escritura científica en clínica. - Granada: Escuela Andaluza de Salud Pública, 1998. - (Monografías de la EASP; 24) Henquin R. Epidemiología y estadística para principiantes. Ciudad Autónoma de Buenos Aires: Corpus Editorial; 2013. Colombia. Ministerio de Salud y Protección Social. (NaN). Análisis de situación en Salud Departamental y municipal Cundinamarca 2017. El Ministerio, Recuperado de : https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/PSP/asiscundinamarca-2017.zip |
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Caro Roa, Ivonne, dir.Suárez, Nelson, dir.Sánchez, Jhon, dir.Puentes Granados, Angie KatherineMonje Ortiz, Juan CarlosTorres Sánchez, Christian AndrésBogotá, Colombia2018-20192020-01-23T15:43:18Z2020-01-23T15:43:18Z2019https://repository.udca.edu.co/handle/11158/2670MH024 P82s 2019 (205792)72 páginas : gráficasEl paro cardiorrespiratorio se define como el cese súbito de la actividad del corazón, tiene tasas de supervivencia a nivel mundial que rondan el 20%, y porcentajes de secuelas neurológicas de aproximadamente un 30%, las cuales generan discapacidad y gastos al sistema. En Colombia se cuenta con poca información que ponga en contexto la magnitud del problema, el objetivo de este estudio es estimar la frecuencia de las secuelas neurológicas post-reanimación, según el tiempo de anoxia, en mayores de edad, atendidos en el Hospital Tunal. Para esto se realizó un estudio descriptivo observacional tipo serie de casos, con muestreo poblacional por conveniencia. Sé incluyeron 15 pacientes, 12 hombres y 3 mujeres, con un promedio de 57,53 años de edad, las comorbilidades prevalentes según su orden de presentación son hipertensión arterial y Cardiopatías. Todos recibieron reanimación cardiopulmonar avanzada; el ritmo de paro más frecuente en esta población la actividad eléctrica sin pulso (AESP). Las alteraciones motoras son las secuelas más frecuentes, en un 33%, seguida por estados de demencia detectados en un 19%; Alteraciones del estado de conciencia en un 14%, la presencia de alteración de pares craneales, coma y muerte encefálica, oscila en un 9% cada una, y finalmente las afasias en un 4,7%. Mediante la escala CPC se caracterizó a los pacientes según su grado de funcionalidad, 2 pacientes presentan muerte encefálica, CPC5 (13.3%); 2 pacientes estado de coma, CPC4 (13.3%) ;3 pacientes CPC3 (19%), 3 pacientes, CPC2 (19%), y 5 pacientes ninguna alteración CPC1 (33.3%).Cardiorespiratory arrest is defined as the sudden cessation of heart activity, has global survival rates of around 20%, and percentages of neurological sequelae of approximately 30%, which generate disability and expenses to the system. In Colombia there is little information that puts in context the magnitude of the problem, the objective of this study is to estimate the frequency of post-resuscitation neurological sequelae, according to the time of anoxia, in elderly patients treated at Tunal Hospital. For this, an observational descriptive study of a series of cases was conducted, with population sampling for convenience. We included 15 patients, 12 men and 3 women, with an average of 57,53 years of age, the prevalent comorbidities according to their order of presentation are arterial hypertension and cardiopathies. All received advanced cardiopulmonary resuscitation; The most frequent rhythm of unemployment in this population is the pulseless electrical activity (AESP). Motor alterations are the most frequent sequels, in 33%, followed by states of dementia detected in 19%; Alterations in the state of consciousness in 14%, the presence of cranial nerve alteration, coma and brain death, oscillate in 9% each, and finally the aphasias in 4.7%. Using the CPC scale, patients were characterized according to their degree of functionality, 2 patients presented with brain death, CPC5 (13.3%); 2 patients were in coma, CPC4 (13.3%), 3 patients CPC3 (19%), 3 patients, CPC2 (19%), and 5 patients no alteration CPC1 (33.3%).Incluye bibliografíaPregradoMédico(a) Cirujanoapplication/pdfspaBogotá : Universidad de Ciencias Aplicadas y Ambientales, 2019Facultad de Ciencias de la SaludMedicinaDerechos Reservados - Universidad de Ciencias Aplicadas y Ambientaleshttps://creativecommons.org/licenses/by-nc-sa/4.0/info:eu-repo/semantics/embargoedAccessAtribución-NoComercial-CompartirIgual 4.0 Internacional (CC BY-NC-SA 4.0)http://purl.org/coar/access_right/c_f1cfManifestaciones NeurológicasParo CardíacoHipoxiaSecuelas neurológicas post-reanimación según el tiempo de anoxia en la población adulta del Hospital Tunal desde Diciembre 2018 Abril 2019Trabajo de grado - Pregradohttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesisinfo:eu-repo/semantics/publishedVersionTexthttp://purl.org/redcol/resource_type/TPhttp://purl.org/coar/version/c_970fb48d4fbd8a85HA. 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El Ministerio, Recuperado de : https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/PSP/asiscundinamarca-2017.zipPublicationORIGINALTG-FINAL ULTRA 2019.pdfTG-FINAL ULTRA 2019.pdfapplication/pdf1394915https://repository.udca.edu.co/bitstreams/4d23130a-8c74-4ac6-89d6-d32227ca71ba/downloadba4c08c5bfff44ff0bf8ad6e01f56749MD51LICENSElicense.txtlicense.txttext/plain; charset=utf-814775https://repository.udca.edu.co/bitstreams/641419c9-6352-41ad-985f-d4ed6a3609ee/downloadf661acf14bedbf9f5d13897a0387e751MD52TEXTTG-FINAL ULTRA 2019.pdf.txtTG-FINAL ULTRA 2019.pdf.txtExtracted texttext/plain150540https://repository.udca.edu.co/bitstreams/3d4e1be3-cb53-4818-94b6-0b03a4a29763/download0265da061880ff8f4516f1218d766556MD53THUMBNAILTG-FINAL ULTRA 2019.pdf.jpgTG-FINAL ULTRA 2019.pdf.jpgGenerated 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en las Obras Colectivas;
b.	Distribuir copias o fonogramas de las Obras, exhibirlas públicamente, ejecutarlas públicamente y/o ponerlas a disposición pública, incluyéndolas como incorporadas en Obras Colectivas, según corresponda;
c.	Distribuir copias de las Obras Derivadas que se generen, exhibirlas públicamente, ejecutarlas públicamente y/o ponerlas a disposición pública.
Los derechos mencionados anteriormente pueden ser ejercidos en todos los medios y formatos, actualmente conocidos o que se inventen en el futuro. Los derechos antes mencionados incluyen el derecho a realizar dichas modificaciones en la medida que sean técnicamente necesarias para ejercer los derechos en otro medio o formatos, pero de otra manera usted no está autorizado para realizar obras derivadas.Todos los derechos no otorgados expresamente por el Licenciante quedan por este medio reservados, incluyendo pero sin limitarse a aquellos que se mencionan en las secciones 4(d) y 4(e).
4. Restricciones.
La licencia otorgada en la anterior Sección 3 está expresamente sujeta y limitada por las siguientes restricciones:
a.	Usted puede distribuir, exhibir públicamente, ejecutar públicamente, o poner a disposición pública la Obra sólo bajo las condiciones de esta Licencia, y Usted debe incluir una copia de esta licencia o del Identificador Universal de Recursos de la misma con cada copia de la Obra que distribuya, exhiba públicamente, ejecute públicamente o ponga a disposición pública. No es posible ofrecer o imponer ninguna condición sobre la Obra que altere o limite las condiciones de esta Licencia o el ejercicio de los derechos de los destinatarios otorgados en este documento. No es posible sublicenciar la Obra. Usted debe mantener intactos todos los avisos que hagan referencia a esta Licencia y a la cláusula de limitación de garantías. Usted no puede distribuir, exhibir públicamente, ejecutar públicamente, o poner a disposición pública la Obra con alguna medida tecnológica que controle el acceso o la utilización de ella de una forma que sea inconsistente con las condiciones de esta Licencia. Lo anterior se aplica a la Obra incorporada a una Obra Colectiva, pero esto no exige que la Obra Colectiva aparte de la obra misma quede sujeta a las condiciones de esta Licencia. Si Usted crea una Obra Colectiva, previo aviso de cualquier Licenciante debe, en la medida de lo posible, eliminar de la Obra Colectiva cualquier referencia a dicho Licenciante o al Autor Original, según lo solicitado por el Licenciante y conforme lo exige la cláusula 4(c).
b.	Usted no puede ejercer ninguno de los derechos que le han sido otorgados en la Sección 3 precedente de modo que estén principalmente destinados o directamente dirigidos a conseguir un provecho comercial o una compensación monetaria privada. El intercambio de la Obra por otras obras protegidas por derechos de autor, ya sea a través de un sistema para compartir archivos digitales (digital file-sharing) o de cualquier otra manera no será considerado como estar destinado principalmente o dirigido directamente a conseguir un provecho comercial o una compensación monetaria privada, siempre que no se realice un pago mediante una compensación monetaria en relación con el intercambio de obras protegidas por el derecho de autor.
c.	Si usted distribuye, exhibe públicamente, ejecuta públicamente o ejecuta públicamente en forma digital la Obra o cualquier Obra Derivada u Obra Colectiva, Usted debe mantener intacta toda la información de derecho de autor de la Obra y proporcionar, de forma razonable según el medio o manera que Usted esté utilizando: (i) el nombre del Autor Original si está provisto (o seudónimo, si fuere aplicable), y/o (ii) el nombre de la parte o las partes que el Autor Original y/o el Licenciante hubieren designado para la atribución (v.g., un instituto patrocinador, editorial, publicación) en la información de los derechos de autor del Licenciante, términos de servicios o de otras formas razonables; el título de la Obra si está provisto; en la medida de lo razonablemente factible y, si está provisto, el Identificador Uniforme de Recursos (Uniform Resource Identifier) que el Licenciante especifica para ser asociado con la Obra, salvo que tal URI no se refiera a la nota sobre los derechos de autor o a la información sobre el licenciamiento de la Obra; y en el caso de una Obra Derivada, atribuir el crédito identificando el uso de la Obra en la Obra Derivada (v.g., "Traducción Francesa de la Obra del Autor Original," o "Guión Cinematográfico basado en la Obra original del Autor Original"). Tal crédito puede ser implementado de cualquier forma razonable; en el caso, sin embargo, de Obras Derivadas u Obras Colectivas, tal crédito aparecerá, como mínimo, donde aparece el crédito de cualquier otro autor comparable y de una manera, al menos, tan destacada como el crédito de otro autor comparable.
d.	Para evitar toda confusión, el Licenciante aclara que, cuando la obra es una composición musical:
i.	Regalías por interpretación y ejecución bajo licencias generales. El Licenciante se reserva el derecho exclusivo de autorizar la ejecución pública o la ejecución pública digital de la obra y de recolectar, sea individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, SAYCO), las regalías por la ejecución pública o por la ejecución pública digital de la obra (por ejemplo Webcast) licenciada bajo licencias generales, si la interpretación o ejecución de la obra está primordialmente orientada por o dirigida a la obtención de una ventaja comercial o una compensación monetaria privada.
ii.	Regalías por Fonogramas. El Licenciante se reserva el derecho exclusivo de recolectar, individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, SAYCO), una agencia de derechos musicales o algún agente designado, las regalías por cualquier fonograma que Usted cree a partir de la obra (“versión cover”) y distribuya, en los términos del régimen de derechos de autor, si la creación o distribución de esa versión cover está primordialmente destinada o dirigida a obtener una ventaja comercial o una compensación monetaria privada.
e.	Gestión de Derechos de Autor sobre Interpretaciones y Ejecuciones Digitales (WebCasting). Para evitar toda confusión, el Licenciante aclara que, cuando la obra sea un fonograma, el Licenciante se reserva el derecho exclusivo de autorizar la ejecución pública digital de la obra (por ejemplo, webcast) y de recolectar, individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, Acinpro), las regalías por la ejecución pública digital de la obra (por ejemplo, webcast), sujeta a las disposiciones aplicables del régimen de Derecho de Autor, si esta ejecución pública digital está primordialmente dirigida a obtener una ventaja comercial o una compensación monetaria privada.
5. Representaciones, Garantías y Limitaciones de Responsabilidad.
A MENOS QUE LAS PARTES LO ACORDARAN DE OTRA FORMA POR ESCRITO, EL LICENCIANTE OFRECE LA OBRA (EN EL ESTADO EN EL QUE SE ENCUENTRA) “TAL CUAL”, SIN BRINDAR GARANTÍAS DE CLASE ALGUNA RESPECTO DE LA OBRA, YA SEA EXPRESA, IMPLÍCITA, LEGAL O CUALQUIERA OTRA, INCLUYENDO, SIN LIMITARSE A ELLAS, GARANTÍAS DE TITULARIDAD, COMERCIABILIDAD, ADAPTABILIDAD O ADECUACIÓN A PROPÓSITO DETERMINADO, AUSENCIA DE INFRACCIÓN, DE AUSENCIA DE DEFECTOS LATENTES O DE OTRO TIPO, O LA PRESENCIA O AUSENCIA DE ERRORES, SEAN O NO DESCUBRIBLES (PUEDAN O NO SER ESTOS DESCUBIERTOS). ALGUNAS JURISDICCIONES NO PERMITEN LA EXCLUSIÓN DE GARANTÍAS IMPLÍCITAS, EN CUYO CASO ESTA EXCLUSIÓN PUEDE NO APLICARSE A USTED.
6. Limitación de responsabilidad.
A MENOS QUE LO EXIJA EXPRESAMENTE LA LEY APLICABLE, EL LICENCIANTE NO SERÁ RESPONSABLE ANTE USTED POR DAÑO ALGUNO, SEA POR RESPONSABILIDAD EXTRACONTRACTUAL, PRECONTRACTUAL O CONTRACTUAL, OBJETIVA O SUBJETIVA, SE TRATE DE DAÑOS MORALES O PATRIMONIALES, DIRECTOS O INDIRECTOS, PREVISTOS O IMPREVISTOS PRODUCIDOS POR EL USO DE ESTA LICENCIA O DE LA OBRA, AUN CUANDO EL LICENCIANTE HAYA SIDO ADVERTIDO DE LA POSIBILIDAD DE DICHOS DAÑOS. ALGUNAS LEYES NO PERMITEN LA EXCLUSIÓN DE CIERTA RESPONSABILIDAD, EN CUYO CASO ESTA EXCLUSIÓN PUEDE NO APLICARSE A USTED.
7. Término.
a.	Esta Licencia y los derechos otorgados en virtud de ella terminarán automáticamente si Usted infringe alguna condición establecida en ella. Sin embargo, los individuos o entidades que han recibido Obras Derivadas o Colectivas de Usted de conformidad con esta Licencia, no verán terminadas sus licencias, siempre que estos individuos o entidades sigan cumpliendo íntegramente las condiciones de estas licencias. Las Secciones 1, 2, 5, 6, 7, y 8 subsistirán a cualquier terminación de esta Licencia.
b.	Sujeta a las condiciones y términos anteriores, la licencia otorgada aquí es perpetua (durante el período de vigencia de los derechos de autor de la obra). No obstante lo anterior, el Licenciante se reserva el derecho a publicar y/o estrenar la Obra bajo condiciones de licencia diferentes o a dejar de distribuirla en los términos de esta Licencia en cualquier momento; en el entendido, sin embargo, que esa elección no servirá para revocar esta licencia o que deba ser otorgada , bajo los términos de esta licencia), y esta licencia continuará en pleno vigor y efecto a menos que sea terminada como se expresa atrás. La Licencia revocada continuará siendo plenamente vigente y efectiva si no se le da término en las condiciones indicadas anteriormente.
8. Varios.
a.	Cada vez que Usted distribuya o ponga a disposición pública la Obra o una Obra Colectiva, el Licenciante ofrecerá al destinatario una licencia en los mismos términos y condiciones que la licencia otorgada a Usted bajo esta Licencia.
b.	Si alguna disposición de esta Licencia resulta invalidada o no exigible, según la legislación vigente, esto no afectará ni la validez ni la aplicabilidad del resto de condiciones de esta Licencia y, sin acción adicional por parte de los sujetos de este acuerdo, aquélla se entenderá reformada lo mínimo necesario para hacer que dicha disposición sea válida y exigible.
c.	Ningún término o disposición de esta Licencia se estimará renunciada y ninguna violación de ella será consentida a menos que esa renuncia o consentimiento sea otorgado por escrito y firmado por la parte que renuncie o consienta.
d.	Esta Licencia refleja el acuerdo pleno entre las partes respecto a la Obra aquí licenciada. No hay arreglos, acuerdos o declaraciones respecto a la Obra que no estén especificados en este documento. El Licenciante no se verá limitado por ninguna disposición adicional que pueda surgir en alguna comunicación emanada de Usted. Esta Licencia no puede ser modificada sin el consentimiento mutuo por escrito del Licenciante y Usted.

 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