Utilidad clínica de la diferencia arterio–venosa de lactato como factor pronóstico de mortalidad en pacientes críticamente enfermos

Autores:
Rodriguez-Yanez, Tomas
Almanza Hurtado, Amilkar
Martinez Avila, Maria Cristina
Borré-Naranjo, Diana
Montes-Farah, Juan Manuel
Cuadrado Cano, Bernarda
Ramos-Clason, Enrique
Dueñas-Castell, Carmelo
Tipo de recurso:
Article of journal
Fecha de publicación:
2022
Institución:
Universidad de Cartagena
Repositorio:
Repositorio Universidad de Cartagena
Idioma:
spa
OAI Identifier:
oai:repositorio.unicartagena.edu.co:11227/14763
Acceso en línea:
https://doi.org/10.32997/rcb-2022-3519
Palabra clave:
tissue perfusion
CO2 delta
lactate
lactate clearance
central venous gases
perfusión tisular
delta de CO2
lactato
depuración de lactato
gases venosos centrales
Rights
openAccess
License
https://creativecommons.org/licenses/by-nc-sa/4.0
id UCART2_a921a83d01001e94c8e6f2a7bc5905f8
oai_identifier_str oai:repositorio.unicartagena.edu.co:11227/14763
network_acronym_str UCART2
network_name_str Repositorio Universidad de Cartagena
repository_id_str
dc.title.spa.fl_str_mv Utilidad clínica de la diferencia arterio–venosa de lactato como factor pronóstico de mortalidad en pacientes críticamente enfermos
dc.title.translated.eng.fl_str_mv Clinical utility of the arterio-venous lactate difference as a prognostic factor of mortality in critically ill patients
title Utilidad clínica de la diferencia arterio–venosa de lactato como factor pronóstico de mortalidad en pacientes críticamente enfermos
spellingShingle Utilidad clínica de la diferencia arterio–venosa de lactato como factor pronóstico de mortalidad en pacientes críticamente enfermos
tissue perfusion
CO2 delta
lactate
lactate clearance
central venous gases
perfusión tisular
delta de CO2
lactato
depuración de lactato
gases venosos centrales
title_short Utilidad clínica de la diferencia arterio–venosa de lactato como factor pronóstico de mortalidad en pacientes críticamente enfermos
title_full Utilidad clínica de la diferencia arterio–venosa de lactato como factor pronóstico de mortalidad en pacientes críticamente enfermos
title_fullStr Utilidad clínica de la diferencia arterio–venosa de lactato como factor pronóstico de mortalidad en pacientes críticamente enfermos
title_full_unstemmed Utilidad clínica de la diferencia arterio–venosa de lactato como factor pronóstico de mortalidad en pacientes críticamente enfermos
title_sort Utilidad clínica de la diferencia arterio–venosa de lactato como factor pronóstico de mortalidad en pacientes críticamente enfermos
dc.creator.fl_str_mv Rodriguez-Yanez, Tomas
Almanza Hurtado, Amilkar
Martinez Avila, Maria Cristina
Borré-Naranjo, Diana
Montes-Farah, Juan Manuel
Cuadrado Cano, Bernarda
Ramos-Clason, Enrique
Dueñas-Castell, Carmelo
dc.contributor.author.spa.fl_str_mv Rodriguez-Yanez, Tomas
Almanza Hurtado, Amilkar
Martinez Avila, Maria Cristina
Borré-Naranjo, Diana
Montes-Farah, Juan Manuel
Cuadrado Cano, Bernarda
Ramos-Clason, Enrique
Dueñas-Castell, Carmelo
dc.subject.eng.fl_str_mv tissue perfusion
CO2 delta
lactate
lactate clearance
central venous gases
topic tissue perfusion
CO2 delta
lactate
lactate clearance
central venous gases
perfusión tisular
delta de CO2
lactato
depuración de lactato
gases venosos centrales
dc.subject.spa.fl_str_mv perfusión tisular
delta de CO2
lactato
depuración de lactato
gases venosos centrales
publishDate 2022
dc.date.accessioned.none.fl_str_mv 2022-01-14 00:00:00
dc.date.available.none.fl_str_mv 2022-01-14 00:00:00
dc.date.issued.none.fl_str_mv 2022-01-14
dc.type.spa.fl_str_mv Artículo de revista
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_2df8fbb1
dc.type.version.spa.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.type.content.spa.fl_str_mv Text
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dc.type.local.eng.fl_str_mv Journal article
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dc.identifier.issn.none.fl_str_mv 2215-7840
dc.identifier.doi.none.fl_str_mv 10.32997/rcb-2022-3519
dc.identifier.eissn.none.fl_str_mv 2389-7252
dc.identifier.url.none.fl_str_mv https://doi.org/10.32997/rcb-2022-3519
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url https://doi.org/10.32997/rcb-2022-3519
dc.language.iso.spa.fl_str_mv spa
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dc.relation.ispartofjournal.spa.fl_str_mv Revista Ciencias Biomédicas
dc.relation.bitstream.none.fl_str_mv https://revistas.unicartagena.edu.co/index.php/cbiomedicas/article/download/3519/3082
dc.relation.citationedition.spa.fl_str_mv Núm. 1 , Año 2022
dc.relation.citationendpage.none.fl_str_mv 18
dc.relation.citationissue.spa.fl_str_mv 1
dc.relation.citationstartpage.none.fl_str_mv 6
dc.relation.citationvolume.spa.fl_str_mv 11
dc.relation.references.spa.fl_str_mv Vincent J-L, De Backer D. Circulatory shock. N Engl J Med. 31 de octubre de 2013;369(18):1726-34.
Cecconi M, De Backer D, Antonelli M, Beale R, Bakker J, Hofer C, et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. Intensive Care Med. diciembre de 2014;40(12):1795-815.
Hasanin A, Mukhtar A, Nassar H. Perfusion indices revisited. J Intensive Care. 2017;5:24.
Mallat J, Lemyze M, Tronchon L, Vallet B, Thevenin D. Use of venous-to-arterial carbon dioxide tension difference to guide resuscitation therapy in septic shock. World J Crit Care Med. 4 de febrero de 2016;5(1):47-56.
Mallat J, Pepy F, Lemyze M, Gasan G, Vangrunderbeeck N, Tronchon L, et al. Central venous-to-arterial carbon dioxide partial pressure difference in early resuscitation from septic shock: a prospective observational study. Eur J Anaesthesiol. julio de 2014;31(7):371-80.
Bakker J, Vincent JL, Gris P, Leon M, Coffernils M, Kahn RJ. Veno-arterial carbon dioxide gradient in human septic shock. Chest. febrero de 1992;101(2):509-15.
Scheeren TWL, Wicke JN, Teboul J-L. Understanding the carbon dioxide gaps. Curr Opin Crit Care. junio de 2018;24(3):181-9.
Al Duhailib Z, Hegazy AF, Lalli R, Fiorini K, Priestap F, Iansavichene A, et al. The Use of Central Venous to Arterial Carbon Dioxide Tension Gap for Outcome Prediction in Critically Ill Patients: A Systematic Review and Meta-Analysis. Crit Care Med. diciembre de 2020;48(12):1855-61.
Mayer K, Trzeciak S, Puri NK. Assessment of the adequacy of oxygen delivery. Curr Opin Crit Care. octubre de 2016;22(5):437-43.
Mikkelsen ME, Miltiades AN, Gaieski DF, Goyal M, Fuchs BD, Shah CV, et al. Serum lactate is associated with mortality in severe sepsis independent of organ failure and shock. Crit Care Med. mayo de 2009;37(5):1670-7.
Trzeciak S, Dellinger RP, Chansky ME, Arnold RC, Schorr C, Milcarek B, et al. Serum lactate as a predictor of mortality in patients with infection. Intensive Care Med. junio de 2007;33(6):970-7.
Nguyen HB, Rivers EP, Knoblich BP, Jacobsen G, Muzzin A, Ressler JA, et al. Early lactate clearance is associated with improved outcome in severe sepsis and septic shock. Crit Care Med. agosto de 2004;32(8):1637-42.
Vallet B, Pinsky MR, Cecconi M. Resuscitation of patients with septic shock: please «mind the gap»! Intensive Care Med. septiembre de 2013;39(9):1653-5.
Kiyatkin ME, Bakker J. Lactate and microcirculation as suitable targets for hemodynamic optimization in resuscitation of circulatory shock. Curr Opin Crit Care. agosto de 2017;23(4):348-54.
Vincent J-L, Quintairos E Silva A, Couto L, Taccone FS. The value of blood lactate kinetics in critically ill patients: a systematic review. Crit Care Lond Engl. 13 de agosto de 2016;20(1):257.
Levy B. Lactate and shock state: the metabolic view. Curr Opin Crit Care. agosto de 2006;12(4):315-21.
Younger JG, Falk JL, Rothrock SG. Relationship between arterial and peripheral venous lactate levels. Acad Emerg Med Off J Soc Acad Emerg Med. julio de 1996;3(7):730-4.
Gallagher EJ, Rodriguez K, Touger M. Agreement between peripheral venous and arterial lactate levels. Ann Emerg Med. abril de 1997;29(4):479-83.
Weil MH, Michaels S, Rackow EC. Comparison of blood lactate concentrations in central venous, pulmonary artery, and arterial blood. Crit Care Med. mayo de 1987;15(5):489-90.
Nascente APM, Assunção M, Guedes CJ, Freitas FGR, Mazza BF, Jackiu M, et al. Comparison of lactate values obtained from different sites and their clinical significance in patients with severe sepsis. Sao Paulo Med J Rev Paul Med. 6 de enero de 2011;129(1):11-6.
Réminiac F, Saint-Etienne C, Runge I, Ayé DY, Benzekri-Lefevre D, Mathonnet A, et al. Are central venous lactate and arterial lactate interchangeable? A human retrospective study. Anesth Analg. septiembre de 2012;115(3):605-10.
Boulain T, Garot D, Vignon P, Lascarrou J-B, Benzekri-Lefevre D, Dequin P-F, et al. Predicting arterial blood gas and lactate from central venous blood analysis in critically ill patients: a multicentre, prospective, diagnostic accuracy study. Br J Anaesth. septiembre de 2016;117(3):341-9.
Takami Y, Ina H. Significance of the Initial Arterial Lactate Level and Transpulmonary Arteriovenous Lactate Difference After Open-Heart Surgery. Surg Today. 1 de marzo de 2002;32(3):207-12.
De Backer D, Creteur J, Zhang H, Norrenberg M, Vincent JL. Lactate production by the lungs in acute lung injury. Am J Respir Crit Care Med. octubre de 1997;156(4 Pt 1):1099-104.
Chieregato A, Marchi M, Zoppellari R, Fabbri E, Cianchi G, Forini E, et al. Detection of early ischemia in severe head injury by means of arteriovenous lactate differences and jugular bulb oxygen saturation. Relationship with CPP, severity indexes and outcome. Preliminary analysis. Acta Neurochir Suppl. 2002;81:289-93.
Middleton P, Kelly A-M, Brown J, Robertson M. Agreement between arterial and central venous values for pH, bicarbonate, base excess, and lactate. Emerg Med J EMJ. agosto de 2006;23(8):622-4.
Bijapur MB, Kudligi NA, Asma S. Central Venous Blood Gas Analysis: An Alternative to Arterial Blood Gas Analysis for pH, PCO2, Bicarbonate, Sodium, Potassium and Chloride in the Intensive Care Unit Patients. Indian J Crit Care Med Peer-Rev Off Publ Indian Soc Crit Care Med. junio de 2019;23(6):258-62.
Esmaeilivand M, Khatony A, Moradi G, Najafi F, Abdi A. Agreement and Correlation between Arterial and Central Venous Blood Gas Following Coronary Artery Bypass Graft Surgery. J Clin Diagn Res JCDR. marzo de 2017;11(3):OC43-6.
Nanjayya VB, McCracken P, Vallance S, Board J, Kelly PJ, Schneider HG, et al. Arterio-VENouS Intra Subject agreement for blood gases within intensive care: The AVENSIS study. J Intensive Care Soc. febrero de 2020;21(1):64-71.
Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. marzo de 2017;43(3):304-77.
Zhou X, Liu D, Su L, Yao B, Long Y, Wang X, et al. Use of stepwise lactate kinetics-oriented hemodynamic therapy could improve the clinical outcomes of patients with sepsis-associated hyperlactatemia. Crit Care Lond Engl. 16 de 2017;21(1):33.
Filho RR, Rocha LL, Corrêa TD, Pessoa CMS, Colombo G, Assuncao MSC. Blood Lactate Levels Cutoff and Mortality Prediction in Sepsis-Time for a Reappraisal? a Retrospective Cohort Study. Shock Augusta Ga. 2016;46(5):480-5.
Gale SC, Kocik JF, Creath R, Crystal JS, Dombrovskiy VY. A comparison of initial lactate and initial base deficit as predictors of mortality after severe blunt trauma. J Surg Res. octubre de 2016;205(2):446-55.
Zhou J, Song J, Gong S, Li L, Zhang H, Wang M. Persistent hyperlactatemia-high central venous-arterial carbon dioxide to arterial-venous oxygen content ratio is associated with poor outcomes in early resuscitation of septic shock. Am J Emerg Med. agosto de 2017;35(8):1136-41.
Lokhandwala S, Andersen LW, Nair S, Patel P, Cocchi MN, Donnino MW. Absolute lactate value vs relative reduction as a predictor of mortality in severe sepsis and septic shock. J Crit Care. 2017;37:179-84.
Bakker J, Postelnicu R, Mukherjee V. Lactate: Where Are We Now? Crit Care Clin. enero de 2020;36(1):115-24.
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spelling Rodriguez-Yanez, TomasAlmanza Hurtado, AmilkarMartinez Avila, Maria CristinaBorré-Naranjo, DianaMontes-Farah, Juan ManuelCuadrado Cano, BernardaRamos-Clason, EnriqueDueñas-Castell, Carmelo2022-01-14 00:00:002022-01-14 00:00:002022-01-142215-784010.32997/rcb-2022-35192389-7252https://doi.org/10.32997/rcb-2022-3519application/pdfspaUniversidad de CartagenaRevista Ciencias Biomédicashttps://revistas.unicartagena.edu.co/index.php/cbiomedicas/article/download/3519/3082Núm. 1 , Año 2022181611Vincent J-L, De Backer D. Circulatory shock. N Engl J Med. 31 de octubre de 2013;369(18):1726-34.Cecconi M, De Backer D, Antonelli M, Beale R, Bakker J, Hofer C, et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. Intensive Care Med. diciembre de 2014;40(12):1795-815.Hasanin A, Mukhtar A, Nassar H. Perfusion indices revisited. J Intensive Care. 2017;5:24.Mallat J, Lemyze M, Tronchon L, Vallet B, Thevenin D. Use of venous-to-arterial carbon dioxide tension difference to guide resuscitation therapy in septic shock. World J Crit Care Med. 4 de febrero de 2016;5(1):47-56.Mallat J, Pepy F, Lemyze M, Gasan G, Vangrunderbeeck N, Tronchon L, et al. Central venous-to-arterial carbon dioxide partial pressure difference in early resuscitation from septic shock: a prospective observational study. Eur J Anaesthesiol. julio de 2014;31(7):371-80.Bakker J, Vincent JL, Gris P, Leon M, Coffernils M, Kahn RJ. Veno-arterial carbon dioxide gradient in human septic shock. Chest. febrero de 1992;101(2):509-15.Scheeren TWL, Wicke JN, Teboul J-L. Understanding the carbon dioxide gaps. Curr Opin Crit Care. junio de 2018;24(3):181-9.Al Duhailib Z, Hegazy AF, Lalli R, Fiorini K, Priestap F, Iansavichene A, et al. The Use of Central Venous to Arterial Carbon Dioxide Tension Gap for Outcome Prediction in Critically Ill Patients: A Systematic Review and Meta-Analysis. Crit Care Med. diciembre de 2020;48(12):1855-61.Mayer K, Trzeciak S, Puri NK. Assessment of the adequacy of oxygen delivery. Curr Opin Crit Care. octubre de 2016;22(5):437-43.Mikkelsen ME, Miltiades AN, Gaieski DF, Goyal M, Fuchs BD, Shah CV, et al. Serum lactate is associated with mortality in severe sepsis independent of organ failure and shock. Crit Care Med. mayo de 2009;37(5):1670-7.Trzeciak S, Dellinger RP, Chansky ME, Arnold RC, Schorr C, Milcarek B, et al. Serum lactate as a predictor of mortality in patients with infection. Intensive Care Med. junio de 2007;33(6):970-7.Nguyen HB, Rivers EP, Knoblich BP, Jacobsen G, Muzzin A, Ressler JA, et al. Early lactate clearance is associated with improved outcome in severe sepsis and septic shock. Crit Care Med. agosto de 2004;32(8):1637-42.Vallet B, Pinsky MR, Cecconi M. Resuscitation of patients with septic shock: please «mind the gap»! Intensive Care Med. septiembre de 2013;39(9):1653-5.Kiyatkin ME, Bakker J. Lactate and microcirculation as suitable targets for hemodynamic optimization in resuscitation of circulatory shock. Curr Opin Crit Care. agosto de 2017;23(4):348-54.Vincent J-L, Quintairos E Silva A, Couto L, Taccone FS. The value of blood lactate kinetics in critically ill patients: a systematic review. Crit Care Lond Engl. 13 de agosto de 2016;20(1):257.Levy B. Lactate and shock state: the metabolic view. Curr Opin Crit Care. agosto de 2006;12(4):315-21.Younger JG, Falk JL, Rothrock SG. Relationship between arterial and peripheral venous lactate levels. Acad Emerg Med Off J Soc Acad Emerg Med. julio de 1996;3(7):730-4.Gallagher EJ, Rodriguez K, Touger M. Agreement between peripheral venous and arterial lactate levels. Ann Emerg Med. abril de 1997;29(4):479-83.Weil MH, Michaels S, Rackow EC. Comparison of blood lactate concentrations in central venous, pulmonary artery, and arterial blood. Crit Care Med. mayo de 1987;15(5):489-90.Nascente APM, Assunção M, Guedes CJ, Freitas FGR, Mazza BF, Jackiu M, et al. Comparison of lactate values obtained from different sites and their clinical significance in patients with severe sepsis. Sao Paulo Med J Rev Paul Med. 6 de enero de 2011;129(1):11-6.Réminiac F, Saint-Etienne C, Runge I, Ayé DY, Benzekri-Lefevre D, Mathonnet A, et al. Are central venous lactate and arterial lactate interchangeable? A human retrospective study. Anesth Analg. septiembre de 2012;115(3):605-10.Boulain T, Garot D, Vignon P, Lascarrou J-B, Benzekri-Lefevre D, Dequin P-F, et al. Predicting arterial blood gas and lactate from central venous blood analysis in critically ill patients: a multicentre, prospective, diagnostic accuracy study. Br J Anaesth. septiembre de 2016;117(3):341-9.Takami Y, Ina H. Significance of the Initial Arterial Lactate Level and Transpulmonary Arteriovenous Lactate Difference After Open-Heart Surgery. Surg Today. 1 de marzo de 2002;32(3):207-12.De Backer D, Creteur J, Zhang H, Norrenberg M, Vincent JL. Lactate production by the lungs in acute lung injury. Am J Respir Crit Care Med. octubre de 1997;156(4 Pt 1):1099-104.Chieregato A, Marchi M, Zoppellari R, Fabbri E, Cianchi G, Forini E, et al. Detection of early ischemia in severe head injury by means of arteriovenous lactate differences and jugular bulb oxygen saturation. Relationship with CPP, severity indexes and outcome. Preliminary analysis. Acta Neurochir Suppl. 2002;81:289-93.Middleton P, Kelly A-M, Brown J, Robertson M. Agreement between arterial and central venous values for pH, bicarbonate, base excess, and lactate. Emerg Med J EMJ. agosto de 2006;23(8):622-4.Bijapur MB, Kudligi NA, Asma S. Central Venous Blood Gas Analysis: An Alternative to Arterial Blood Gas Analysis for pH, PCO2, Bicarbonate, Sodium, Potassium and Chloride in the Intensive Care Unit Patients. Indian J Crit Care Med Peer-Rev Off Publ Indian Soc Crit Care Med. junio de 2019;23(6):258-62.Esmaeilivand M, Khatony A, Moradi G, Najafi F, Abdi A. Agreement and Correlation between Arterial and Central Venous Blood Gas Following Coronary Artery Bypass Graft Surgery. J Clin Diagn Res JCDR. marzo de 2017;11(3):OC43-6.Nanjayya VB, McCracken P, Vallance S, Board J, Kelly PJ, Schneider HG, et al. Arterio-VENouS Intra Subject agreement for blood gases within intensive care: The AVENSIS study. J Intensive Care Soc. febrero de 2020;21(1):64-71.Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. marzo de 2017;43(3):304-77.Zhou X, Liu D, Su L, Yao B, Long Y, Wang X, et al. Use of stepwise lactate kinetics-oriented hemodynamic therapy could improve the clinical outcomes of patients with sepsis-associated hyperlactatemia. Crit Care Lond Engl. 16 de 2017;21(1):33.Filho RR, Rocha LL, Corrêa TD, Pessoa CMS, Colombo G, Assuncao MSC. Blood Lactate Levels Cutoff and Mortality Prediction in Sepsis-Time for a Reappraisal? a Retrospective Cohort Study. Shock Augusta Ga. 2016;46(5):480-5.Gale SC, Kocik JF, Creath R, Crystal JS, Dombrovskiy VY. A comparison of initial lactate and initial base deficit as predictors of mortality after severe blunt trauma. J Surg Res. octubre de 2016;205(2):446-55.Zhou J, Song J, Gong S, Li L, Zhang H, Wang M. Persistent hyperlactatemia-high central venous-arterial carbon dioxide to arterial-venous oxygen content ratio is associated with poor outcomes in early resuscitation of septic shock. Am J Emerg Med. agosto de 2017;35(8):1136-41.Lokhandwala S, Andersen LW, Nair S, Patel P, Cocchi MN, Donnino MW. Absolute lactate value vs relative reduction as a predictor of mortality in severe sepsis and septic shock. J Crit Care. 2017;37:179-84.Bakker J, Postelnicu R, Mukherjee V. Lactate: Where Are We Now? Crit Care Clin. enero de 2020;36(1):115-24.Tomas Rodriguez-Yanez, Amilkar Almanza Hurtado, Maria Cristina Martinez Avila, Diana Borré-Naranjo, Juan Manuel Montes-Farah, Bernarda Cuadrado Cano, Enrique Ramos-Clason, Carmelo Dueñas-Castell - 2022https://creativecommons.org/licenses/by-nc-sa/4.0http://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessEsta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.https://revistas.unicartagena.edu.co/index.php/cbiomedicas/article/view/3519tissue perfusionCO2 deltalactatelactate clearancecentral venous gasesperfusión tisulardelta de CO2lactatodepuración de lactatogases venosos centralesUtilidad clínica de la diferencia arterio–venosa de lactato como factor pronóstico de mortalidad en pacientes críticamente enfermosClinical utility of the arterio-venous lactate difference as a prognostic factor of mortality in critically ill patientsArtículo de revistainfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/version/c_970fb48d4fbd8a85http://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articleJournal articlehttp://purl.org/redcol/resource_type/ARTPublicationOREORE.xmltext/xml3046https://repositorio.unicartagena.edu.co/bitstreams/b8824e83-7e52-4fd9-b7f1-53d15941b146/download789fe4d5dfb85a7c97497c4d060987c5MD5111227/14763oai:repositorio.unicartagena.edu.co:11227/147632024-09-05 15:30:42.351https://creativecommons.org/licenses/by-nc-sa/4.0Tomas Rodriguez-Yanez, Amilkar Almanza Hurtado, Maria Cristina Martinez Avila, Diana Borré-Naranjo, Juan Manuel Montes-Farah, Bernarda Cuadrado Cano, Enrique Ramos-Clason, Carmelo Dueñas-Castell - 2022metadata.onlyhttps://repositorio.unicartagena.edu.coBiblioteca Digital Universidad de Cartagenabdigital@metabiblioteca.com