Parámetros de atrofia muscular como predictores de desenlaces clínicos en pacientes de Unidad de Cuidados Intensivos

ilustraciones, fotografías

Autores:
Guzmán-David, Cristian Arvey
Tipo de recurso:
Fecha de publicación:
2023
Institución:
Universidad Nacional de Colombia
Repositorio:
Universidad Nacional de Colombia
Idioma:
spa
OAI Identifier:
oai:repositorio.unal.edu.co:unal/84141
Acceso en línea:
https://repositorio.unal.edu.co/handle/unal/84141
https://repositorio.unal.edu.co/
Palabra clave:
610 - Medicina y salud::612 - Fisiología humana
Unidad de cuidados intensivos
Trastornos musculares atróficos
Intensive Care Units
Muscular Disorders, Atrophic
Ultrasonografía
Morbilidad
Mortalidad
Unidad de Cuidados Intensivos
Atrofia Muscular
Ultrasonography
Morbidity
Mortality
Intensive Care Units
Muscular Atrophy
Rights
openAccess
License
Atribución-NoComercial 4.0 Internacional
id UNACIONAL2_b80a8ddb1b9527b2c16ad118342a90a7
oai_identifier_str oai:repositorio.unal.edu.co:unal/84141
network_acronym_str UNACIONAL2
network_name_str Universidad Nacional de Colombia
repository_id_str
dc.title.spa.fl_str_mv Parámetros de atrofia muscular como predictores de desenlaces clínicos en pacientes de Unidad de Cuidados Intensivos
dc.title.translated.eng.fl_str_mv Parameters of muscle atrophy as predictors of clinical outcomes in intensive care unit patients.
title Parámetros de atrofia muscular como predictores de desenlaces clínicos en pacientes de Unidad de Cuidados Intensivos
spellingShingle Parámetros de atrofia muscular como predictores de desenlaces clínicos en pacientes de Unidad de Cuidados Intensivos
610 - Medicina y salud::612 - Fisiología humana
Unidad de cuidados intensivos
Trastornos musculares atróficos
Intensive Care Units
Muscular Disorders, Atrophic
Ultrasonografía
Morbilidad
Mortalidad
Unidad de Cuidados Intensivos
Atrofia Muscular
Ultrasonography
Morbidity
Mortality
Intensive Care Units
Muscular Atrophy
title_short Parámetros de atrofia muscular como predictores de desenlaces clínicos en pacientes de Unidad de Cuidados Intensivos
title_full Parámetros de atrofia muscular como predictores de desenlaces clínicos en pacientes de Unidad de Cuidados Intensivos
title_fullStr Parámetros de atrofia muscular como predictores de desenlaces clínicos en pacientes de Unidad de Cuidados Intensivos
title_full_unstemmed Parámetros de atrofia muscular como predictores de desenlaces clínicos en pacientes de Unidad de Cuidados Intensivos
title_sort Parámetros de atrofia muscular como predictores de desenlaces clínicos en pacientes de Unidad de Cuidados Intensivos
dc.creator.fl_str_mv Guzmán-David, Cristian Arvey
dc.contributor.advisor.none.fl_str_mv Hernández-Álvarez, Edgar Debray
dc.contributor.author.none.fl_str_mv Guzmán-David, Cristian Arvey
dc.contributor.researchgroup.spa.fl_str_mv Profundización en Kinesioterapia
dc.contributor.orcid.spa.fl_str_mv 0000-0001-6259-8210
dc.contributor.cvlac.spa.fl_str_mv 0001535680
dc.subject.ddc.spa.fl_str_mv 610 - Medicina y salud::612 - Fisiología humana
topic 610 - Medicina y salud::612 - Fisiología humana
Unidad de cuidados intensivos
Trastornos musculares atróficos
Intensive Care Units
Muscular Disorders, Atrophic
Ultrasonografía
Morbilidad
Mortalidad
Unidad de Cuidados Intensivos
Atrofia Muscular
Ultrasonography
Morbidity
Mortality
Intensive Care Units
Muscular Atrophy
dc.subject.decs.spa.fl_str_mv Unidad de cuidados intensivos
Trastornos musculares atróficos
dc.subject.decs.eng.fl_str_mv Intensive Care Units
Muscular Disorders, Atrophic
dc.subject.proposal.spa.fl_str_mv Ultrasonografía
Morbilidad
Mortalidad
Unidad de Cuidados Intensivos
Atrofia Muscular
dc.subject.proposal.eng.fl_str_mv Ultrasonography
Morbidity
Mortality
Intensive Care Units
Muscular Atrophy
description ilustraciones, fotografías
publishDate 2023
dc.date.accessioned.none.fl_str_mv 2023-07-05T14:51:26Z
dc.date.available.none.fl_str_mv 2023-07-05T14:51:26Z
dc.date.issued.none.fl_str_mv 2023-07-04
dc.type.spa.fl_str_mv Trabajo de grado - Maestría
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/masterThesis
dc.type.version.spa.fl_str_mv info:eu-repo/semantics/acceptedVersion
dc.type.content.spa.fl_str_mv Text
dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/TM
status_str acceptedVersion
dc.identifier.uri.none.fl_str_mv https://repositorio.unal.edu.co/handle/unal/84141
dc.identifier.instname.spa.fl_str_mv Universidad Nacional de Colombia
dc.identifier.reponame.spa.fl_str_mv Repositorio Institucional Universidad Nacional de Colombia
dc.identifier.repourl.spa.fl_str_mv https://repositorio.unal.edu.co/
url https://repositorio.unal.edu.co/handle/unal/84141
https://repositorio.unal.edu.co/
identifier_str_mv Universidad Nacional de Colombia
Repositorio Institucional Universidad Nacional de Colombia
dc.language.iso.spa.fl_str_mv spa
language spa
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dc.publisher.faculty.spa.fl_str_mv Facultad de Medicina
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dc.publisher.branch.spa.fl_str_mv Universidad Nacional de Colombia - Sede Bogotá
institution Universidad Nacional de Colombia
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spelling Atribución-NoComercial 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Hernández-Álvarez, Edgar Debrayfa9a7a2690d393738d1bca07e4f117fdGuzmán-David, Cristian Arvey03371a130bc5b062e3bb9bbba0e591c6Profundización en Kinesioterapia0000-0001-6259-821000015356802023-07-05T14:51:26Z2023-07-05T14:51:26Z2023-07-04https://repositorio.unal.edu.co/handle/unal/84141Universidad Nacional de ColombiaRepositorio Institucional Universidad Nacional de Colombiahttps://repositorio.unal.edu.co/ilustraciones, fotografíasLa atrofia muscular implica alteraciones de tipo estructural y funcional relacionadas con la producción de fuerza muscular y movimiento. Esta condición se ha informado como la principal razón de la presencia de debilidad muscular generalizada; refleja la gravedad de la enfermedad y puede tener un impacto profundo en los resultados clínicos a corto y largo plazo, tales como: prolongación del tiempo con soporte ventilatorio, aumento de la estancia en Unidad de Cuidados Intensivos (UCI), disminución del estado funcional, extensión en las cifras de mortalidad, entre otras. Objetivo: Determinar si los parámetros de atrofia muscular mediante ecografía predicen tempranamente la debilidad muscular, morbilidad (días en Ventilación Mecánica (VM), días libres de VM y días de estancia en UCI), y mortalidad a 28 días en pacientes de la UCI del Hospital Universitario Nacional de Colombia. Tipo de estudio: Estudio observacional analítico tipo cohorte prospectiva. Metodología: Se incluyeron pacientes mayores de 18 años con patologías médicas o quirúrgicas, que requerían ventilación mecánica por más de 24 horas. Se excluyeron sujetos con comorbilidades que impedían la valoración de la fuerza muscular. Se registraron variables demográficas, diagnóstico, y factores de riesgo para debilidad muscular. El factor de exposición fue la atrofia muscular medida por ecografía. Los desenlaces considerados fueron fuerza muscular mediante Medical Research Council (MRC), fuerza muscular respiratoria, dinamometría manual y morbimortalidad. El análisis estadístico fue efectuado con el programa IBM-SPSS-Versión 19. Resultados: Se analizaron los resultados de 31 pacientes, 54.8% fue del sexo masculino, la edad promedio fue de 62.52 ±15,39. Las medidas de Área de Sección Transversal (AST) al inicio para cuádriceps derecho e izquierdo fue de 3,89 ±1,48 y 3,78 ±1,44cm2, mientras que el espesor muscular (EM) fue de 1,08 ±0,37 y 1,06 ±0,32cm respectivamente. A las 72 horas todas estas medidas presentaron disminución que osciló entre 5,39 a 16,96%. La atrofia mayor al 10% se presentó en el 58% del total de la cohorte. Se identificaron Odds Ratios (OR) que sugieren riesgo clínico de desenlaces como Debilidad Muscular Adquirida en la Unidad de Cuidados Intensivos (DAUCI) o morbilidad. Conclusión: Los pacientes analizados presentaron una pérdida consistente de la masa muscular en un periodo relativamente temprano. La ecografía muscular puede ser considerada como herramienta para el seguimiento temprano de la pérdida de masa muscular. La presencia de atrofia muscular confiere un mayor riesgo clínico para el desarrollo de DAUCI de extremidades y prensión manual. (Texto tomado de la fuente)Muscle atrophy involves structural and functional alterations related to muscle strength production and movement. This condition has been reported as the main reason for the presence of generalized muscle weakness; it reflects the severity of the disease and can have a profound impact on short- and long-term clinical outcomes, such as: prolongation of time on ventilatory support, increased Intensive Care United (ICU) stay, decreased functional status, increased mortality, among others. Objective: To determine whether muscle atrophy parameters by ultrasound predict early muscle weakness, morbidity (days in Mechanical Ventilation (MV), days free of MV and days of ICU stay), and 28-day mortality in patients in the ICU of the Hospital Universitario Nacional de Colombia. Type of study: Analytical observational prospective cohort study. Methodology: Patients older than 18 years with medical or surgical pathologies that requiring mechanical ventilation for more than 24 hours were included. Subjects with comorbidities that prevented the assessment of muscle strength were excluded. Demographic variables, diagnosis, and risk factors for muscle weakness were recorded. The exposure factor was muscle atrophy measured by ultrasound. The outcomes considered were muscle strength by Medical Research Council (MRC), respiratory muscle strength, manual dynamometry, morbidity and mortality. Statistical analysis was performed with IBM-SPSS-Version 19. Results: The results of 31 patients were analyzed, 54.8% were male, the average age was 62.52 ±15.39. The cross-sectional area (CSA) measurements at baseline for right and left quadriceps were 3.89 ±1.48 and 3.78 ±1.44cm2, while muscle thickness (MT) was 1.08 ±0.37 and 1.06 ±0.32cm respectively. At 72 hours all these measurements showed a decrease ranging from 5.39 to 16.96%. Atrophy greater than 10% was present in 58% of the total cohort. Odds Ratios (OR) were identified suggesting clinical risk of outcomes such as Intensive Care Unit Acquired Muscle Weakness (ICUAW) or morbidity. Conclusion: The patients analyzed presented a consistent loss of muscle mass in a relatively early period. Muscle ultrasound can be considered as a tool for early monitoring of muscle wasting. The presence of muscle atrophy confers an increased clinical risk for the development of limb ICUAW and manual grip.MaestríaMagíster en FisiologíaSalud Muscular, Cuidado Crítico y Biomarcadores101 páginasapplication/pdfspa610 - Medicina y salud::612 - Fisiología humanaUnidad de cuidados intensivosTrastornos musculares atróficosIntensive Care UnitsMuscular Disorders, AtrophicUltrasonografíaMorbilidadMortalidadUnidad de Cuidados IntensivosAtrofia MuscularUltrasonographyMorbidityMortalityIntensive Care UnitsMuscular AtrophyParámetros de atrofia muscular como predictores de desenlaces clínicos en pacientes de Unidad de Cuidados IntensivosParameters of muscle atrophy as predictors of clinical outcomes in intensive care unit patients.Trabajo de grado - Maestríainfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/acceptedVersionTexthttp://purl.org/redcol/resource_type/TMBogotá - Medicina - Maestría en FisiologíaFacultad de MedicinaBogotá,ColombiaUniversidad Nacional de Colombia - Sede BogotáHermans G, Van den Berghe G. 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Crit Care Med. marzo de 2019;47(3):e256.CONVOCATORIA NACIONAL PARA EL FOMENTO DE ALIANZAS INTERDISCIPLINARIAS QUE ARTICULEN INVESTIGACIÓN, CREACIÓN, EXTENSIÓN Y FORMACIÓN EN LA UNIVERSIDAD NACIONAL DE COLOMBIA 2019-2022Dirección Nacional de Investigación y Laboratorios de la Universidad Nacional de ColombiaEstudiantesInvestigadoresMaestrosLICENSElicense.txtlicense.txttext/plain; charset=utf-85879https://repositorio.unal.edu.co/bitstream/unal/84141/1/license.txteb34b1cf90b7e1103fc9dfd26be24b4aMD51ORIGINALTesis ECO-UCI.pdfTesis ECO-UCI.pdfTesis de Maestría en Fisiologíaapplication/pdf2403587https://repositorio.unal.edu.co/bitstream/unal/84141/2/Tesis%20ECO-UCI.pdf6c7103b0eaebb44b70cd56ecc7050fdeMD52THUMBNAILTesis ECO-UCI.pdf.jpgTesis ECO-UCI.pdf.jpgGenerated Thumbnailimage/jpeg4709https://repositorio.unal.edu.co/bitstream/unal/84141/3/Tesis%20ECO-UCI.pdf.jpgacdf92afeeafde7b5523b4f8164b5164MD53unal/84141oai:repositorio.unal.edu.co:unal/841412024-08-13 23:36:58.987Repositorio Institucional 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