Factores de riesgo para transfusión intraoperatoria de globulos rojos en trasplante hepático en la Fundación Cardioinfatil

Introducción: El trasplante hepático es un procedimiento salvador en pacientes con patología hepática terminal. La hemorragia que requiere transfusión de glóbulos rojos empaquetados (GRE) es una de las complicaciones más frecuentes y se asocia con un aumento de la morbimortalidad. Objetivo: Identifi...

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Autor Principal: Ballen Tole, Manuel Camilo
Otros Autores: Franco Gruntorad, Germán Andrés
Formato: Tesis de maestría (Master Thesis)
Lenguaje:Español (Spanish)
Publicado: Universidad del Rosario 2018
Materias:
Acceso en línea:http://repository.urosario.edu.co/handle/10336/18312
id ir-10336-18312
recordtype dspace
institution EdocUR - Universidad del Rosario
collection DSpace
language Español (Spanish)
topic Trasplante hepático
Transfusión
Glóbulos rojos
Glóbulos rojos empaquetados
Factores de riesgo
Salvador de células hemoglobina
Varias ramas de la medicina, Cirugía
Trasplantes de hígado
Eritrocitos
Tranfusion
Liver transplant
Red blood cells
Risk factors
Cell saver
Hemoglobin
spellingShingle Trasplante hepático
Transfusión
Glóbulos rojos
Glóbulos rojos empaquetados
Factores de riesgo
Salvador de células hemoglobina
Varias ramas de la medicina, Cirugía
Trasplantes de hígado
Eritrocitos
Tranfusion
Liver transplant
Red blood cells
Risk factors
Cell saver
Hemoglobin
Ballen Tole, Manuel Camilo
Factores de riesgo para transfusión intraoperatoria de globulos rojos en trasplante hepático en la Fundación Cardioinfatil
description Introducción: El trasplante hepático es un procedimiento salvador en pacientes con patología hepática terminal. La hemorragia que requiere transfusión de glóbulos rojos empaquetados (GRE) es una de las complicaciones más frecuentes y se asocia con un aumento de la morbimortalidad. Objetivo: Identificar factores de riesgo asociados a la transfusión de GRE durante el intraoperatorio en los pacientes adultos sometidos a trasplante hepático en la Fundación CardioInfantil. Métodos: Estudio analítico de casos y controles, se dividió la población de pacientes que fueron llevados al procedimiento en aquellos que requirieron transfusión de GRE y aquellos que no, se analizaron factores de riesgo identificados y conductas que podrían disminuir la probabilidad de transfusión de GRE. La población de referencia fueron los pacientes en quienes se realizó trasplante hepático ortotópico durante 2013-2017. Resultados: Se identificaron 190 procedimientos, la frecuencia de transfusión de GRE fue de 54,2%, posterior al análisis multivariado contrario a lo que había sido concluido por otros investigadores el uso de salvador de células se comportó como factor de riesgo; coincidiendo con lo reportado por otros grupos de trasplante hepático el tiempo de fase anhepática superior a 50 minutos, edad del donante mayor a 39,5 años y como factor protector hemoglobina (Hb) mayor a 12,6 g/dl siendo este último parámetro el que puede ser optimizado previo al procedimiento. Discusión: Se considera que para optimizar la morbimortalidad de los pacientes que van a ser llevados a este procedimiento se debe optimizar la Hb mientras el paciente se encuentre en lista de espera.
author2 Franco Gruntorad, Germán Andrés
author_facet Franco Gruntorad, Germán Andrés
Ballen Tole, Manuel Camilo
format Tesis de maestría (Master Thesis)
author Ballen Tole, Manuel Camilo
author_sort Ballen Tole, Manuel Camilo
title Factores de riesgo para transfusión intraoperatoria de globulos rojos en trasplante hepático en la Fundación Cardioinfatil
title_short Factores de riesgo para transfusión intraoperatoria de globulos rojos en trasplante hepático en la Fundación Cardioinfatil
title_full Factores de riesgo para transfusión intraoperatoria de globulos rojos en trasplante hepático en la Fundación Cardioinfatil
title_fullStr Factores de riesgo para transfusión intraoperatoria de globulos rojos en trasplante hepático en la Fundación Cardioinfatil
title_full_unstemmed Factores de riesgo para transfusión intraoperatoria de globulos rojos en trasplante hepático en la Fundación Cardioinfatil
title_sort factores de riesgo para transfusión intraoperatoria de globulos rojos en trasplante hepático en la fundación cardioinfatil
publisher Universidad del Rosario
publishDate 2018
url http://repository.urosario.edu.co/handle/10336/18312
_version_ 1694382445960364032
spelling ir-10336-183122021-03-01T19:22:51Z Factores de riesgo para transfusión intraoperatoria de globulos rojos en trasplante hepático en la Fundación Cardioinfatil Ballen Tole, Manuel Camilo Franco Gruntorad, Germán Andrés Alzate, Juan Pablo Mejia, Gilberto Rivera, Jairo Trasplante hepático Transfusión Glóbulos rojos Glóbulos rojos empaquetados Factores de riesgo Salvador de células hemoglobina Varias ramas de la medicina, Cirugía Trasplantes de hígado Eritrocitos Tranfusion Liver transplant Red blood cells Risk factors Cell saver Hemoglobin Introducción: El trasplante hepático es un procedimiento salvador en pacientes con patología hepática terminal. La hemorragia que requiere transfusión de glóbulos rojos empaquetados (GRE) es una de las complicaciones más frecuentes y se asocia con un aumento de la morbimortalidad. Objetivo: Identificar factores de riesgo asociados a la transfusión de GRE durante el intraoperatorio en los pacientes adultos sometidos a trasplante hepático en la Fundación CardioInfantil. Métodos: Estudio analítico de casos y controles, se dividió la población de pacientes que fueron llevados al procedimiento en aquellos que requirieron transfusión de GRE y aquellos que no, se analizaron factores de riesgo identificados y conductas que podrían disminuir la probabilidad de transfusión de GRE. La población de referencia fueron los pacientes en quienes se realizó trasplante hepático ortotópico durante 2013-2017. Resultados: Se identificaron 190 procedimientos, la frecuencia de transfusión de GRE fue de 54,2%, posterior al análisis multivariado contrario a lo que había sido concluido por otros investigadores el uso de salvador de células se comportó como factor de riesgo; coincidiendo con lo reportado por otros grupos de trasplante hepático el tiempo de fase anhepática superior a 50 minutos, edad del donante mayor a 39,5 años y como factor protector hemoglobina (Hb) mayor a 12,6 g/dl siendo este último parámetro el que puede ser optimizado previo al procedimiento. Discusión: Se considera que para optimizar la morbimortalidad de los pacientes que van a ser llevados a este procedimiento se debe optimizar la Hb mientras el paciente se encuentre en lista de espera. Introduction: Liver transplant is a salvage procedure in patients with terminal liver pathology. Hemorrhage with requirement of red blood cell (RBC) transfusion is a common complication associated with increased morbidity and mortality. Objective: To Recognize risk factors associated with intraoperative use of RBC transfusion in adult patients undergoing liver transplantation at CardioInfantil Foundation Center. Method: Sample population consists of patients who required orthotopic liver transplant between 2013-2017. A case control study was performed. the group of patients undergoing the procedure was divided between patients who required RBC transfusion and those who did not require RBC transfusion, risk factors and strategies that could decrease RBC transfusion were analyzed. Results: 190 procedures were included, RBC transfusion requirement frequency was 54,2%; after multivariate analysis and contrary to previous publications, use of cell saver was a risk factor RBC transfusion. Like results reported by other liver transplant groups anhepatic phase more than 50 minutes, donor age more than 39,5 years old and hemoglobin (hb) greater than 12,6 g/dl were protector variables for RBC transfusion. Discussion: To optimize morbidity and mortality of patients undergoing liver transplantation, hb must be optimized. 2019-08-18 01:01:01: Script de automatizacion de embargos. info:eu-repo/date/embargoEnd/2019-08-17 2018-07-26 2018-08-17T20:28:31Z info:eu-repo/semantics/masterThesis info:eu-repo/semantics/acceptedVersion http://repository.urosario.edu.co/handle/10336/18312 spa info:eu-repo/semantics/openAccess application/pdf Universidad del Rosario Especialización en Anestesiología FCI Facultad de Medicina instname:Universidad del Rosario reponame:Repositorio Institucional EdocUR Parra CO, Cirujana M, María L, Arrázola O, Posso H, Asesor V. Survival in Patients with Liver Transplantation performed in the Fundación Cardioinfantil between 2005 and 2013 Camila. 2015;1–53. Available from: http://repository.urosario.edu.co/bitstream/handle/10336/10554/1015398846-2015.pdf?sequence=1&isAllowed=y Mejía GA, Olarte-Parra C, Pedraza A, Rivera JB, Benavides CA. 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