{"id":14972,"date":"2018-03-09T09:01:55","date_gmt":"2018-03-09T09:01:55","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/respuesta-de-estres-en-el-nino-cra%c2%adtico\/"},"modified":"2018-03-09T09:01:55","modified_gmt":"2018-03-09T09:01:55","slug":"respuesta-de-estres-en-el-nino-cra%c2%adtico","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/respuesta-de-estres-en-el-nino-cra%c2%adtico\/","title":{"rendered":"Respuesta de estr\u00e9s en el ni\u00f1o cr\u00edtico"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Jos\u00e9 Andr\u00e9s Concha Torre <\/strong><\/h2>\n<p>En el ni\u00f1o cr\u00edtico existe una respuesta al da\u00f1o org\u00e1nico grave y la infecci\u00f3n que tiene como misi\u00f3n mantener el equilibrio del medio interno. se producen una serie de cambios debidos a una respuesta endocrina, metab\u00f3lica, hemodin\u00e1mica e inflamatoria a la agresi\u00f3n. Esta respuesta puede ser insuficiente, adecuada o excesiva. Las respuestas insuficiente y excesiva son inadecuadas y, si persiten en el tiempo, perjudicales para el propio paciente. La situaci\u00f3n ideal consistir\u00eda en encontrar una serie de marcadores en fases precoces de la respuesta al estr\u00e9s que nos orientan sobre la evoluci\u00f3n final del paciente.  para ello se estudiaron dos grupos de pacientes (infecci\u00f3n meningoc\u00f3cica y politraumatismo) y se midieron al ingreso catecolaminas, cortisol, insulina, citoquinas proinflamatorias,procalcitonina y prote\u00edna c reactiva en plasma, as\u00ed como catecolaminas y cortisol en orina. En la segunda parte del estudio se observ\u00f3 la evoluci\u00f3n de procalcitonina y prote\u00edna c reactiva en los cinco primeros d\u00edas de ingreso. La gravedad de los pacientes se valor\u00f3 mediante el pediatric risk of mortality score (prism), el therapeutic intervention scoring system (tiss), clasificaci\u00f3n de hayden del proceso s\u00e9ptico (en infecciones) y el pediatric trauma score (pts) en politraumatismos. Las variables de estudio se relacionaron con la evoluci\u00f3n final de los pacientes: favorable o desfavorable (aparici\u00f3n de secuelas o exitus).  ambos grupos de pacientes presentaron respuestas sist\u00e9mica al estr\u00e9s. en los pacientes con infecci\u00f3n meningoc\u00f3cica se observ\u00f3 una respuesta diferente en funci\u00f3n de la gravedad inicial del cuadro y de la evoluci\u00f3n final, hecho que no ocurri\u00f3 en los plitraumatizados. Al estratificar a los pacientes por gravedad mediante an\u00e1lisis discriminante y comparar las dos patolog\u00edas, se observ\u00f3 que la respuesta de estr\u00e9s no es universal, ya que el de los politraumatismos. Al estudiar la evoluci\u00f3n de la procalcitoni<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Respuesta de estr\u00e9s en el ni\u00f1o cr\u00edtico<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Respuesta de estr\u00e9s en el ni\u00f1o cr\u00edtico <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Jos\u00e9 Andr\u00e9s Concha Torre <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Oviedo<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 21\/12\/2001<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Manuel Crespo Hernandez<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: alfredo Blanco quiros <\/li>\n<li>Jos\u00e9 Mar\u00eda Martinon sanchez (vocal)<\/li>\n<li> L\u00f3pez sastre Jos\u00e9 blas (vocal)<\/li>\n<li>Jos\u00e9 Paz jimen\u00e9z (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Jos\u00e9 Andr\u00e9s Concha Torre En el ni\u00f1o cr\u00edtico existe una respuesta al da\u00f1o org\u00e1nico grave y la [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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