{"id":97514,"date":"2018-03-11T10:18:03","date_gmt":"2018-03-11T10:18:03","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/protea%c2%adna-c-reactiva-y-procalcitonina-en-el-postoperatorio-de-ciruga%c2%ada-carda%c2%adaca-pediatrica\/"},"modified":"2018-03-11T10:18:03","modified_gmt":"2018-03-11T10:18:03","slug":"protea%c2%adna-c-reactiva-y-procalcitonina-en-el-postoperatorio-de-ciruga%c2%ada-carda%c2%adaca-pediatrica","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/pediatria\/protea%c2%adna-c-reactiva-y-procalcitonina-en-el-postoperatorio-de-ciruga%c2%ada-carda%c2%adaca-pediatrica\/","title":{"rendered":"Prote\u00edna c reactiva y procalcitonina en el postoperatorio de cirugia card\u00edaca pedi\u00e1trica."},"content":{"rendered":"<h2>Tesis doctoral de <strong> David Crespo Marcos <\/strong><\/h2>\n<p>Objetivos: estudiar el comportamiento de la prote\u00edna c reactiva (pcr) y la procalcitonina (pct) en el postoperatorio de cirug\u00edas intestinal y cardiaca en ni\u00f1os, valorando en la cardiaca su posible correlaci\u00f3n con la morbi-mortalidad, y analizando el papel de ambos reactantes en la detecci\u00f3n precoz de complicaciones graves. m\u00e9todos: estudio prospectivo observacional anal\u00edtico en las unidades de cuidados intensivos pedi\u00e1tricos de los hospitales central de asturias y gregorio mara\u00f1\u00f3n de Madrid.  Se registraron durante las primeras 72 horas los valores de pcr y pct, dividiendo a los ni\u00f1os en 3 grupos: cirug\u00eda card\u00edaca, cirug\u00eda intestinal y grupo control. resultados: se recogieron datos de 193 ni\u00f1os (cirug\u00eda card\u00edaca, n=59; cirug\u00eda intestinal, n=37; grupo control, n=97) a lo largo de 5 a\u00f1os. En cirug\u00eda card\u00edaca, 15 pacientes desarrollaron complicaciones (infecciosas, n=6; hemodin\u00e1micas, n=9). En los 3 grupos se produjo aumento de la pct y la pcr, con valores m\u00e1ximos a las 24 y 48 horas, respectivamente. El ascenso fue superior tras cirug\u00eda intestinal (pct 3,88 ng\/ml; pcr 20,9 mg\/dl) en relaci\u00f3n a cirug\u00eda card\u00edaca (pct 1,82 ng\/ml; pcr 6,9 mg\/dl) y controles (pct 0,73 ng\/ml; pcr 3,5 mg\/dl). No hubo diferencias en las cifras de pct al dividir los ni\u00f1os seg\u00fan la t\u00e9cnica de cirug\u00eda card\u00edaca empleada. Los ni\u00f1os con escala prism > 10 presentaron pct m\u00e1s altas (0,34 ng\/ml a las 24 y 3,65 ng\/ml a las 48 horas) que aquellos con prism \u00c2\u00bf 10  (0,09 ng\/ml y  0,98 ng\/ml). Para identificar complicaciones, obtuvimos unos puntos de corte \u00f3ptimos para pct > 0,17 ng\/ml (sensibilidad 73,3%; especificidad 72,2%) a las 0 y pct > 1,98 ng\/ml (sensibilidad 57,1%; especificidad 87%) a las 24 horas, sin diferencias entre complicaciones infecciosas y hemodin\u00e1micas. Observamos niveles superiores al ingreso en los ni\u00f1os que fallecieron (n=3; pct 1,11 ng\/ml) en comparaci\u00f3n con los supervivientes (n=56; pct 0,14 ng\/ml). conclusiones: las cirug\u00edas en ni\u00f1os inducen aumento de la pct y la pcr, mayor en cirug\u00eda intestinal en relaci\u00f3n a card\u00edaca. La pct, a diferencia de la pcr, se correlaciona con la gravedad,  puede tener capacidad pron\u00f3stica y ser capaz de detectar complicaciones postquir\u00fargicas en el postoperatorio de cirug\u00eda card\u00edaca. El papel de la pct para distinguir distintos tipos de complicaciones es controvertido y requerir\u00e1 la realizaci\u00f3n de estudios m\u00e1s amplios.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Prote\u00edna c reactiva y procalcitonina en el postoperatorio de cirugia card\u00edaca pedi\u00e1trica.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Prote\u00edna c reactiva y procalcitonina en el postoperatorio de cirugia card\u00edaca pedi\u00e1trica. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 David Crespo Marcos <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Oviedo<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 27\/11\/2009<\/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: jose Lopez sastre <\/li>\n<li>julio Ardura fern\u00e1ndez (vocal)<\/li>\n<li>f\u00e9lix Lorente toledano (vocal)<\/li>\n<li>alfredo Blanco quiros (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de David Crespo Marcos Objetivos: estudiar el comportamiento de la prote\u00edna c reactiva (pcr) y la procalcitonina (pct) 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