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dc.contributor.advisorMuñoz Montoya, Juan Estebanspa
dc.contributor.advisorCarreño Rodríguez, José Nelspa
dc.contributor.authorMuñoz Montoya, Juan Esteban
dc.contributor.authorCarreño Rodríguez, José Nel
dc.contributor.authorMaldonado Moran, Miguel Ángel
dc.contributor.authorLuque Suarez, Juan Carlos
dc.coverage.spatialMedicinaspa
dc.date.accessioned2020-03-11T14:26:26Z
dc.date.available2020-03-11T14:26:26Z
dc.date.issued2020-11-07
dc.identifier.urihttp://hdl.handle.net/10654/35091
dc.description.abstractIntroducción: La Hemorragia Subaracnoidea ocupa el 5% de las consultas al servicio de urgencias. Su mortalidad antes de llegar al servicio de urgencias alcanza el 20% y en el primer mes un 40%. El vasoespasmo cerebral es la complicación más temida y más estudiada en la actualidad. Objetivo: Determinar la correlación entre las velocidades sistólicas de la arteria cerebral media evaluadas con doppler transcraneano y los niveles séricos de dióxido de carbono en pacientes con hemorragia subaracnoidea. Metodología: Estudio de corte transversal con componente analítico. Se revisaron las historias clínicas y resultados de Doppler transcraneano (velocidad sistólica de arteria cerebral media derecha (VSACMD) y velocidad sistólica de arteria cerebral media izquierda (VSACMI)) y niveles séricos de dióxido de carbono (CO2), durante los primeros 14 días en los pacientes con diagnóstico de hemorragia subaracnoidea de origen aneurismático. Se utilizó coeficiente de Correlación de Spearman / Pearson para determinar la correlación entre variables. Resultados: Se incluyó un total de 54 pacientes con hemorragia subaracnoidea de origen aneurismático. La complicación más frecuente fue vasoespasmo cerebral, presentándose en 22 pacientes (55,5%). Se realizó el coeficiente de correlación de Spearman / Pearson y se encontró, una correlación positiva entre la VSACMI y VSACMD en el grupo vasoespasmo 0.016 y grupo sin vasoespasmo de 0.000, a diferencia, no se observó una correlación entre los niveles séricos de CO2, las VSACMI y VSACMD, en el grupo de vasoespasmo: VSACMI: 0.81 y VSACMD: 0.61 y grupo sin vasoespasmo: VSACMI: 0.41 y VSACMD: 0.33 con (P >0.05). Conclusiones: En pacientes con hemorragia subaracnoidea, los niveles séricos de CO2 no se correlacionan con las velocidades sistólicas cerebrales. Este hallazgo contradice las teorías sobre la fisiología del CO2 en los vasos sanguíneos cerebrales en población sana. Se requieren más estudios para confirmar este hallazgo. PALABRAS CLAVES: Hemorragia Subaracnoidea, Aneurisma Intracraneal, Vasoespasmo Intracraneal, Ultrasonografía Doppler Transcraneal, Arteria Cerebral Media, Dióxido de Carbono.spa
dc.description.tableofcontentsTABLA DE CONTENIDO CONTENIDO 1. RESUMEN 8 2. IDENTIFICACIÓN Y FORMULACIÓN DEL PROBLEMA 9 3. OBJETIVOS 11 3.1 Objetivo Principal General: 11 3.2 Objetivos Secundarios Específicos: 11 4. METODOLOGÍA 12 a. Clasificación del diseño del estudio 12 b. Lugar donde se realiza la investigación 12 c. Características de la población estudiada: 12 d. Variables que se midieron en el estudio: 12 e. Aspectos del proceso de medición y seguimiento: 13 f. Selección de la muestra: 13 g. Criterios de Inclusión: 13 h. Criterios de Exclusión: 13 5. PLAN DE ANÁLISIS 15 6. ASPECTOS ETICOS 16 7. RESULTADOS 17 8. DISCUSIÓN 28 9. CONCLUSIÓN 35 10. BIBLIOGRAFÍA 36 LISTADO DE TABLAS Tabla 1. Características demográficas de los pacientes con hemorragia subaracnoidea de origen aneurismático 18 Tabla 2: Escalas de severidad y pronóstico en los pacientes con hemorragia subaracnoidea de origen aneurismático 19 Tabla 3: Resultados de velocidades sistólicas de arteria cerebrales medias y nivel de dióxido de carbono en los pacientes con hemorragia subaracnoidea de origen aneurismático. 20 Tabla 5: Comparación de grupos vasoespasmo vs no vasoespasmo en hemorragia subaracnoidea de origen aneurismático. 22 Tabla 6: Correlación de variables de comparación de grupos vasoespasmo vs no vasoespasmo en los pacientes con hemorragia subaracnoidea de origen aneurismático. 23 Tabla 7: Tablas de Spearman Rank para correlación de variables en el grupo de vasoespasmo en pacientes con hemorragia subaracnoidea de origen aneurismático. 24 Tabla 8: Tablas de Spearman Rank para correlación de variables en el grupo de no vasoespasmo en pacientes con hemorragia subaracnoidea de origen aneurismático 26 LISTA DE GRÁFICOS Gráfica 1. Gráfica de correlación de variables en el grupo de vasoespasmo cerebral en hemorragia subaracnoidea de origen aneurismático 25 Gráfica 2. Gráfica de correlación de variables en el grupo de no vasoespasmo cerebral en hemorragia subaracnoidea de origen aneurismático 27 LISTA DE FIGURAS Figura 1. Complicaciones agudas y subagudas de los pacientes con hemorragia subaracnoidea de origen aneurismático. 20spa
dc.formatpdfspa
dc.format.mimetypeapplication/pdfspa
dc.language.isospaspa
dc.language.isospaspa
dc.publisherUniversidad Militar Nueva Granadaspa
dc.rightsDerechos Reservados - Universidad Militar Nueva Granada, 2020spa
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.5/co/spa
dc.titleCorrelación del dióxido de carbono y velocidad sistólica de arteria cerebral media en los pacientes con Hemorragia Subaracnoidea espontánea de origen aneurismáticospa
dc.typeinfo:eu-repo/semantics/bachelorThesisspa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.publisher.departmentFacultad de Medicinaspa
dc.type.localTrabajo de gradospa
dc.description.abstractenglishIntroduction: Subaracnoid hemorrhage occupies 5% of the consultations to the emergency department. Their mortality before reaching the emergency department reaches 20% and in the first month 40%. Cerebral vasospasm is the most feared and most studied complication today. Objective: To determine the correlation between systolic velocities of the middle cerebral artery evaluated with transcranial doppler and serum levels of carbon dioxide in patients with subarachnoid hemorrhage. Methodology: Cross-sectional study with analytical component. The medical records and results of transcranial Doppler (systolic velocity of the right middle cerebral artery (VSACMD) and systolic velocity of the left middle cerebral artery (VSACMI)) and serum levels of carbon dioxide (CO2) were reviewed during the first 14 days in Patients diagnosed with subarachnoid hemorrhage of aneurysmal origin. Spearman / Pearson Correlation coefficient was used to determine the correlation between variables. Results: A total of 54 patients with aneurysmal subarachnoid hemorrhage were included. The most frequent complication was cerebral vasospasm, presenting in 22 patients (55.5%). The Spearman / Pearson correlation coefficient was performed and a positive correlation was found between the VSACMI and VSACMD in the 0.016 vasospasm group and 0.000 vasospasm group, in contrast, no correlation was observed between the serum CO2 levels, the VSACMI and VSACMD, in the vasospasm group: VSACMI: 0.81 and VSACMD: 0.61 and group without vasospasm: VSACMI: 0.41 and VSACMD: 0.33 with (P> 0.05). Conclusions: In patients with subarachnoid hemorrhage, serum CO2 levels do not correlate with cerebral systolic velocities. This finding contradicts the theories about the physiology of CO2 in cerebral blood vessels in a healthy population. More studies are required to confirm this finding. Keywords: Subaracnoid Hemorrhage, Intracranial Aneurysm, Intracranial Vasospasm, Transcranial Doppler Ultrasonography, Middle Cerebral Artery, Carbon Dioxide.eng
dc.title.translatedCarbon dioxide correlation and systolic velocity of the middle cerebral artery in patients with spontaneous subaracnoid hemorrhage of aneurysmal originspa
dc.subject.keywordsSubaracnoid Hemorrhagespa
dc.subject.keywordsIntracranial Aneurysmspa
dc.subject.keywordsIntracranial Vasospasmspa
dc.subject.keywordsTranscranial Doppler Ultrasonographyspa
dc.subject.keywordsMiddle Cerebral Arteryspa
dc.subject.keywordsCarbon Dioxidespa
dc.publisher.programNeurocirugíaspa
dc.creator.degreenameEspecialista en Neurocirugíaspa
dc.subject.decsNEUROCIRUGIA
dc.subject.decsENFERMEDADES HEMORRAGICAS
dc.subject.decsANEURISMA INTRACRANEAL
dc.subject.decsTRASTORNOS CEREBROVASCULARES
dc.contributor.corporatenameUniversidad Militar Nueva Granadaspa
dc.contributor.corporatenameHospital Militar Centralspa
dc.description.degreelevelEspecializaciónspa
dc.publisher.facultyMedicina y Ciencias de la Salud - Neurocirugíaspa
dc.type.dcmi-type-vocabularyTextspa
dc.type.versioninfo:eu-repo/semantics/acceptedVersionspa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadasspa
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dc.subject.proposalHemorragia Subaracnoideaspa
dc.subject.proposalAneurisma Intracranealspa
dc.subject.proposalVasoespasmo Intracranealspa
dc.subject.proposalUltrasonografía Doppler Transcranealspa
dc.subject.proposalArteria Cerebral Mediaspa
dc.subject.proposalDióxido de Carbonospa
dc.description.abstractotherIntrodução: A hemorragia subaracnoide ocupa 5% das consultas ao departamento de emergência. Sua mortalidade antes de chegar ao departamento de emergência chega a 20% e no primeiro mês a 40%. O vasoespasmo cerebral é a complicação mais temida e mais estudada atualmente. Objetivo: Determinar a correlação entre as velocidades sistólicas da artéria cerebral média avaliadas com doppler transcraniano e os níveis séricos de dióxido de carbono em pacientes com hemorragia subaracnóidea. Metodologia: Estudo transversal com componente analítico. Os registros médicos e os resultados do Doppler transcraniano (velocidade sistólica da artéria cerebral média direita (VSACMD) e velocidade sistólica da artéria cerebral média esquerda (VSACMI)) e os níveis séricos de dióxido de carbono (CO2) foram revistos durante os primeiros 14 dias em Pacientes diagnosticados com hemorragia subaracnóidea de origem aneurismática. O coeficiente de correlação de Spearman / Pearson foi utilizado para determinar a correlação entre as variáveis. Resultados: Foram incluídos 54 pacientes com hemorragia subaracnóidea aneurismática. A complicação mais frequente foi o vasoespasmo cerebral, apresentando-se em 22 pacientes (55,5%). O coeficiente de correlação de Spearman / Pearson foi realizado e foi encontrada uma correlação positiva entre o VSACMI e o VSACMD no grupo vasospasmo 0,016 e no grupo vasospasmo 0,000. Por outro lado, nenhuma correlação foi observada entre os níveis séricos de CO2; VSACMI e VSACMD, no grupo vasospasmo: VSACMI: 0,81 e VSACMD: 0,61 e grupo sem vasospasmo: VSACMI: 0,41 e VSACMD: 0,33 com (P> 0,05). Conclusões: Em pacientes com hemorragia subaracnóidea, os níveis séricos de CO2 não se correlacionam com as velocidades sistólicas cerebrais. Esse achado contradiz as teorias sobre a fisiologia do CO2 nos vasos sanguíneos cerebrais em uma população saudável. Mais estudos são necessários para confirmar esse achado. Palavras Chave: Hemorragia subaracnoide, aneurisma intracraniano, vasoespasmo intracraniano, ultrassonografia Doppler transcraniana, artéria cerebral média, dióxido de carbono.


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