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Valoración ecográfica del posicionamiento del tubo endotraqueal en población pediátrica (Estudio piloto)

dc.contributor.advisorRodríguez Gómez, Ciro Alfonsospa
dc.contributor.advisorMeléndez Flórez, Héctor Juliospa
dc.contributor.authorArdila Torres, Luis Guillermospa
dc.coverage.spatialBucaramanga (Santander, Colombia)spa
dc.date.accessioned2020-08-05T16:19:16Z
dc.date.available2020-08-05T16:19:16Z
dc.date.issued2020-06-30
dc.identifier.urihttp://hdl.handle.net/20.500.12749/7158
dc.description.abstractEl propósito del presente estudio es evaluar la utilidad de la ecografía como herramienta diagnóstica para determinar el mal posicionamiento del tubo endotraqueal (TET) en población pediátrica, pues su incidencia reportada es del 30-50%. Nuestra hipótesis infiere que el ultrasonido tiene una sensibilidad y especificidad mayor al 90% para establecer malposición. Métodos: Se recolectó una muestra a conveniencia, prospectiva, de pacientes que fueron intubados para recibir soporte ventilatorio en la Unidad de Cuidados intensivos neonatales, previo aval mediante consentimiento informado, se procedió a realizar la evaluación ecográfica y posterior cotejo con la radiografía de tórax. El resultado primario fue determinar la concordancia de mal posicionamiento del tubo endotraqueal del examen ecográfico y la radiografía de tórax. Resultados: La incidencia de malposición del TET en 14 eventos de intubación evaluados fue del 35,6%, la sensibilidad para determinar malposición por ecografía fue del 40%, la especificidad y el valor predictivo positivo del 100% y un valor predictivo negativo del 75%. Conclusiones: La ecografía es una herramienta útil para determinar una eventual malposición del tubo endotraqueal, soportada en su alta especificidad y alto valor predictivo positivo. Sin embargo, los signos ecográficos que determinan un correcto posicionamiento no son suficientes para determinar su adecuada posición, por lo tanto es necesario confirmarla con la radiografía de tórax, teniendo en cuenta la baja representabilidad muestral del presente estudio, se requieren estudios con un mayor tamaño muestral, con el fin de precisar el conocimiento sobre el rendimiento diagnóstico de la ecografía como herramienta para determinar su correcta o incorrecta posición del TET.spa
dc.description.tableofcontents1. INFORMACIÓN GENERAL DEL PROYECTO DE INVESTIGACIÓN ................................ 4 2. INTRODUCCIÓN ......................................................................................................................... 6 3. PLANTEAMIENTO DEL PROBLEMA ..................................................................................... 7 3.1 PREGUNTA DE INVESTIGACIÓN ........................................................................................9 3.2 HIPÓTESIS INVESTIGATIVA ...............................................................................................9 4. MARCO TEÓRICO .....................................................................................................................9 5. OBJETIVOS .............................................................................................................................. 30 5.1 OBJETIVO GENERAL .......................................................................................................... 30 5.2 OBJETIVOS ESPECÍFICOS .................................................................................................. 31 5. METODOLOGÍA ........................................................................................................................ 31 5.1 Tipo de estudio ................................................................................................................... 31 5.2 Diseño Muestral ................................................................................................................. 31 5.3 Población Elegible ............................................................................................................. 32 5.4 Criterios de selección ....................................................................................................... 32 5.4.1 Criterios de inclusión: ...............................................................................................................................32 5.4.2 Criterios de exclusión: ..............................................................................................................................32 5.5 Variables Resultado (Ver anexo 1). .............................................................................. 33 5.5.1 Variable de Resultado: ..............................................................................................................................33 5.5.2 Variables Independientes: Ver Anexo 1. .............................................................................................35 5.8 Métodos para el control de calidad de los datos ....................................................... 37 5.9 Análisis de los datos .......................................................................................................... 37 5.10 Medidas de Bioseguridad. ............................................................................................. 39 6. CONSIDERACIONES ÉTICAS ................................................................................................. 41 7. IMPACTOS Y PRODUCTOS ESPERADOS ........................................................................... 42 8. CRONOGRAMA DE ACTIVIDADES ...................................................................................... 43 9. PRESUPUESTO.......................................................................................................................... 46 10. RESULTADOS .......................................................................................................................... 47 11. DISCUSIÓN .............................................................................................................................. 53 12. BIBLIOGRAFÍA ....................................................................................................................... 56 13. ANEXOS .................................................................................................................................... 64 13.1 ANEXO 1 ............................................................................................................................. 64 13.2 ANEXO 2 ............................................................................................................................. 67 13.3 ANEXO 3 ............................................................................................................................. 70spa
dc.format.mimetypeapplication/pdfspa
dc.language.isospaspa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.titleValoración ecográfica del posicionamiento del tubo endotraqueal en población pediátrica (Estudio piloto)spa
dc.title.translatedUltrasonographic evaluation of the positioning of the endotracheal tube in the pediatric population (pilot study)eng
dc.degree.nameEspecialista en Anestesiologíaspa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.rights.localAbierto (Texto Completo)spa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.programEspecialización en Anestesiologíaspa
dc.description.degreelevelEspecializaciónspa
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.localTesisspa
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.subject.keywordsAnesthesiologyeng
dc.subject.keywordsMedical scienceseng
dc.subject.keywordsHealth scienceseng
dc.subject.keywordsMedicineeng
dc.subject.keywordsAirway managementeng
dc.subject.keywordsIntratracheal intubationeng
dc.subject.keywordsUltrasonographyeng
dc.subject.keywordsPediatricseng
dc.subject.keywordsUltrasoundeng
dc.subject.keywordsUltrasonic diagnosiseng
dc.subject.keywordsPediatric intensive careeng
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga - UNABspa
dc.identifier.reponamereponame:Repositorio Institucional UNABspa
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.accessrightshttp://purl.org/coar/access_right/c_abf2spa
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dc.contributor.cvlachttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000320609*
dc.contributor.orcidhttps://orcid.org/0000-0003-1791-8099*
dc.subject.lembAnestesiologíaspa
dc.subject.lembCiencias médicasspa
dc.subject.lembMedicinaspa
dc.subject.lembEcografíaspa
dc.subject.lembDiagnóstico ultrasónicospa
dc.subject.lembCuidados intensivos pediátricosspa
dc.identifier.repourlrepourl:https://repository.unab.edu.cospa
dc.description.abstractenglishSummary: The purpose of the present study is to evaluate the usefulness of ultrasound as a diagnostic tool to determine the bad positioning of the endotracheal tube (TET) in the pediatric population, since its reported incidence is 30-50%. Our hypothesis inferred that ultrasound has a sensitivity and specificity greater than 90% to establish malposition. Methods: A prospective sample was collected from patients who were intubated to receive ventilatory support in the Neonatal Intensive Care Unit, after endorsement by informed consent, the ultrasound evaluation was performed and subsequent comparison with the chest x-ray. The primary outcome was to determine the concordance of endotracheal tube mispositioning from ultrasound examination and chest radiography. Results: The incidence of TET malposition in 14 evaluated intubation events was 35.6%, the sensitivity to determine malposition by ultrasound was 40%, the specificity and the positive predictive value of 100% and a negative predictive value of 75 %. Conclusions: Ultrasound is a useful tool to determine an eventual endotracheal tube malposition, supported by its high specificity and high positive predictive value. However, the ultrasound signs that determine a correct positioning are not enough to determine its proper position, therefore it is necessary to confirm it with the chest radiography. Taking into account the low representability of the sample of the present study, studies with a greater sample size are required in order to clarify the knowledge on the diagnostic performance of ultrasound as a tool to determine its correct or incorrect TET position.eng
dc.subject.proposalCiencias de la saludspa
dc.subject.proposalManejo de la vía aéreaspa
dc.subject.proposalIntubación intratraquealspa
dc.subject.proposalUltrasonografíaspa
dc.subject.proposalPediatríaspa
dc.type.redcolhttp://purl.org/redcol/resource_type/TM
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*
dc.coverage.campusUNAB Campus Bucaramangaspa
dc.description.learningmodalityModalidad Presencialspa


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Atribución-NoComercial-SinDerivadas 2.5 Colombia
Excepto si se señala otra cosa, la licencia del ítem se describe como Atribución-NoComercial-SinDerivadas 2.5 Colombia