Terapia transfusional y técnicas de ahorro sanguíneo intraoperatorio en pacientes sometidos a cirugía no cardiaca. Recomendaciones basadas en síntesis de la evidencia

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dc.contributor.advisorVásquez Hernández, Skarlet Marcell
dc.contributor.advisorÁlvarez Robles, Saul
dc.contributor.apolounabVásquez Hernández, Skarlet Marcell [skarlet-m-vásquez]spa
dc.contributor.authorSerrano Vásquez, Rafael Enrique
dc.contributor.cvlacVásquez Hernández, Skarlet Marcell [0001349039]spa
dc.contributor.cvlacÁlvarez Robles, Saul [0000833797]spa
dc.contributor.orcidVásquez Hernández, Skarlet Marcell [0000-0003-2552-9819]spa
dc.contributor.orcidÁlvarez Robles, Saul [0000-0002-3676-0058]spa
dc.coverage.campusUNAB Campus Bucaramangaspa
dc.coverage.spatialBucaramanga (Santander, Colombia)spa
dc.coverage.temporal2022 - 2024spa
dc.date.accessioned2024-05-20T16:44:38Z
dc.date.available2024-05-20T16:44:38Z
dc.date.issued2024-04-22
dc.degree.nameMagíster en Métodos para la Producción y Aplicación de Conocimiento Científico en Saludspa
dc.description.abstractA nivel mundial, muchas cirugías mayores requieren transfusiones, lo que conlleva riesgos de reacciones adversas e infecciones. A pesar de las técnicas disponibles para reducir la necesidad de transfusiones, muchas guías clínicas están desactualizadas y no cubren todas las poblaciones de pacientes no cardíacos. Este estudio tiene como objetivo desarrollar recomendaciones para la terapia transfusional y las técnicas de ahorro sanguíneo en cirugías no cardíacas, utilizando la metodología GRADE. Se formularon cinco preguntas PICO tras una búsqueda sistemática y revisión de la literatura, priorizando revisiones sistemáticas y ensayos clínicos aleatorizados. Se evaluó el riesgo de sesgo y la certeza de la evidencia con herramientas AMSTAR II y Rob-2. Las recomendaciones finales se basan en seis estudios clave y un marco EtD, destacando la necesidad de ensayos clínicos más robustos y mejor diseñados.spa
dc.description.abstractenglishGlobally, many major surgeries require transfusions, which carry risks of adverse reactions and infections. Despite the available techniques to reduce the need for transfusions, many clinical guidelines are outdated and do not cover all non-cardiac patient populations. This study aims to develop recommendations for transfusion therapy and blood conservation techniques in non-cardiac surgeries using the GRADE methodology. Five PICO questions were formulated after a systematic search and literature review, prioritizing systematic reviews and randomized clinical trials. The risk of bias and the certainty of evidence were assessed using AMSTAR II and Rob-2 tools. The final recommendations are based on six key studies and an EtD framework, highlighting the need for more robust and well-designed clinical trials.spa
dc.description.degreelevelMaestríaspa
dc.description.learningmodalityModalidad Presencialspa
dc.description.tableofcontents1. TITULO DEL PROYECTO 8 2. RESUMEN 8 3. DESCRIPCION DEL PROYECTO 12 3.1. PLANTEAMIENTO Y JUSTIFICACION DEL PROBLEMA 12 3.2. MARCO TEORICO 14 3.3. ESTADO DEL ARTE 18 3.4. OBJETIVOS 21 3.4.1. Objetivo General 23 3.4.2. Objetivos específicos 23 3.5. METODOLOGIA 23 3.5.1. Selección de las preguntas PICO 23 3.5.2. Estrategias de búsqueda de la literatura 26 3.5.3. Selección de los estudios 27 3.5.4. Evaluación de la calidad metodológica 28 3.5.5. Generación de recomendaciones basadas en la evidencia 28 3.5.6. Modificaciones al protocolo 29 4. RESULTADOS – DESARROLLO DE LAS PREGUNTAS 30 4.1. PREGUNTA PICO 1 30 4.1.1. Estudios de referencia y desenlaces extraídos 30 4.1.2. Juicios 33 4.1.3. Formulación de la recomendación pregunta PICO 1 36 4.2. PREGUNTA PICO 2 37 4.2.1. Estudios de referencia y desenlaces extraídos 37 4.2.2. Formulación de la recomendación pregunta PICO 2 43 4.3. PREGUNTA PICO 3 44 4.3.1. Estudios de referencia y desenlaces extraídos 44 4.3.2. Juicios 55 4.3.3. Formulación de la recomendación pregunta PICO 3 58 4.4. PREGUNTA PICO 4 58 4.4.1. Estudios de referencia y desenlaces extraídos 58 4.4.2. Juicios 62 4.4.3. Formulación de la recomendación pregunta PICO 4 64 4.5. PREGUNTA PICO 5 65 4.5.1. Estudios de referencia y desenlaces extraídos 65 4.5.2. Juicios 69 4.5.3. Formulación de la recomendación pregunta PICO 5 71 5. CONCLUSIONES 74 6. REFERENCIAS BIBLIOGRAFICAS 75 7. ANEXOSspa
dc.format.mimetypeapplication/pdfspa
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga - UNABspa
dc.identifier.reponamereponame:Repositorio Institucional UNABspa
dc.identifier.repourlrepourl:https://repository.unab.edu.cospa
dc.identifier.urihttp://hdl.handle.net/20.500.12749/24651
dc.language.isospaspa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.publisher.programMaestría en Métodos para la Producción y Aplicación de Conocimiento Científico en Saludspa
dc.publisher.programidMPA-2236
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dc.relation.references72. Houston BL, Uminski K, Mutter T, Rimmer E, Houston DS, Menard CE, Garland A, Ariano R, Tinmouth A, Abou-Setta AM, Rabbani R, Neilson C, Rochwerg B, Turgeon AF, Falk J, Breau RH, Fergusson DA, Zarychanski R. Efficacy and Safety of Tranexamic Acid in Major Non-Cardiac Surgeries at High Risk for Transfusion: A Systematic Review and MetaAnalysis. Transfus Med Rev. 2020 Jan;34(1):51-62. doi: 10.1016/j.tmrv.2019.10.001. Epub 2019 Oct 23. PMID: 31982293.spa
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dc.relation.references84. Bouzat P, Charbit J, Abback PS, Huet-Garrigue D, Delhaye N, Leone M, Marcotte G, David JS, Levrat A, Asehnoune K, Pottecher J, Duranteau J, Courvalin E, Adolle A, Sourd D, Bosson JL, Riou B, Gauss T, Payen JF; PROCOAG Study Group. Efficacy and Safety of Early Administration of 4-Factor Prothrombin Complex Concentrate in Patients With Trauma at Risk of Massive Transfusion: The PROCOAG Randomized Clinical Trial. JAMA. 2023 Apr 25;329(16):1367-1375. doi: 10.1001/jama.2023.4080. PMID: 36942533; PMCID: PMC10031505.spa
dc.relation.references85. Maegele M, Lefering R, Yucel N, et al. Early coagulopathy in multiple injury: an analysis from the German trauma registry on 8724 patients. Injury. 2007;38:298-304.spa
dc.relation.references86. Bassin L, Stone M, Krol M, Reich DL. Risk factors for intraoperative coagulopathy in cardiac surgery. Heart Lung Circ. 2010;19:506.spa
dc.relation.references87. Silvergleid AJ. Inmunologic transfusión reactions. UpToDate. Disponible en: https://www.uptodate.com/contents/immunologic-transfusion-reactionsspa
dc.relation.references88. Kleinman S, Kor DJ. Transfusion-related acute lung injury (TRALI). UpToDate. Disponible en: https://www.uptodate.com/contents/transfusion-related-acute-lung-injury-tralispa
dc.relation.references89. Khan S, Davenport R, Raza I, et al. Damage control resuscitation using blood component therapy in standard doses has a limited effect on coagulopathy during trauma hemorrhage. Intensive Care Med. 2015;41:239-247.spa
dc.relation.references90. Franchini M, Lippi G. Prothrombin complex concentrates: an update. Blood Transfus. 2010;8(3):149-154. doi:10.2450/2010.0149-09spa
dc.relation.uriapolohttps://apolo.unab.edu.co/en/persons/skarlet-m-v%C3%A1squezspa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*
dc.rights.localAbierto (Texto Completo)spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.subject.keywordsMedical sciencesspa
dc.subject.keywordsHealth sciencesspa
dc.subject.keywordsNon-cardiac surgeryspa
dc.subject.keywordsBlood-saving techniquesspa
dc.subject.keywordsPlasma exchangespa
dc.subject.keywordsBlood (Transfusion)spa
dc.subject.keywordsBlood cellsspa
dc.subject.keywordsLiterature reviewspa
dc.subject.keywordsInformation storage and retrieval systemsspa
dc.subject.lembCiencias médicasspa
dc.subject.lembIntercambio plasmáticospa
dc.subject.lembTransfusión de sangrespa
dc.subject.lembCélulas sanguíneasspa
dc.subject.lembRevisión de literaturaspa
dc.subject.lembSistemas de almacenamiento y recuperación de informaciónspa
dc.subject.proposalCiencias de la saludspa
dc.subject.proposalTransfusiónspa
dc.subject.proposalCirugía no cardiacaspa
dc.subject.proposalTécnicas de ahorro sanguíneospa
dc.subject.proposalGRADEspa
dc.titleTerapia transfusional y técnicas de ahorro sanguíneo intraoperatorio en pacientes sometidos a cirugía no cardiaca. Recomendaciones basadas en síntesis de la evidenciaspa
dc.title.translatedTransfusion Therapy and Intraoperative Blood Conservation Techniques in Patients Undergoing Non-Cardiac Surgery. Evidence-Based Recommendationsspa
dc.typeThesiseng
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.type.coarversionhttp://purl.org/coar/version/c_ab4af688f83e57aaspa
dc.type.driverinfo:eu-repo/semantics/masterThesisspa
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersionspa
dc.type.localTesisspa
dc.type.redcolhttp://purl.org/redcol/resource_type/TMspa

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Maestría en Métodos para la Producción y Aplicación de Conocimiento Científico en Salud