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Autor Marisol Bedoya Arias
Comentario :
Jefe Departamento de Gestión Información Clínica, Hospital Pablo Tobón Uribe
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Documentos disponibles escritos por este autor (3)
Clasificado(s) por (Año de edición descendente) Refinar búsquedaThe potential impact of admission insulin levels on patient outcome in the intensive care unit / Gisela de la Rosa Echavez ; Esdras Martín Vásquez Mejía ; Jorge Hernando Donado Gómez ; Marisol Bedoya Arias ; Álvaro Humberto Restrepo Cuartas ; Gustavo Roncancio ; Carlos Alberto Cadavid Gutiérrez ; Fabián Alberto Jaimes Barragán
Título : The potential impact of admission insulin levels on patient outcome in the intensive care unit Tipo de documento : documento electrónico Autores : Gisela de la Rosa Echavez, ; Esdras Martín Vásquez Mejía, ; Jorge Hernando Donado Gómez, ; Marisol Bedoya Arias, ; Álvaro Humberto Restrepo Cuartas, ; Gustavo Roncancio, ; Carlos Alberto Cadavid Gutiérrez, ; Fabián Alberto Jaimes Barragán, Fecha de publicación : 2013 Títulos uniformes : Journal of Trauma and Acute Care Surgery Idioma : Inglés (eng) Palabras clave : Insulin insulin resistance critical care critical illness outcome Resumen : Background: Blood levels of insulin in patients with critical illness at admission to the intensive care unit (ICU) and its association with in hospital mortality are not fully defined. Our objective was to determine this association in a cohort of patients with critical illness who attended in a mixed ICU. Methods: Prospective cohort was nested in a randomized clinical trial conducted in a 12-bed mixed ICU in a tertiary hospital in Medellin (Colombia). One hundred sixty consecutively admitted patients, 15 years or older, were analyzed. Blood insulin and blood glucose levels were measured at admission to the ICU, as well as Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. A logistic regression model was created with in-hospital mortality as the outcome. Results: In-hospital mortality was 57 (35.6%) of 160. Survivors had lower Acute Physiology and Chronic Health Evaluation II (median, 13 vs. 17) and lower insulin levels (median, 6.5 vs. 9 µU/mL) than did nonsurvivors. More women than men died (27 [48.2%] of 56 vs. 30 [28.8%] of 104), and 39% of the deaths (n = 22) occurred in patients with sepsis. Patients with insulin levels greater than 15 µU/mL had a higher mortality rate compared with patients with values of 5 µU/mL to 15 µU/mL (odds ratio, 3.57; 95% confidence interval, 1.18–10.8). Conclusion: At admission to the ICU, patients with critical illness showed hyperglycemia and relatively decreased insulin levels. High levels of insulin were independently associated with in-hospital mortality in this study population. Mención de responsabilidad : Gisela De La Rosa, Esdras Martin Vasquez, Alvaro Mauricio Quintero, Jorge Hernando Donado, Marisol Bedoya, Alvaro Humberto Restrepo, Gustavo Roncancio, Carlos Alberto Cadavid, Fabian Alberto Jaimes, Grupo de Investigacion en Cuidado Intensivo GICI-HPTU Referencia : J Trauma Acute Care Surg. 2013 Jan;74(1):270-5. DOI (Digital Object Identifier) : 10.1097/TA.0b013e3182788042 PMID : 23271103 En línea : https://journals.lww.com/jtrauma/Abstract/2013/01000/The_potential_impact_of_adm [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3660 The potential impact of admission insulin levels on patient outcome in the intensive care unit [documento electrónico] / Gisela de la Rosa Echavez, ; Esdras Martín Vásquez Mejía, ; Jorge Hernando Donado Gómez, ; Marisol Bedoya Arias, ; Álvaro Humberto Restrepo Cuartas, ; Gustavo Roncancio, ; Carlos Alberto Cadavid Gutiérrez, ; Fabián Alberto Jaimes Barragán, . - 2013.
Obra : Journal of Trauma and Acute Care Surgery
Idioma : Inglés (eng)
Palabras clave : Insulin insulin resistance critical care critical illness outcome Resumen : Background: Blood levels of insulin in patients with critical illness at admission to the intensive care unit (ICU) and its association with in hospital mortality are not fully defined. Our objective was to determine this association in a cohort of patients with critical illness who attended in a mixed ICU. Methods: Prospective cohort was nested in a randomized clinical trial conducted in a 12-bed mixed ICU in a tertiary hospital in Medellin (Colombia). One hundred sixty consecutively admitted patients, 15 years or older, were analyzed. Blood insulin and blood glucose levels were measured at admission to the ICU, as well as Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. A logistic regression model was created with in-hospital mortality as the outcome. Results: In-hospital mortality was 57 (35.6%) of 160. Survivors had lower Acute Physiology and Chronic Health Evaluation II (median, 13 vs. 17) and lower insulin levels (median, 6.5 vs. 9 µU/mL) than did nonsurvivors. More women than men died (27 [48.2%] of 56 vs. 30 [28.8%] of 104), and 39% of the deaths (n = 22) occurred in patients with sepsis. Patients with insulin levels greater than 15 µU/mL had a higher mortality rate compared with patients with values of 5 µU/mL to 15 µU/mL (odds ratio, 3.57; 95% confidence interval, 1.18–10.8). Conclusion: At admission to the ICU, patients with critical illness showed hyperglycemia and relatively decreased insulin levels. High levels of insulin were independently associated with in-hospital mortality in this study population. Mención de responsabilidad : Gisela De La Rosa, Esdras Martin Vasquez, Alvaro Mauricio Quintero, Jorge Hernando Donado, Marisol Bedoya, Alvaro Humberto Restrepo, Gustavo Roncancio, Carlos Alberto Cadavid, Fabian Alberto Jaimes, Grupo de Investigacion en Cuidado Intensivo GICI-HPTU Referencia : J Trauma Acute Care Surg. 2013 Jan;74(1):270-5. DOI (Digital Object Identifier) : 10.1097/TA.0b013e3182788042 PMID : 23271103 En línea : https://journals.lww.com/jtrauma/Abstract/2013/01000/The_potential_impact_of_adm [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3660 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000233 AC-2013-001 Archivo digital Producción Científica Artículos científicos Disponible 
Título : Strict glycaemic control in patients hospitalised in a mixed medical and surgical intensive care unit: a randomised clinical trial Tipo de documento : documento electrónico Autores : Gisela de la Rosa Echavez, ; Jorge Hernando Donado Gómez, ; Álvaro Humberto Restrepo Cuartas, ; Nora Elena Saldarriaga Cartagena, ; Marisol Bedoya Arias, ; Juan Manuel Toro Escobar, ; Jorge Byron Velásquez Botero, ; Juan Carlos Valencia, ; Pablo Henrique Alemán Ochoa, ; Clara María Arango Toro, ; Esdras Martín Vásquez Mejía, ; Juan Carlos Chavarriaga Zapata, ; Andrés Yepes Pérez, ; William Pulido, ; Carlos Alberto Cadavid Gutiérrez, Fecha de publicación : 2008 Títulos uniformes : Critical Care Idioma : Inglés (eng) Resumen : Introduction: Critically ill patients can develop hyperglycaemia even if they do not have diabetes. Intensive insulin therapy decreases morbidity and mortality rates in patients in a surgical intensive care unit (ICU) and decreases morbidity in patients in a medical ICU. The effect of this therapy on patients in a mixed medical/surgical ICU is unknown. Our goal was to assess whether the effect of intensive insulin therapy, compared with standard therapy, decreases morbidity and mortality in patients hospitalised in a mixed ICU. Methods: This is a prospective, randomised, non-blinded, single-centre clinical trial in a medical/surgical ICU. Patients were randomly assigned to receive either intensive insulin therapy to maintain glucose levels between 80 and 110 mg/dl (4.4 to 6.1 mmol/l) or standard insulin therapy to maintain glucose levels between 180 and 200 mg/dl (10 and 11.1 mmol/l). The primary end point was mortality at 28 days. Results: Over a period of 30 months, 504 patients were enrolled. The 28-day mortality rate was 32.4% (81 of 250) in the standard insulin therapy group and 36.6% (93 of 254) in the intensive insulin therapy group (Relative Risk [RR]: 1.1; 95% confidence interval [CI]: 0.85 to 1.42). The ICU mortality in the standard insulin therapy group was 31.2% (78 of 250) and 33.1% (84 of 254) in the intensive insulin therapy group (RR: 1.06; 95%CI: 0.82 to 1.36). There was no statistically significant reduction in the rate of ICU-acquired infections: 33.2% in the standard insulin therapy group compared with 27.17% in the intensive insulin therapy group (RR: 0.82; 95%CI: 0.63 to 1.07). The rate of hypoglycaemia (≤ 40 mg/dl) was 1.7% in the standard insulin therapy group and 8.5% in the intensive insulin therapy group (RR: 5.04; 95% CI: 1.20 to21.12). Conclusions: IIT used to maintain glucose levels within normal limits did not reduce morbidity or mortality of patients admitted to a mixed medical/surgical ICU. Furthermore, this therapy increased the risk of hypoglycaemia. Mención de responsabilidad : Gisela Del Carmen De La Rosa, Jorge Hernando Donado, Alvaro Humberto Restrepo, Alvaro Mauricio Quintero, Luis Gabriel González, Nora Elena Saldarriaga, Marisol Bedoya, Juan Manuel Toro, Jorge Byron Velásquez, Juan Carlos Valencia, Clara Maria Arango, Pablo Henrique Aleman, Esdras Martin Vasquez, Juan Carlos Chavarriaga, Andrés Yepes, William Pulido, Carlos Alberto Cadavid & Grupo de Investigacion en Cuidado intensivo: GICI-HPTU Referencia : Crit Care. 2008;12(5):R120. DOI (Digital Object Identifier) : 10.1186/cc7017 PMID : 18799004 Derechos de uso : CC BY En línea : https://ccforum.biomedcentral.com/articles/10.1186/cc7017 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3467 Strict glycaemic control in patients hospitalised in a mixed medical and surgical intensive care unit: a randomised clinical trial [documento electrónico] / Gisela de la Rosa Echavez, ; Jorge Hernando Donado Gómez, ; Álvaro Humberto Restrepo Cuartas, ; Nora Elena Saldarriaga Cartagena, ; Marisol Bedoya Arias, ; Juan Manuel Toro Escobar, ; Jorge Byron Velásquez Botero, ; Juan Carlos Valencia, ; Pablo Henrique Alemán Ochoa, ; Clara María Arango Toro, ; Esdras Martín Vásquez Mejía, ; Juan Carlos Chavarriaga Zapata, ; Andrés Yepes Pérez, ; William Pulido, ; Carlos Alberto Cadavid Gutiérrez, . - 2008.
Obra : Critical Care
Idioma : Inglés (eng)
Resumen : Introduction: Critically ill patients can develop hyperglycaemia even if they do not have diabetes. Intensive insulin therapy decreases morbidity and mortality rates in patients in a surgical intensive care unit (ICU) and decreases morbidity in patients in a medical ICU. The effect of this therapy on patients in a mixed medical/surgical ICU is unknown. Our goal was to assess whether the effect of intensive insulin therapy, compared with standard therapy, decreases morbidity and mortality in patients hospitalised in a mixed ICU. Methods: This is a prospective, randomised, non-blinded, single-centre clinical trial in a medical/surgical ICU. Patients were randomly assigned to receive either intensive insulin therapy to maintain glucose levels between 80 and 110 mg/dl (4.4 to 6.1 mmol/l) or standard insulin therapy to maintain glucose levels between 180 and 200 mg/dl (10 and 11.1 mmol/l). The primary end point was mortality at 28 days. Results: Over a period of 30 months, 504 patients were enrolled. The 28-day mortality rate was 32.4% (81 of 250) in the standard insulin therapy group and 36.6% (93 of 254) in the intensive insulin therapy group (Relative Risk [RR]: 1.1; 95% confidence interval [CI]: 0.85 to 1.42). The ICU mortality in the standard insulin therapy group was 31.2% (78 of 250) and 33.1% (84 of 254) in the intensive insulin therapy group (RR: 1.06; 95%CI: 0.82 to 1.36). There was no statistically significant reduction in the rate of ICU-acquired infections: 33.2% in the standard insulin therapy group compared with 27.17% in the intensive insulin therapy group (RR: 0.82; 95%CI: 0.63 to 1.07). The rate of hypoglycaemia (≤ 40 mg/dl) was 1.7% in the standard insulin therapy group and 8.5% in the intensive insulin therapy group (RR: 5.04; 95% CI: 1.20 to21.12). Conclusions: IIT used to maintain glucose levels within normal limits did not reduce morbidity or mortality of patients admitted to a mixed medical/surgical ICU. Furthermore, this therapy increased the risk of hypoglycaemia. Mención de responsabilidad : Gisela Del Carmen De La Rosa, Jorge Hernando Donado, Alvaro Humberto Restrepo, Alvaro Mauricio Quintero, Luis Gabriel González, Nora Elena Saldarriaga, Marisol Bedoya, Juan Manuel Toro, Jorge Byron Velásquez, Juan Carlos Valencia, Clara Maria Arango, Pablo Henrique Aleman, Esdras Martin Vasquez, Juan Carlos Chavarriaga, Andrés Yepes, William Pulido, Carlos Alberto Cadavid & Grupo de Investigacion en Cuidado intensivo: GICI-HPTU Referencia : Crit Care. 2008;12(5):R120. DOI (Digital Object Identifier) : 10.1186/cc7017 PMID : 18799004 Derechos de uso : CC BY En línea : https://ccforum.biomedcentral.com/articles/10.1186/cc7017 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3467 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000035 AC-2008-008 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
2008-008.pdfAdobe Acrobat PDF
Título : Púrpura fulminans asociada al embarazo Otros títulos : Pregnacy associated purpura fulminans Tipo de documento : documento electrónico Autores : Luis Gabriel González Pérez, ; Álvaro Mauricio Quintero Ossa, ; Carlos Alberto Cadavid Gutiérrez, ; Jorge Hernando Donado Gómez, ; Ricardo César Restrepo Correa, ; Juan Manuel Toro Escobar, ; Nora Elena Saldarriaga Cartagena, ; Esdras Martín Vásquez Mejía, ; Marisol Bedoya Arias, ; Gisela de la Rosa Echavez, Fecha de publicación : 2005 Títulos uniformes : Iatreia Idioma : Español (spa) Palabras clave : Coagulación intravascular diseminada embarazo escherichia coli heparina proteina C púrpura fulminans Resumen : La púrpura fulminans (PF) es una enfermedad cutánea purpúrica aguda asociada a un síndrome de coagulación intravascular diseminada (CID). Sus causas conocidas incluyen infecciones virales y bacterianas así como trombofilias. Es sabido que durante el embarazo existen alteraciones en los mecanismos hemostáticos, sin embargo, no se ha demostrado que estos fenómenos por sí solos ayuden al desarrollo de la PF. Se describe el caso de una mujer de 22 años, quien tuvo PF en circunstancias inusuales tales como el desarrollo de su cuadro durante el embarazo y el origen probable en una infección por Ecoli. Se presentan los hallazgos clínicos, las intervenciones médicas y quirúrgicas y el desenlace. La paciente sobrevivió, pero hubo necesidad de amputarle las falanges distales de tres artejos del pie izquierdo. Mención de responsabilidad : Luis G. González P., Alvaro M. Quintero Ossa, Carlos A. Cadavid Gutiérrez, Jorge Hernando Donado Gómez, Alvaro H. Restrepo C., Juan M. Toro Escobar, Nora E. Saldarriaga Cartagena, Martín E. Vásquez, Gisela de la Rosa Echavez, Marisol Bedoya A. Referencia : Iatreia. 2005;18(2):302-07. Derechos de uso : CC BY-NC-SA En línea : https://revistas.udea.edu.co/index.php/iatreia/article/view/4166 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3437 Púrpura fulminans asociada al embarazo = Pregnacy associated purpura fulminans [documento electrónico] / Luis Gabriel González Pérez, ; Álvaro Mauricio Quintero Ossa, ; Carlos Alberto Cadavid Gutiérrez, ; Jorge Hernando Donado Gómez, ; Ricardo César Restrepo Correa, ; Juan Manuel Toro Escobar, ; Nora Elena Saldarriaga Cartagena, ; Esdras Martín Vásquez Mejía, ; Marisol Bedoya Arias, ; Gisela de la Rosa Echavez, . - 2005.
Obra : Iatreia
Idioma : Español (spa)
Palabras clave : Coagulación intravascular diseminada embarazo escherichia coli heparina proteina C púrpura fulminans Resumen : La púrpura fulminans (PF) es una enfermedad cutánea purpúrica aguda asociada a un síndrome de coagulación intravascular diseminada (CID). Sus causas conocidas incluyen infecciones virales y bacterianas así como trombofilias. Es sabido que durante el embarazo existen alteraciones en los mecanismos hemostáticos, sin embargo, no se ha demostrado que estos fenómenos por sí solos ayuden al desarrollo de la PF. Se describe el caso de una mujer de 22 años, quien tuvo PF en circunstancias inusuales tales como el desarrollo de su cuadro durante el embarazo y el origen probable en una infección por Ecoli. Se presentan los hallazgos clínicos, las intervenciones médicas y quirúrgicas y el desenlace. La paciente sobrevivió, pero hubo necesidad de amputarle las falanges distales de tres artejos del pie izquierdo. Mención de responsabilidad : Luis G. González P., Alvaro M. Quintero Ossa, Carlos A. Cadavid Gutiérrez, Jorge Hernando Donado Gómez, Alvaro H. Restrepo C., Juan M. Toro Escobar, Nora E. Saldarriaga Cartagena, Martín E. Vásquez, Gisela de la Rosa Echavez, Marisol Bedoya A. Referencia : Iatreia. 2005;18(2):302-07. Derechos de uso : CC BY-NC-SA En línea : https://revistas.udea.edu.co/index.php/iatreia/article/view/4166 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3437 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000004 AC-2005-003 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
2005-003.pdfAdobe Acrobat PDF
