Tratamiento de los recién nacidos de muy bajo peso al nacer. ¿Se basa en la evidencia?
Case of the very low birth weight infant: is it evidenced-based
A.E. Curley
, T.R.J. Tubman, H.L. Halliday
Autor para correspondencia
h.halliday@qub.ac.uk
Correspondencia: Regional Neonatal Unit, Royal Maternity Hospital, Grosvenor Road, Belfast BT12 6BB, Irlanda del Norte.
Correspondencia: Regional Neonatal Unit, Royal Maternity Hospital, Grosvenor Road, Belfast BT12 6BB, Irlanda del Norte.
Regional Neonatal Unit, Royal Maternity Hospital, Belfast, y Department of Child Health. The Queen's University of Belfast, Irlanda del Norte
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"apellidos" => "Halliday" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Regional Neonatal Unit, Royal Maternity Hospital, Belfast, y Department of Child Health. The Queen's University of Belfast, Irlanda del Norte" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Regional Neonatal Unit, Royal Maternity Hospital, Grosvenor Road, Belfast BT12 6BB, Irlanda del Norte." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Case of the very low birth weight infant: is it evidenced-based" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-04-30" "fechaAceptado" => "2000-04-30" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186369" "palabras" => array:4 [ 0 => "Recién nacidos de muy bajo peso" 1 => "Medicina basada en la evidencia" 2 => "Intervenciones terapéuticas" 3 => "Cuidados intensivos neonatales" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec186370" "palabras" => array:4 [ 0 => "Very low birthweight infants" 1 => "Evidence-based medicine" 2 => "Therapeutic interventions" 3 => "Neonatal intensive care" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determinar qué porcentaje de intervenciones terapéuticas para los recién nacidos de muy bajo peso al nacer sometidos a cuidados intensivos neonatales está basado en la evidencia.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se revisó retrospectivamente el tratamiento de 80 recién nacidos de muy bajo peso al nacer ingresados en nuestra unidad neonatal durante 1998. Para cada diagnóstico clínico, por ejemplo, síndrome de distrés respi-ratorio, conducto arterioso permeable o enfermedad pulmonar crónica, se registraron todas las intervenciones. A continuación se clasificó cada intervención de acuerdo con el nivel de evidencia que la apoyaba. El nivel I estuvo respaldado por la evidencia a partir de ensayos aleatori-zados controlados o metaanálisis de múltiples ensayos. El nivel II incluyó intervenciones respaldadas por evidencias no experimentales convincentes en situaciones en que los ensayos aleatorizados controlados serían innecesarios o poco éticos. El nivel III eran tratamientos de uso común sin una evidencia sustancial de apoyo. Estas clasificaciones se realizaron después de una búsqueda extensa en MEDLINE, The Cochrane Database y el Randomised Controlled Trial Register, una búsqueda manual detallada de los estudios publicados así como la utilización de la experiencia y conocimientos locales.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En las historias clínicas de 80 recién nacidos se registraron 943 intervenciones terapéuticas diferentes. En conjunto, se puso de manifiesto que el 91,3% estaban basadas en la evidencia, de las cuales un 58,7% eran de nivel I, un 32,6% eran de nivel II y sólamente un 8,7% eran de nivel III.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El 91,3% de intervenciones para recién nacidos de muy bajo peso al nacer en nuestra unidad de cuidados intensivos neonatales se basaron en la evidencia y solamente un 8,7% carecían de evidencia sustancial de apoyo. El tratamiento de los recién nacidos de muy bajo peso al nacer se basa en su mayor parte en la evidencia.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To determine what percentage of therapeutic interven-tions for very low birth weight infants undergoind neo-natal intensive care is evidence based</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The management of 80 very low birth weight infants admitted to our neonatal unit during 1998 was retrospectively reviewed. For each clinical diagnosis e.g. respiratory distress syndrome, patent ductus arteriosus or chronic lung disease all interventions were recorder. Each intervention was then categorised according to the level of supporting evidence. Level I was supported by evidence from randomised controlled trials or meta-analysis of multiple trials. Level II included interventions backed by convincing non-experimental evidence where randomised controlled trials would be unnecessary or unethical. Level III were treatments in commons use without substantial supporting evidence. These categorisations were made after extensive researching of Medline, The Coch-rane Database and the Randomised Controlled Trial Register, detailed hand-searching of the literature as well as using local expertise and knowledge.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">943 separate interventions were recorded in the charts of the 80 babies. Overall 91.3% were shown to be evidence-based of which 58.7% were level I, 32.6% were level II and only 8.7% were level III.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">91.3% of interventions for very low birth weight infants in our neonatal intensive care unit were evidence-based and only 8.7% had no substantial supporting evidence. Care of the very low birthweight infants is largely evidence-based.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografìa" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evidence-based medicine: what it is and what it isnn't" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D.L. Sackett" 1 => "W.M. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 14 | 18 | 32 |
| 2024 Octubre | 58 | 51 | 109 |
| 2024 Septiembre | 88 | 51 | 139 |
| 2024 Agosto | 83 | 76 | 159 |
| 2024 Julio | 64 | 56 | 120 |
| 2024 Junio | 77 | 33 | 110 |
| 2024 Mayo | 103 | 42 | 145 |
| 2024 Abril | 90 | 34 | 124 |
| 2024 Marzo | 83 | 67 | 150 |
| 2024 Febrero | 107 | 47 | 154 |
| 2024 Enero | 81 | 32 | 113 |
| 2023 Diciembre | 79 | 34 | 113 |
| 2023 Noviembre | 112 | 39 | 151 |
| 2023 Octubre | 106 | 22 | 128 |
| 2023 Septiembre | 71 | 21 | 92 |
| 2023 Agosto | 70 | 26 | 96 |
| 2023 Julio | 114 | 39 | 153 |
| 2023 Junio | 109 | 31 | 140 |
| 2023 Mayo | 151 | 23 | 174 |
| 2023 Abril | 74 | 22 | 96 |
| 2023 Marzo | 94 | 23 | 117 |
| 2023 Febrero | 86 | 17 | 103 |
| 2023 Enero | 77 | 26 | 103 |
| 2022 Diciembre | 100 | 17 | 117 |
| 2022 Noviembre | 150 | 36 | 186 |
| 2022 Octubre | 118 | 56 | 174 |
| 2022 Septiembre | 182 | 48 | 230 |
| 2022 Agosto | 116 | 56 | 172 |
| 2022 Julio | 107 | 42 | 149 |
| 2022 Junio | 134 | 44 | 178 |
| 2022 Mayo | 113 | 40 | 153 |
| 2022 Abril | 125 | 50 | 175 |
| 2022 Marzo | 135 | 51 | 186 |
| 2022 Febrero | 106 | 28 | 134 |
| 2022 Enero | 140 | 57 | 197 |
| 2021 Diciembre | 75 | 72 | 147 |
| 2021 Noviembre | 138 | 72 | 210 |
| 2021 Octubre | 196 | 93 | 289 |
| 2021 Septiembre | 159 | 91 | 250 |
| 2021 Agosto | 104 | 39 | 143 |
| 2021 Julio | 117 | 48 | 165 |
| 2021 Junio | 143 | 59 | 202 |
| 2021 Mayo | 134 | 33 | 167 |
| 2021 Abril | 328 | 79 | 407 |
| 2021 Marzo | 161 | 41 | 202 |
| 2021 Febrero | 153 | 40 | 193 |
| 2021 Enero | 123 | 48 | 171 |
| 2020 Diciembre | 105 | 83 | 188 |
| 2020 Noviembre | 103 | 33 | 136 |
| 2020 Octubre | 65 | 20 | 85 |
| 2020 Septiembre | 126 | 27 | 153 |
| 2020 Agosto | 100 | 14 | 114 |
| 2020 Julio | 96 | 16 | 112 |
| 2020 Junio | 106 | 23 | 129 |
| 2020 Mayo | 98 | 13 | 111 |
| 2020 Abril | 89 | 21 | 110 |
| 2020 Marzo | 45 | 14 | 59 |
| 2020 Febrero | 100 | 18 | 118 |
| 2020 Enero | 84 | 29 | 113 |
| 2019 Diciembre | 89 | 15 | 104 |
| 2019 Noviembre | 39 | 26 | 65 |
| 2019 Octubre | 13 | 17 | 30 |
| 2019 Septiembre | 103 | 21 | 124 |
| 2019 Agosto | 54 | 26 | 80 |
| 2019 Julio | 38 | 26 | 64 |
| 2019 Junio | 80 | 45 | 125 |
| 2019 Mayo | 155 | 34 | 189 |
| 2019 Abril | 117 | 35 | 152 |
| 2019 Marzo | 62 | 25 | 87 |
| 2019 Febrero | 63 | 15 | 78 |
| 2019 Enero | 47 | 17 | 64 |
| 2018 Diciembre | 45 | 15 | 60 |
| 2018 Noviembre | 73 | 15 | 88 |
| 2018 Octubre | 83 | 19 | 102 |
| 2018 Septiembre | 44 | 5 | 49 |
| 2018 Agosto | 1 | 0 | 1 |
| 2018 Julio | 2 | 0 | 2 |
| 2018 Mayo | 4 | 0 | 4 |
| 2018 Abril | 23 | 0 | 23 |
| 2018 Marzo | 11 | 0 | 11 |
| 2018 Febrero | 8 | 0 | 8 |
| 2018 Enero | 10 | 0 | 10 |
| 2017 Diciembre | 16 | 0 | 16 |
| 2017 Noviembre | 14 | 0 | 14 |
| 2017 Octubre | 14 | 0 | 14 |
| 2017 Septiembre | 11 | 0 | 11 |
| 2017 Agosto | 8 | 0 | 8 |
| 2017 Julio | 11 | 1 | 12 |
| 2017 Junio | 21 | 7 | 28 |
| 2017 Mayo | 21 | 5 | 26 |
| 2017 Abril | 21 | 20 | 41 |
| 2017 Marzo | 11 | 2 | 13 |
| 2017 Febrero | 7 | 2 | 9 |
| 2017 Enero | 5 | 4 | 9 |
| 2016 Diciembre | 22 | 5 | 27 |
| 2016 Noviembre | 66 | 2 | 68 |
| 2016 Octubre | 69 | 10 | 79 |
| 2016 Septiembre | 47 | 5 | 52 |
| 2016 Agosto | 33 | 3 | 36 |
| 2016 Julio | 16 | 8 | 24 |
| 2016 Marzo | 4 | 0 | 4 |
| 2016 Febrero | 3 | 0 | 3 |
| 2015 Diciembre | 3 | 0 | 3 |
| 2015 Noviembre | 1 | 0 | 1 |
| 2015 Octubre | 1 | 0 | 1 |
| 2015 Septiembre | 2 | 0 | 2 |
| 2015 Agosto | 1 | 0 | 1 |
| 2015 Julio | 10 | 0 | 10 |
| 2015 Junio | 7 | 0 | 7 |
| 2015 Mayo | 19 | 7 | 26 |
| 2015 Abril | 15 | 0 | 15 |
| 2015 Marzo | 8 | 0 | 8 |
| 2015 Febrero | 3 | 0 | 3 |
| 2015 Enero | 12 | 0 | 12 |
| 2014 Diciembre | 8 | 1 | 9 |
| 2014 Noviembre | 9 | 0 | 9 |
| 2014 Octubre | 10 | 0 | 10 |
| 2014 Septiembre | 6 | 3 | 9 |
| 2014 Agosto | 9 | 1 | 10 |
| 2014 Julio | 6 | 1 | 7 |
| 2014 Junio | 14 | 2 | 16 |
| 2014 Mayo | 13 | 1 | 14 |
| 2014 Abril | 8 | 2 | 10 |
| 2014 Marzo | 11 | 5 | 16 |
| 2014 Febrero | 8 | 10 | 18 |
| 2014 Enero | 9 | 5 | 14 |
| 2013 Diciembre | 17 | 8 | 25 |
| 2013 Noviembre | 12 | 6 | 18 |
| 2013 Octubre | 15 | 5 | 20 |
| 2013 Septiembre | 16 | 10 | 26 |
| 2013 Agosto | 10 | 3 | 13 |
| 2013 Julio | 3 | 5 | 8 |
| 2013 Junio | 1 | 1 | 2 |
| 2013 Mayo | 4 | 1 | 5 |
| 2013 Abril | 5 | 2 | 7 |
| 2013 Marzo | 4 | 3 | 7 |
| 2013 Febrero | 18 | 3 | 21 |
| 2013 Enero | 12 | 2 | 14 |
| 2012 Diciembre | 8 | 1 | 9 |
| 2012 Noviembre | 8 | 1 | 9 |
| 2012 Octubre | 3 | 3 | 6 |
| 2012 Septiembre | 1 | 1 | 2 |
| 2012 Agosto | 1 | 0 | 1 |
| 2000 Mayo | 1893 | 0 | 1893 |
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