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    "titulo" => "Tratamiento de los recién nacidos de muy bajo peso al nacer. ¿Se basa en la evidencia?"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determinar qu&#233; porcentaje de intervenciones terap&#233;uticas para los reci&#233;n nacidos de muy bajo peso al nacer sometidos a cuidados intensivos neonatales est&#225; basado en la evidencia&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se revis&#243; retrospectivamente el tratamiento de 80 reci&#233;n nacidos de muy bajo peso al nacer ingresados en nuestra unidad neonatal durante 1998&#46; Para cada diagn&#243;stico cl&#237;nico&#44; por ejemplo&#44; s&#237;ndrome de distr&#233;s respi-ratorio&#44; conducto arterioso permeable o enfermedad pulmonar cr&#243;nica&#44; se registraron todas las intervenciones&#46; A continuaci&#243;n se clasific&#243; cada intervenci&#243;n de acuerdo con el nivel de evidencia que la apoyaba&#46; El nivel I estuvo respaldado por la evidencia a partir de ensayos aleatori-zados controlados o metaan&#225;lisis de m&#250;ltiples ensayos&#46; El nivel II incluy&#243; intervenciones respaldadas por evidencias no experimentales convincentes en situaciones en que los ensayos aleatorizados controlados ser&#237;an innecesarios o poco &#233;ticos&#46; El nivel III eran tratamientos de uso com&#250;n sin una evidencia sustancial de apoyo&#46; Estas clasificaciones se realizaron despu&#233;s de una b&#250;squeda extensa en MEDLINE&#44; The Cochrane Database y el Randomised Controlled Trial Register&#44; una b&#250;squeda manual detallada de los estudios publicados as&#237; como la utilizaci&#243;n de la experiencia y conocimientos locales&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En las historias cl&#237;nicas de 80 reci&#233;n nacidos se registraron 943 intervenciones terap&#233;uticas diferentes&#46; En conjunto&#44; se puso de manifiesto que el 91&#44;3&#37; estaban basadas en la evidencia&#44; de las cuales un 58&#44;7&#37; eran de nivel I&#44; un 32&#44;6&#37; eran de nivel II y s&#243;lamente un 8&#44;7&#37; eran de nivel III&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El 91&#44;3&#37; de intervenciones para reci&#233;n nacidos de muy bajo peso al nacer en nuestra unidad de cuidados intensivos neonatales se basaron en la evidencia y solamente un 8&#44;7&#37; carec&#237;an de evidencia sustancial de apoyo&#46; El tratamiento de los reci&#233;n nacidos de muy bajo peso al nacer se basa en su mayor parte en la evidencia&#46;</p>"
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        "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&#46; For each clinical diagnosis e&#46;g&#46; respiratory distress syndrome&#44; patent ductus arteriosus or chronic lung disease all interventions were recorder&#46; Each intervention was then categorised according to the level of supporting evidence&#46; Level I was supported by evidence from randomised controlled trials or meta-analysis of multiple trials&#46; Level II included interventions backed by convincing non-experimental evidence where randomised controlled trials would be unnecessary or unethical&#46; Level III were treatments in commons use without substantial supporting evidence&#46; These categorisations were made after extensive researching of Medline&#44; The Coch-rane Database and the Randomised Controlled Trial Register&#44; detailed hand-searching of the literature as well as using local expertise and knowledge&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">943 separate interventions were recorded in the charts of the 80 babies&#46; Overall 91&#46;3&#37; were shown to be evidence-based of which 58&#46;7&#37; were level I&#44; 32&#46;6&#37; were level II and only 8&#46;7&#37; were level III&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">91&#46;3&#37; of interventions for very low birth weight infants in our neonatal intensive care unit were evidence-based and only 8&#46;7&#37; had no substantial supporting evidence&#46; Care of the very low birthweight infants is largely evidence-based&#46;</p>"
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Vol. 52. Núm. 6.
Páginas 554-560 (junio 2000)
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Vol. 52. Núm. 6.
Páginas 554-560 (junio 2000)
Acceso a texto completo
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
Visitas
13175
A.E. Curley
Autor para correspondencia
h.halliday@qub.ac.uk

Correspondencia: Regional Neonatal Unit, Royal Maternity Hospital, Grosvenor Road, Belfast BT12 6BB, Irlanda del Norte.
, T.R.J. Tubman, H.L. Halliday
Regional Neonatal Unit, Royal Maternity Hospital, Belfast, y Department of Child Health. The Queen's University of Belfast, Irlanda del Norte
Este artículo ha recibido
Información del artículo
Objetivos

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.

Métodos

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.

Resultados

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.

Conclusiones

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.

Palabras clave:
Recién nacidos de muy bajo peso
Medicina basada en la evidencia
Intervenciones terapéuticas
Cuidados intensivos neonatales
Objectives

To determine what percentage of therapeutic interven-tions for very low birth weight infants undergoind neo-natal intensive care is evidence based

Methods

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.

Results

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.

Conclusions

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.

Key words:
Very low birthweight infants
Evidence-based medicine
Therapeutic interventions
Neonatal intensive care
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