{"id":2374,"date":"2014-02-20T14:51:04","date_gmt":"2014-02-20T14:51:04","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/ccicup\/"},"modified":"2025-05-13T20:27:28","modified_gmt":"2025-05-13T20:27:28","slug":"ccicup","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/es\/ccicup\/","title":{"rendered":"Criterios para la Consideraci\u00f3n de Admisi\u00f3n en UTI para Pacientes sin una Necesidad Obvia"},"content":{"rendered":"<div class=\"7ca9444b8380138fe077da07353677a4\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Un paciente sin una necesidad obvia fue definido como aquel que no requiri\u00f3 intubaci\u00f3n endotraqueal y ventilaci\u00f3n mec\u00e1nica o como ausencia de hipotensi\u00f3n que requiere vasopresores en el servicio de urgencias. El riesgo aumenta proporcionalmente con la presencia de m\u00e1s de tres criterios.<br \/>\n<!--more--><br \/>\n<strong>Criterios para la Consideraci\u00f3n de Admisi\u00f3n en UTI para Pacientes sin una Necesidad Obvia<\/strong><\/p>\n<table border=\"1\" width=\"100%\" cellspacing=\"0\" cellpadding=\"4\">\n<colgroup>\n<col width=\"79*\" \/>\n<col width=\"177*\" \/><\/colgroup>\n<tbody>\n<tr valign=\"TOP\">\n<td width=\"31%\"><strong>Criterio<\/strong><\/td>\n<td width=\"69%\"><strong>Definici\u00f3n<\/strong><\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\" valign=\"TOP\" width=\"100%\"><strong>Criterios menores IDSA\u2013ATS<\/strong><\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"31%\">Confusi\u00f3n<\/td>\n<td width=\"69%\">Ninguna especificada<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"31%\">Urea\u00a0nitrogenada\u00a0en sangre elevada<\/td>\n<td width=\"69%\">Urea\u00a0nitrogenada\u00a0en sangre &gt;\/=20 mg\/dl<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"31%\">Taquipnea<\/td>\n<td width=\"69%\">Frecuencia respiratoria &gt;\/= 30 respiraciones\/min<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"31%\">Infiltrados multilobares\u00a0observados en la radiograf\u00eda<\/td>\n<td width=\"69%\">Ninguna especificada<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"31%\">Hipoxemia<\/td>\n<td width=\"69%\">Relaci\u00f3n de la presi\u00f3n parcial de ox\u00edgeno en sangre arterial sobre la fracci\u00f3n de ox\u00edgeno inspirado &lt;250 mm de Hg<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"31%\">Trombocitopenia<\/td>\n<td width=\"69%\">&lt;100.000 plaquetas\/mm3<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"31%\">Hipotensi\u00f3n<\/td>\n<td width=\"69%\">Hipotensi\u00f3n (presi\u00f3n sist\u00f3lica &lt;90 mm \u200b\u200bHg) que requieren reanimaci\u00f3n agresiva con fluidos<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"31%\">Hipotermia<\/td>\n<td width=\"69%\">Temperatura central &lt;36\u202f\u00b0C<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"31%\">Leucopenia<\/td>\n<td width=\"69%\">Gl\u00f3bulos blancos &lt;4000\/mm3<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\" valign=\"TOP\" width=\"100%\"><strong>Otros criterios<\/strong><\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"31%\">Acidosis l\u00e1ctica<\/td>\n<td width=\"69%\">Nivel de \u00e1cido l\u00e1ctico &gt;\/=4 mmol\/litro<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"31%\">pH bajo<\/td>\n<td width=\"69%\">&lt;7,30\u20137,35,\u00a0dependiendo de sistema de puntuaci\u00f3n*<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"31%\">Alb\u00famina baja<\/td>\n<td width=\"69%\">&lt;3,5 g\/dl<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"31%\">Hiponatremia<\/td>\n<td width=\"69%\">Nivel de sodio &lt;130 mmol\/litro<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"31%\">Leucocitosis<\/td>\n<td width=\"69%\">Recuento de leucocitos &gt;20.000\/mm3<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"31%\">Taquicardia<\/td>\n<td width=\"69%\">Frecuencia card\u00edaca &gt;\/= 125 latidos\/min<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"31%\">Edad avanzada<\/td>\n<td width=\"69%\">&gt;80\u00a0a\u00f1os<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>* El criterio de un nivel de pH de menos de 7,30 se utiliza en el c\u00e1lculo de la puntuaci\u00f3n CURXO. El criterio de un nivel de pH de menos de 7,35 se utiliza en el c\u00e1lculo de las puntuaciones de SMART-COP y REA-UCI.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Bibliograf\u00eda:<\/strong><\/p>\n<ol>\n<li>Wunderink RG, Waterer GW. Clinical practice. Community-acquired pneumonia. N Engl J Med. 2014 Feb 6;370(6):543-51.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24499212\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Charles PG, Wolfe R, Whitby M, Fine MJ, Fuller AJ, Stirling R, Wright AA, Ramirez JA, Christiansen KJ, Waterer GW, Pierce RJ, Armstrong JG, Korman TM, Holmes P, Obrosky DS, Peyrani P, Johnson B, Hooy M; Australian Community-Acquired Pneumonia Study Collaboration, Grayson ML. SMART-COP: a tool for predicting the need for intensive respiratory or vasopressor support in community-acquired pneumonia. Clin Infect Dis. 2008 Aug 1;47(3):375-84\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18558884\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>Renaud B, Labar\u00e8re J, Coma E, Santin A, Hayon J, Gurgui M, Camus N, Roupie E, H\u00e9mery F, Herv\u00e9 J, Salloum M, Fine MJ, Brun-Buisson C. Risk stratification of early admission to the intensive care unit of patients with no major criteria of severe community-acquired pneumonia: development of an international prediction rule. Crit Care. 2009;13(2):R54.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19358736\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>Espa\u00f1a PP, Capelastegui A, Gorordo I, Esteban C, Oribe M, Ortega M, Bilbao A, Quintana JM. Development and validation of a clinical prediction rule for severe community-acquired pneumonia. Am J Respir Crit Care Med. 2006 Dec 1;174(11):1249-56.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/16973986\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Creado Mar 14, 2014.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Un paciente sin una necesidad obvia fue definido como aquel que no requiri\u00f3 intubaci\u00f3n endotraqueal y ventilaci\u00f3n mec\u00e1nica o como ausencia de hipotensi\u00f3n que requiere vasopresores en el servicio de urgencias. El riesgo aumenta proporcionalmente con la presencia de m\u00e1s de tres criterios.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[148],"tags":[982,981,980,979,16,15,978,977,976,975,974,973,972,983],"class_list":["post-2374","post","type-post","status-publish","format-standard","hentry","category-critical-care","tag-admision","tag-admission","tag-considerar","tag-consideration","tag-criteria","tag-criterios","tag-icu","tag-necesidad","tag-need","tag-obvia","tag-obvious","tag-patients","tag-sin","tag-without"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2374","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/comments?post=2374"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2374\/revisions"}],"predecessor-version":[{"id":9289,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2374\/revisions\/9289"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/media?parent=2374"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/categories?post=2374"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/tags?post=2374"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}