{"id":2475,"date":"2009-07-28T12:49:17","date_gmt":"2009-07-28T12:49:17","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/uticap\/"},"modified":"2025-05-14T19:09:19","modified_gmt":"2025-05-14T19:09:19","slug":"uticap","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/es\/uticap\/","title":{"rendered":"Gu\u00eda para la Admisi\u00f3n en Unidad de Cuidados Intensivos para Neumon\u00eda Adquirida en la Comunidad (NAC) Grave"},"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>La Infectious Diseases Society of America (IDSA)\/American Thoracic Society (ATS), revisaron recientemente los factores de riesgo y desarrollaron en forma objetiva criterios mayores y menores para identificar pacientes que requieran una admisi\u00f3n directa en la Unidad de Cuidados Intensivos (UCI). La m\u00e1s actualizada de las definiciones como la necesidad de ventilaci\u00f3n mec\u00e1nica invasiva o shock s\u00e9ptico, requiriendo vasopresores, como indicadores absolutos para la admisi\u00f3n directa a una UCI. Para los pacientes que no cumplen ninguno de estos dos criterios mayores, se han propuesto criterios menores que se basan en CURB-65 y en criterios ATS con nuevas adiciones. Para la admisi\u00f3n en una UCI o unidad de alto nivel, los pacientes deben cumplir al menos tres de estos criterios menores.<\/p>\n<p><!--more--><\/p>\n<p><strong>Criterios para neumon\u00eda adquirida en la comunidad grave<\/strong><\/p>\n<p><strong>Criterios mayores<\/strong><\/p>\n<ul>\n<li>Ventilaci\u00f3n mec\u00e1nica invasiva<\/li>\n<li>Shock s\u00e9ptico con necesidad de vasopresores<\/li>\n<\/ul>\n<p><strong>Criterios menores\u00a0<\/strong>(al menos tres de estos)<\/p>\n<ul>\n<li>Frecuencia respiratoria \u2265 30 respiraciones\/minuto<\/li>\n<li>Relaci\u00f3n PaO<sub>2<\/sub>\/FiO<sub>2<\/sub> \u2264 250<\/li>\n<li>Infiltrados multilobares<\/li>\n<li>Confusi\u00f3n \/ desorientaci\u00f3n de reciente comienzo<\/li>\n<li>Uremia (nivel de BUN\u00a0 \u2265 20 mg\/dl)<\/li>\n<li>Leucopenia (GB &lt;4000 cel\/mm<sup>3<\/sup>)<\/li>\n<li>Trombocitopenia (plaquetas &lt;100.000 cel\/mm<sup>3<\/sup>)<\/li>\n<li>Hipotermia (temperatura central &lt;36\u202f\u00b0C)<\/li>\n<li>Hipotensi\u00f3n que requiere reanimaci\u00f3n agresiva con fluidos<\/li>\n<\/ul>\n<p>BUN, nitr\u00f3geno ureico en sangre; FiO<sub>2<\/sub>, fracci\u00f3n inspirada de ox\u00edgeno; PaO<sub>2<\/sub>, tensi\u00f3n arterial de ox\u00edgeno; GB, gl\u00f3bulos blancos.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Bibliograf\u00eda:<\/strong><\/p>\n<ol>\n<li>Rello J. Demographics, guidelines, and clinical experience in severe community-acquired pneumonia. Crit Care. 2008;12 Suppl 6:S2. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19105795\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM Jr, Musher DM, Niederman MS, Torres A, Whitney CG; Infectious Diseases Society of America; American Thoracic Society. Infectious Diseases Society of America\/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007 Mar 1;44 Suppl 2:S27-72. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/17278083\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<br \/>\n<\/a><\/li>\n<li>Metlay JP, Waterer GW, Long AC, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019;200(7):e45\u2013e67. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/31573350\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Creado Jul 28, 2009<br \/>\nActualizado Mar 25, 2020<\/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>La Infectious Diseases Society of America (IDSA)\/American Thoracic Society (ATS), revisaron recientemente los factores de riesgo y desarrollaron en forma objetiva criterios mayores y menores para identificar pacientes que requieran una admisi\u00f3n directa en la Unidad de Cuidados Intensivos (UCI). La m\u00e1s actualizada de las definiciones como la necesidad de ventilaci\u00f3n mec\u00e1nica invasiva o shock [&hellip;]<\/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":[1430,982,981,1429,1436,629,1437,1438,1439,273,274,1344,1431,1432,1433,985,984,330,329,1434,1435,1375],"class_list":["post-2475","post","type-post","status-publish","format-standard","hentry","category-critical-care","tag-acquired","tag-admision","tag-admission","tag-adquirida","tag-cap","tag-care","tag-community","tag-comunidad","tag-cuidados","tag-guia","tag-guidelines","tag-infectious","tag-intensiva","tag-intensive","tag-nac","tag-neumonia","tag-pneumonia","tag-severa","tag-severe","tag-unidad","tag-unit","tag-uti"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2475","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=2475"}],"version-history":[{"count":5,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2475\/revisions"}],"predecessor-version":[{"id":9168,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2475\/revisions\/9168"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/media?parent=2475"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/categories?post=2475"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/tags?post=2475"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}