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Desarrollo de servicios de tomografía computarizada cardíaca congénita en entornos de bajos recursos: un enfoque de
Shazia Mohsin1, Saira Siddiqui2,3,4, Tahira Gill5
1Section of Pediatric Cardiology, Division of Cardiothoracic Sciences, Sindh Institute of Urology and Transplantation, Karachi, Pakistan. shzmhsn@gmail.com.
Pediatric cardiology
|August 22, 2025
Resumen
La implementación de una tomografía computarizada cardíaca congénita (TCC) de alta calidad en entornos con pocos recursos es posible. Los métodos estructurados de mejora de la calidad y la tutoría virtual mejoraron significativamente la seguridad y la precisión del diagnóstico para las evaluaciones de enfermedades cardíacas congénitas (CHD).
Área de la Ciencia:
- Imágenes médicas
- Cardiología
- Mejora de la calidad
Sus antecedentes:
- La evaluación de la enfermedad cardíaca congénita (ECC) mediante tomografía computarizada cardíaca (TCC) está subutilizada en los países de ingresos bajos y medios (PIBM).
- Las barreras incluyen una formación limitada y desafíos sistémicos.
- Son escasas las estrategias estructuradas de mejora de la calidad (QI) para la aplicación segura de las TCC.
Objetivo del estudio:
- Implementar un servicio de TCC congénita de alta calidad en un hospital público con recursos limitados.
- Utilización de métodos estructurados de información cualitativa, colaboración multidisciplinaria y formación innovadora.
Principales métodos:
- Iniciativa llevada a cabo en un hospital terciario público en Pakistán (enero 2023 - junio 2024).
- Intervenciones: desarrollo de protocolos, capacitación de proveedores, tutoría a distancia, revisión de diagnósticos.
- Métricas monitoreadas: dosis de radiación, tensión del tubo, tasa de error de diagnóstico (DER), eventos adversos relacionados con la sedación (SER).
Principales resultados:
- Se realizaron 118 exploraciones CCT congénitas.
- La dosis media de radiación disminuyó significativamente (915 a 62 mGy*cm).
- La optimización de la tensión del tubo alcanzó el 100%, el DER y el SER se redujeron al 0% después de la intervención y se mantuvieron.
Conclusiones:
- Los servicios de TCC congénita pueden implementarse con seguridad en entornos de escasos recursos.
- La inteligencia estructurada, la tutoría y la colaboración son la clave.
- Este modelo es potencialmente aplicable a entornos de atención médica similares.
Palabras clave:
Desarrollo de capacidadesTomografía cardíaca congénitaEnfermedad cardíaca congénitaError de diagnósticoPaíses de bajos y medianos ingresosColaboración multidisciplinarMejora de la calidadOptimización de la dosis de radiaciónSistemas de salud sosteniblesMentoría virtualMás Videos Relacionados
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