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Patrones de práctica postoperatoria tras la cirugía de Glenn bidireccional: una encuesta
Bennett Weinerman1,2, Soon Bin Kwon2,3, Eva W Cheung1
1Division of Pediatric Critical Care and Hospital Medicine, https://ror.org/00hj8s172Columbia University College of Physicians and Surgeons, New York, NY, USA.
Cardiology in the young
|January 23, 2026
Resumen
La atención postoperatoria de niños tras la cirugía de Glenn bidireccional carece de consenso entre los proveedores. Este estudio revela estrategias de manejo variadas y destaca la necesidad de objetivos estandarizados y basados en la evidencia para optimizar los resultados de los pacientes.
Área de la Ciencia:
- Cardiología Pediátrica
- Cirugía Cardíaca
- Medicina de Cuidados Intensivos
Sus antecedentes:
- La cirugía de Glenn bidireccional es un procedimiento de estadificación crítico para la cardiopatía congénita (CC) univentricular.
- Las estrategias óptimas de manejo postoperatorio para estos pacientes siguen sin investigarse adecuadamente.
- Se estima que 1000 niños estadounidenses al año requieren esta intervención para la CC.
Objetivo del estudio:
- Encuestar a los proveedores de cuidados intensivos pediátricos cardiológicos sobre sus estrategias de manejo post-cirugía de Glenn bidireccional.
- Identificar las prácticas actuales y las áreas de consenso o variabilidad en la atención postoperatoria.
- Subrayar la necesidad de protocolos de manejo estandarizados.
Principales métodos:
- Se envió por correo electrónico una encuesta anónima de 12 preguntas basada en la web a proveedores de cuidados intensivos pediátricos cardiológicos.
- La encuesta recopiló datos demográficos y se centró en los objetivos fisiológicos postoperatorios.
- Respondieron treinta y cinco proveedores, en su mayoría médicos adjuntos con amplia experiencia.
Principales resultados:
- Existe una falta significativa de consenso sobre el manejo postoperatorio después de la cirugía de Glenn bidireccional.
- Se observó un consenso de menos del 75% para objetivos específicos, incluidos SpO2, presión arterial media y pH.
- Los patrones de práctica son muy variables, lo que indica la necesidad de estrategias de atención optimizadas.
Conclusiones:
- La atención postoperatoria actual para pacientes con cirugía de Glenn bidireccional se caracteriza por una variabilidad significativa en los proveedores.
- Existe una clara necesidad de desarrollar objetivos basados en la evidencia y orientados a los resultados.
- Los protocolos estandarizados son esenciales para optimizar la atención y los resultados de estos niños vulnerables.
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