Oñate Ramírez Ana Lorena, Rendón Macías Mario Enrique, Iglesias Leboreiro José, Bernárdez Zapata Isabel
División de Posgrado, Facultad Mexicana de Medicina, Universidad La Salle, México, D.F., México.
Unidad de Investigación en Epidemiología Clínica, Hospital de Pediatría Centro Médico Nacional S. XXI, Instituto Mexicano del Seguro Social, México, D.F., México.
Bol Med Hosp Infant Mex. 2014 Jul-Aug;71(4):227-232. doi: 10.1016/j.bmhimx.2014.08.007. Epub 2015 May 19.
The aim of this study was to analyze the medical care of children<5 years of age with acute bronchiolitis in relation to the most relevant practices of evidence-based guidelines for bronchiolitis.
We reviewed the charts of 197 hospitalized infants with acute bronchiolitis during 2012 to 2013 to analyse whether the guideline recommendations were used according to: American Academic of Pediatritians (AAP), Scotish Intercollegiate Guidelines Network (SIGN), Sector Salud México (SS), and Guía Práctica Clínica Bronquiolitis, España (GPCBA).
We evaluated 197 patients attended by 49 pediatricians. Of the recommended actions, in 110 patients (55.8%) aspirate secretions were indicated, 105 patients (53%) received supplemental oxygen and 63 patients (31.9%) used inhaled hypertonic solution. Non-recommended actions were carried out in 166 patients (84%) who received inhaled bronchodilators, 143 patients (72%) who inhaled steroids, 110 patients (55.8%) who were prescribed antibiotics, 76 patients (38%) who had nebulization and 52 patients (26.3%) were administered systemic steroids. Physicians with<10 years of expertise prescribed more systemic steroids.
Despite the dissemination of good clinical practice guidelines for the management of acute bronchiolitis, its adoption has not been totally completed.
本研究旨在分析5岁以下急性细支气管炎患儿的医疗护理情况,并与细支气管炎循证指南中最相关的做法进行对比。
我们回顾了2012年至2013年期间197例住院急性细支气管炎婴儿的病历,以分析是否按照美国儿科学会(AAP)、苏格兰校际指南网络(SIGN)、墨西哥卫生部(SS)和西班牙临床实践指南《细支气管炎》(GPCBA)的建议进行治疗。
我们评估了由49名儿科医生诊治的197例患者。在推荐的治疗措施中,110例患者(55.8%)进行了吸痰,105例患者(53%)接受了补充氧气治疗,63例患者(31.9%)使用了吸入性高渗溶液。166例患者(84%)接受了吸入性支气管扩张剂治疗,143例患者(72%)吸入了类固醇,110例患者(55.8%)使用了抗生素,76例患者(38%)进行了雾化治疗,52例患者(26.3%)接受了全身性类固醇治疗,这些均为不推荐的治疗措施。从业经验不足10年的医生开出了更多的全身性类固醇药物。
尽管已传播了关于急性细支气管炎管理的良好临床实践指南,但其采用尚未完全完成。