Papers by Olga Lucía Cortés
Investigación y Educación en Enfermería
Objective. To describe the clinical characteristics, treatment, evolution, and nursing care of ad... more Objective. To describe the clinical characteristics, treatment, evolution, and nursing care of adult patients with severe acute respiratory distress syndrome who were positive for SARS-CoV-2 and hospitalized in intensive care units (ICUs) during the first peak of the pandemic in Colombia, 2020. Methods. Multicenter descriptive study of four high-complexity hospitals in Colombia, which included 473 consecutive adult patients admitted to intensive care units with a confirmed diagnosis of SARS CoV-2. Sociodemographic and clinical information - comorbidities, treatment and evolution - and nursing care provided were included. Results. Of the patients included, 43.7% died, 88.8% had pneumonia, and 60.2% developed respiratory distress syndrome. Most of those who died were men. Those who died had a median age of 68.4 years and a higher frequency of comorbidities (hypertension, cardiovascular disease, chronic obstructive pulmonary disease, and higher body mass index). They were admitted to...
RESUMEN A pesar de los beneficios documentados acerca de la rehabilitación cardiovascular (RC) de... more RESUMEN A pesar de los beneficios documentados acerca de la rehabilitación cardiovascular (RC) después de un infarto agudo de miocardio (IAM), existe aún incertidumbre sobre la implementación de la ambulación precoz como el elemento inicial de la RC durante el periodo de hospitalización. El siguiente artículo presenta una revisión de la literatura acerca de la práctica del inicio de la caminada o ambulación de pacientes hospitalizados con un diagnóstico de IAM. En este se incluye una descripción de los patrones (día, hora, tipo de actividad) de movilización observados en algunas instituciones de salud, desde que el paciente se sienta en su cama, se levanta e inicia su primera caminada. Además se explora la evidencia existente sobre el efecto de la ambulación precoz y se hace una actualización crítica sobre las guías de manejo que orientan esta práctica en hospitalización. Finalmente, se describe la importancia de la implementación de la ambulación precoz, teniendo en cuenta los avan...
BMC Sports Science, Medicine and Rehabilitation, 2021
Background Even though the importance of preparing patients for a surgical event is recognized, t... more Background Even though the importance of preparing patients for a surgical event is recognized, there are still gaps about the benefit of improving functional capacity by walking during the waiting time among patients scheduled for non-cardiac surgery. The aim of this study was to evaluate the impact of pre-surgical walking in-hospital length of stay, early ambulation, and the appearance of complications after surgery among patients scheduled for non-cardiac surgery. Methods A two-arm, single- blinded randomized controlled trial was developed from May 2016 to August 2017. Eligible outpatients scheduled for non-cardiac surgery, capable of walking, were randomized (2:1 ratio) to receive a prescription of walking 150 min/week during the whole pre-surgical waiting time (n = 249) or conventional care (n = 119). The primary outcome was the difference in hospital length of stay, and secondary results were time to first ambulation during hospitalization, description of ischemic events durin...
Revista Salud Uis, 2009
A pesar de los beneficios documentados acerca de la rehabilitación cardiovascular (RC) después de... more A pesar de los beneficios documentados acerca de la rehabilitación cardiovascular (RC) después de un infarto agudo de miocardio (IAM), existe aún incertidumbre sobre la implementación de la ambulación precoz como el elemento inicial de la RC durante el periodo de hospitalización. El siguiente artículo presenta una revisión de la literatura acerca de la práctica del inicio de la caminada o ambulación de pacientes hospitalizados con un diagnóstico de IAM. En este se incluye una descripción de los patrones (día, hora, tipo de actividad) de movilización observados en algunas instituciones de salud, desde que el paciente se sienta en su cama, se levanta e inicia su primera caminada. Además se explora la evidencia existente sobre el efecto de la ambulación precoz y se hace una actualización crítica sobre las guías de manejo que orientan esta práctica en hospitalización. Finalmente, se describe la importancia de la implementación de la ambulación precoz, teniendo en cuenta los avances científicos del tratamiento del infarto y sus posibles determinantes, basados
JAMA, Jan 3, 2014
Acute kidney injury, a common complication of surgery, is associated with poor outcomes and high ... more Acute kidney injury, a common complication of surgery, is associated with poor outcomes and high health care costs. Some studies suggest aspirin or clonidine administered during the perioperative period reduces the risk of acute kidney injury; however, these effects are uncertain and each intervention has the potential for harm. To determine whether aspirin compared with placebo, and clonidine compared with placebo, alters the risk of perioperative acute kidney injury. A 2 × 2 factorial randomized, blinded, clinical trial of 6905 patients undergoing noncardiac surgery from 88 centers in 22 countries with consecutive patients enrolled between January 2011 and December 2013. Patients were assigned to take aspirin (200 mg) or placebo 2 to 4 hours before surgery and then aspirin (100 mg) or placebo daily up to 30 days after surgery, and were assigned to take oral clonidine (0.2 mg) or placebo 2 to 4 hours before surgery, and then a transdermal clonidine patch (which provided clonidine a...
Ciencia y enfermería, 2010
Objetivo: Determinar el impacto de la ambulación temprana (AT) en la presencia de cefalea y dolor... more Objetivo: Determinar el impacto de la ambulación temprana (AT) en la presencia de cefalea y dolor lumbar en pacientes sometidos a procedimientos quirúrgicos bajo anestesia espinal. Material y método: Revisión sistemática y meta-análisis que revisó las bases de datos MEDLINE, CINAhL online, healthStar, EMBASE, el Cochrane Library Controlled Trials Registry, LILACS y consulta de expertos. Incluyó estudios experimentales aleatorizados en cualquier idioma comparando pacientes sometidos a anestesia subaracnoidea aleatorizados durante su hospitalización a un grupo de ambulación temprana (intervención) o a un grupo control/cuidado estandarizado (reposo cama). La elegibilidad y la calidad de los artículos fue realizada por cuatro revisores de manera independiente. Luego se realizó la extracción de la información. Se calculó riesgo relativo (RR), 95 % de intervalos de confianza usando el modelo de efecto random. Resultados: Respecto de la cefalea y dolor lumbar 24 h posteriores a la anestesia espinal se identificaron seis estudios entre 1988-2008, teniendo en cuenta los criterios de elegibilidad. Se observaron 41 cefaleas (16.9% de 242) y 24 dolor lumbar (21.6% de 111) entre pacientes asignados a una ambulación temprana (DT), comparado con 54 cefaleas (22.3% de 207) y 32 dolor lumbar (27.5% de 116) entre pacientes con anestesia espinal asignados al grupo control (RR=0.67, 95% CI 0.44,1.02; y RR= 0.79, IC 95% 0.46, 1.34 respectivamente). Conclusión: El meta-análisis sugiere que puede existir beneficio hacia una disminución de cefalea y dolor lumbar en pacientes que reciben AT posterior a anestesia espinal.
JAMA, 2012
Context Of the 200 million adults worldwide who undergo noncardiac surgery each year, more than 1... more Context Of the 200 million adults worldwide who undergo noncardiac surgery each year, more than 1 million will die within 30 days. Objective To determine the relationship between the peak fourth-generation troponin T (TnT) measurement in the first 3 days after noncardiac surgery and 30-day mortality. Design, Setting, and Participants A prospective, international cohort study that enrolled patients from August 6, 2007, to January 11, 2011. Eligible patients were aged 45 years and older and required at least an overnight hospital admission after having noncardiac surgery. Main Outcome Measures Patients' TnT levels were measured 6 to 12 hours after surgery and on days 1, 2, and 3 after surgery. We undertook Cox regression analysis in which the dependent variable was mortality until 30 days after surgery, and the independent variables included 24 preoperative variables. We repeated this analysis, adding the peak TnT measurement during the first 3 postoperative days as an independent variable and used a minimum P value approach to determine if there were TnT thresholds that independently altered patients' risk of death. Results A total of 15 133 patients were included in this study. The 30-day mortality rate was 1.9% (95% CI, 1.7%-2.1%). Multivariable analysis demonstrated that peak TnT values of at least 0.02 ng/mL, occurring in 11.6% of patients, were associated with higher 30-day mortality compared with the reference group (peak TnT Յ 0.01 ng/mL): peak TnT of 0.02 ng/mL (adjusted hazard ratio [aHR], 2.41; 95% CI, 1.33-3.77); 0.03 to 0.29 ng/mL (aHR, 5.00; 95% CI, 3.72-6.76); and 0.30 ng/mL or greater (aHR, 10.48; 95% CI, 6.25-16.62). Patients with a peak TnT value of 0.01 ng/mL or less, 0.02, 0.03-0.29, and 0.30 or greater had 30-day mortality rates of 1.0%, 4.0%, 9.3%, and 16.9%, respectively. Peak TnT measurement added incremental prognostic value to discriminate those likely to die within 30 days for the model with peak TnT measurement vs without (C index=0.85 vs 0.81; difference, 0.4; 95% CI, 0.2-0.5; PϽ.001 for difference between C index values). The net reclassification improvement with TnT was 25.0% (PϽ.001). Conclusion Among patients undergoing noncardiac surgery, the peak postoperative TnT measurement during the first 3 days after surgery was significantly associated with 30-day mortality.
Annals of surgery, Jan 8, 2017
To determine the prognostic relevance, clinical characteristics, and 30-day outcomes associated w... more To determine the prognostic relevance, clinical characteristics, and 30-day outcomes associated with myocardial injury after noncardiac surgery (MINS) in vascular surgical patients. MINS has been independently associated with 30-day mortality after noncardiac surgery. The characteristics and prognostic importance of MINS in vascular surgery patients are poorly described. This was an international prospective cohort study of 15,102 noncardiac surgery patients 45 years or older, of whom 502 patients underwent vascular surgery. All patients had fourth-generation plasma troponin T (TnT) concentrations measured during the first 3 postoperative days. MINS was defined as a TnT of 0.03 ng/mL of higher secondary to ischemia. The objectives of the present study were to determine (i) if MINS is prognostically important in vascular surgical patients, (ii) the clinical characteristics of vascular surgery patients with and without MINS, (iii) the 30-day outcomes for vascular surgery patients with...
Investigación y Educación en Enfermería
Objective. This work sought to evaluate result indicators of the specialized vascular access prog... more Objective. This work sought to evaluate result indicators of the specialized vascular access program led by nursing during the period between 01 January 2018 and 31 December 2019 at Fundación Cardioinfantil -Instituto de Cardiología (Colombia). Methods. This was a retrospective descriptive study based on medical records of 1,210 patients who received insertion of vascular access devices by the specialized group of nurses. Result indicators are described. Results. Of all the patients who received insertion of a vascular access catheter, 53.1% were women, with mean age of 34.2 years, admitted to critical care services with cardiovascular problems and sepsis (90.2%). Placement of the peripherally inserted central catheter, midline and arterial was echo-guided between 91% and 100%, with a success rate on the first puncture of 66%. The average duration time of the peripherally inserted central catheter was 25.3 days, that of the midline catheter was 8 days, with a reach of 57% until the...
MedUNAB, Aug 1, 2016
Introduction: Prehabilitation is a multidisciplinary program that combines a set of interventions... more Introduction: Prehabilitation is a multidisciplinary program that combines a set of interventions (walking, aerobic exercises, inspiratory muscle training, nutrition education and psychological management) aimed at improving the functional capacity of patients before assuming any type of surgery. Its purpose is to physically prepare patients before going to surgery (especially the adult and older adult population) and favor rapid rehabilitation, reduction of postoperative complications, and adequate preparation for hospital discharge. Despite the knowledge of the importance of this intervention it is not a practice implemented and little is known about its benefit in the postoperative results of noncardiac surgery patients. Objective: To describe the prehabilitation and the scope of the scientific evidence in this topic. To present the PAMP project as a research model of prehabilitation in non-cardiac surgery. Methodology: We performed a non-systematic review of the literature on the fundamentals of prehabilitation, its origens, types of interventions, importance and its efficacy in the reduction of postoperative events in noncardiac surgery patients. Furthermore, we performed a literature review including systematic reviews and meta-analyzes of clinical trials on interventions of prehabilitation programs. Finally, this article presents the scope of the PAMP project in all its phases and its progress towards the implementation of a clinical trial of prehabilitation in Colombia through the PAMP phase II study was described. Conclusions: It is necessary to implement innovative multidisciplinary strategies that promote better results in the postoperative period of patients undergoing noncardiac surgery.
MedUNAB, 2016
Introducción: La implementación de guías de práctica clínica (GPC) es una estrategia que tiene co... more Introducción: La implementación de guías de práctica clínica (GPC) es una estrategia que tiene como fin el aumento del uso de la evidencia en el contexto de toma de decisiones y construcción de políticas en salud. Profesionales de enfermería de la Fundación Cardioinfantil-Institución de Cardiología (FCI-IC) establecieron un convenio colaborativo con la Asociación de Enfermeras de Ontario (RNAO), Canadá, con el fin de implementar y evaluar tres de sus GPC en adultos hospitalizados. Objetivo: Describir el diseño, proceso y evaluación preliminar del plan de implementación entre julio 2012 y diciembre 2014. Metodología: La selección de GPC se realizó previo diagnóstico de necesidades y factibilidad: dos preventivas y una de cuidado. Las GPC de prevención fueron: Una de caídas y otra de úlceras por presión (UPP). La GPC de cuidado fue valoración y manejo de úlceras de pie diabético. Los indicadores seleccionados para las GPC prevención fueron frecuencia de evaluación y confirmación del r...
Cochrane Database of Systematic Reviews, 2014
Trypanocidal drugs for chronic asymptomatic Trypanosoma cruzi infection (Review)
Anesthesiology, 2014
Background: Myocardial injury after noncardiac surgery (MINS) was defined as prognostically relev... more Background: Myocardial injury after noncardiac surgery (MINS) was defined as prognostically relevant myocardial injury due to ischemia that occurs during or within 30 days after noncardiac surgery. The study’s four objectives were to determine the diagnostic criteria, characteristics, predictors, and 30-day outcomes of MINS. Methods: In this international, prospective cohort study of 15,065 patients aged 45 yr or older who underwent in-patient noncardiac surgery, troponin T was measured during the first 3 postoperative days. Patients with a troponin T level of 0.04 ng/ml or greater (elevated “abnormal” laboratory threshold) were assessed for ischemic features (i.e., ischemic symptoms and electrocardiography findings). Patients adjudicated as having a nonischemic troponin elevation (e.g., sepsis) were excluded. To establish diagnostic criteria for MINS, the authors used Cox regression analyses in which the dependent variable was 30-day mortality (260 deaths) and independent variables...
BMC Nursing
Background Despite being considered preventable, ulcers due to pressure affect between 30 and 50%... more Background Despite being considered preventable, ulcers due to pressure affect between 30 and 50% of patients at high and very high risk and susceptibility, especially those hospitalized under critical care. Despite a lack of evidence over the efficacy in prevention against ulcers due to pressure, hourly repositioning in critical care as an intervention is used with more or less frequency to alleviate pressure on patients’ tissues. This brings up the objective of our study, which is to evaluate the efficacy in prevention of ulcers due to pressure acquired during hospitalization, specifically regarding two frequency levels of repositioning or manual posture switching in adults hospitalized in different intensive care units in different Colombian hospitals. Methods A nurse-applied cluster randomized controlled trial of parallel groups (two branches), in which 22 eligible ICUs (each consisting of 150 patients), will be randomized to a high-frequency level repositioning intervention or ...
Investigación y Educación en Enfermería
Article linked to research: PENFUP: Evaluation of the impact of using skin protectors versus conv... more Article linked to research: PENFUP: Evaluation of the impact of using skin protectors versus conventional care with skin lubrication in preventing pressure ulcers in high-and very high-risk patients admitted to all the medical-surgical care services: multi-centric clinical trial.
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Papers by Olga Lucía Cortés