LAS UCI CON DISPOSITIVOS, CLAVES PARA TRATAR PACIENTES COVID-19

Actualidad Salud / Cuidado personal
630 comentarios en LAS UCI CON DISPOSITIVOS, CLAVES PARA TRATAR PACIENTES COVID-19

HÁBITOS DE PROTECCIÓN LA MEJOR BIOSEGURIDAD

Es importante destacar una de las medidas de contención como los distanciamientos sociales se usan para no colapsar los sistemas de salud; la evidencia respectiva demuestra que la clave del éxito en estos procesos no es el aislamiento no protector sino la adecuada interacción con los hábitos de protección y bioseguridad, para aprender a vivir con COVID-19 y su agente infeccioso silente.

Es necesario establecer un parámetro estadístico inicial, aproximadamente la tasa de mortalidad es de 3.4% de la población, Tasa de hospitalización 19%, Tasa de Propagación. Comunitaria 10 al 40%, sin contar que existe una variación para cada localidad mundial afectada, los cuales determinan valores oscilantes bajos en los porcentajes de personas que ingresan a UCI con dificultad respiratoria grave según los modelos matemáticos.

El colapso de las Unidades de Cuidados Intensivos, no solo se debe aludir al coronavirus, se deben analizar múltiples variables incluyendo; los escasos recursos financieros, los limitados equipos de bioseguridad y el número de centros de atención con unidad de cuidado crítico.

Así mismo, muchos estudios demuestran que hay múltiples patologías que saturan un centro de cuidados intensivos durante todo el año sin ser por causas pandémicas.

Es necesario determinar que se requieren más unidades de cuidado crítico que cuenten con la disponibilidad de dispositivos clave como los ventiladores para el tratamiento de pacientes con síntomas respiratorios graves.

Esta propuesta se debe acompañar de estudios y análisis presupuestales para disminuir los costos, siendo el factor económico una de las principales limitantes para la expansión de unidades, lo que permitiría prevenir el colapso del sistema de salud ante nuevas eventualidades.

LA CUARENTENA:

  • La palabra cuarentena se usó por primera vez en Venecia, Italia en 1127 con respecto a la lepra y se usó ampliamente en respuesta a la Peste Negra, aunque no fue hasta 300 años después que el Reino Unido comenzó a imponer cuarentena en respuesta a la peste.
  • El objetivo primario de la Cuarentena ante el COVID-19 no es solo prevenir, debido a que se reconoce que solo el 16 al 20% de prevención de contagio en una persona que se resguarde, deja el 80% de probabilidades de luego tener una posibilidad alta de contagio; ante los diversos estudios la medida de distanciamiento social preventivo es óptimo si se lleva a cabo con las medidas de higiene. (No olvidar Repercusiones económicas).
  • La cuarentena es la separación y restricción del movimiento de personas que potencialmente han estado expuestas a una enfermedad contagiosa para determinar si son sospechosos o pacientes sintomáticos, lo que reduce el riesgo de que infecten a otros.
  • Las cuarentenas en toda la ciudad también se impusieron en áreas de China y Canadá durante el brote de 2003 del síndrome respiratorio agudo severo (SRAS), mientras que aldeas enteras en muchos países de África occidental se pusieron en cuarentena durante el brote de Ébola de 2014.
  • Los formuladores de políticas necesitan urgentemente síntesis de evidencia para producir orientación para el público. En circunstancias como estas, la OMS recomienda revisiones rápidas.
  • La separación de los seres queridos, la pérdida de libertad, la incertidumbre sobre el estado de la enfermedad y el aburrimiento pueden, en ocasiones, crear efectos dramáticos.
  • El uso exitoso de la cuarentena como medida de salud pública requiere que reduzcamos en la medida de lo posible los efectos negativos asociados.

ORÍGENES ANIMALES DE LOS CORONAVIRUS HUMANOS.

Todos los coronavirus que han causado enfermedades a los humanos han tenido orígenes animales, generalmente en murciélagos o roedores. El coronavirus del síndrome respiratorio agudo severo (SARS- CoV) y el coronavirus del síndrome respiratorio del Medio Oriente (MERSCoV) y se transmitieron a los humanos desde los murciélagos por gatos de civeta y camellos dromedarios, respectivamente. El SARS-CoV-2 de 2019 probablemente se transmitió a los humanos a través de pangolines que se venden ilegalmente en los mercados chinos.

Los coronavirus relacionados con el SARS están cubiertos por proteínas espiga que contienen un dominio variable de unión al receptor (RBD). Este RBD se une al receptor de la enzima convertidora de angiotensina-2 (ACE-2) que se encuentra en el corazón, los pulmones, los riñones y el tracto gastrointestinal, lo que facilita la entrada viral en las células diana. Según la secuenciación genómica, la RBD del SARS-CoV-2 parece ser una versión mutada de su virus más estrechamente relacionado, RaTG13, muestreado de murciélagos (Rhinolophus affinis).

Con lo que sabemos sobre la patogénesis del virus SARS-CoV, parece razonable suponer que aquellos con niveles más altos de receptores ACE-2 pueden estar en mayor riesgo. Se especuló que la expresión de los receptores ACE-2 puede estar relacionada con la raza, específicamente después de que un informe inicial sugiriera que los hombres asiáticos tenían una mayor proporción de células que expresan ACE-2 que los blancos y los afroamericanos.

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