Browsing by Author "Dagnino Sepúlveda, Jorge"
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- ItemComplicaciones cardiopulmonares asociadas a Propofol versus sedación tradicional para procedimientos endoscópicos digestivos en adultos : revisión sistemática y metaanálisis de estudios clínicos randomizados (ECR)(2016) Carmona B., Javiera; Auad A., Hernán; Altermatt, Fernando; Dagnino Sepúlveda, Jorge; Carmona B., Javiera; Auad A., Hernán; Altermatt, Fernando; Dagnino Sepúlveda, Jorge
- ItemDelphi method to achieve clinical consensus for a bpmn representation of the central venous access placement for training purposes(2020) de la Fuente Sanhueza, René Francisco; Fuentes Henríquez, Ricardo Sergio; Muñoz Gama, Jorge; Dagnino Sepúlveda, Jorge; Sepúlveda Fernández, Marcos ErnestoProper teaching of the technical skills necessary to perform a medical procedure begins with its breakdown into its constituent steps. Currently available methodologies require substantial resources and their results may be biased. Therefore, it is difficult to generate the necessary breakdown capable of supporting a procedural curriculum. The aim of our work was to breakdown the steps required for ultrasound guided Central Venous Catheter (CVC) placement and represent this procedure graphically using the standard BPMN notation. Methods: We performed the first breakdown based on the activities defined in validated evaluation checklists, which were then graphically represented in BPMN. In order to establish clinical consensus, we used the Delphi method by conducting an online survey in which experts were asked to score the suitability of the proposed activities and eventually propose new activities. Results: Surveys were answered by 13 experts from three medical specialties and eight different institutions in two rounds. The final model included 28 activities proposed in the initial model and four new activities proposed by the experts; seven activities from the initial model were excluded. Conclusions: The proposed methodology proved to be simple and effective, generating a graphic representation to represent activities, decision points, and alternative paths. This approach is complementary to more classical representations for the development of a solid knowledge base that allows the standardization of medical procedures for teaching purposes.
- Item[Nocturnal hypoxemia after abdominal surgery: associated factors and usefulness of oxygen therapy](1997) Bugedo Tarraza, Guillermo; González Sotomayor, Julio; Cuadra F., Juan Carlos de la; Asenjo, C.; Gajardo, A.; Huechillán, I.; Añazco, R.; Torregrosa, S.; Dagnino Sepúlveda, JorgeBackground: Postoperative nocturnal hypoxemia (PONH) is a main factor in the genesis of respiratory, cardiac and neurologic complications after surgery. Aim: To describe the phenomenon of PONH after elective laparoscopy and laparotomy, and to evaluate the usefulness of oxygen therapy in its prevention. Patients and methods: Fifteen elective patients (6 M, 9 F, 51 +/- 8 years old) scheduled for laparotomy (n = 8) or laparoscopy (n = 7) were studied. Ventilatory parameters and pulse oximetry were measured pre and postoperatively. Patients were randomly assigned to receive oxygen by nasal cannula either during the first or the second postoperative night. Results: PONH (SatO2 < 85) developed in seven patients (47%), of which four had undergone laparoscopic surgery. PONH was more frequent in mildly obese patients and those presenting preoperative hypoxemia (p = 0.03). Peak Flow was lower in patients presenting PONH (p = 0.04). In five patients, PONH was associated with significant tachycardia. Oxygen administration was associated with a higher SatO2 and prevented PONH in 6/7 patients. Conclusions: PONH is a common event in patients older than 40 years scheduled for open or laparoscopic abdominal surgery, and develops more frequently in those with preoperative nocturnal hypoxemia and greater ventilatory impairment. PONH can be prevented, most of the time, with oxygen administration.
- ItemOndansetron and droperidol in the prevention of postoperative nausea and vomiting(1999) Bugedo Tarraza, Guillermo; González Sotomayor, Julio; Asenjo, C.; Cuadra F., Juan Carlos de la; Gajardo, A.; Castillo Fuenzalida, Luis; Muñoz L., Hernán; Dagnino Sepúlveda, JorgeWe have performed a prospective, randomized, double-blind clinical study to assess the efficacy of ondansetron, droperidol, or both, in preventing postoperative emesis. We studied 242 patients undergoing biliary or gynaecological surgery under general anaesthesia. Shortly before induction of anaesthesia, patients received: saline i.v. (group 1, n=62); droperidol 2.5 mg i.v. (group 2, n=60); ondansetron 4 mg i.v. (group 3, n=57); or droperidol 2.5 mg with ondansetron 4 mg i.v. (group 4, n=63). Nausea occurred in 45%, 37%, 32% and 29% (P=0.234) and vomiting in 23%, 17%, 9% and 5% (P=0.016) of patients in groups 1, 2, 3 and 4, respectively, during the first 24 h. Groups 2 and 4 had greater sedation scores than group 1 during the first 3 h (P<0.01). We conclude that both droperidol and ondansetron showed a significant antiemetic effect, ondansetron was not significantly better than droperidol, and the combination of droperidol and ondansetron was better than droperidol but no better than ondansetron alone.
- ItemOndansetron and droperidol in the prevention of postoperative nausea and vomiting(Wiley, 1999) Bugedo Tarraza, Guillermo; González Sotomayor, Julio; Asenjo, C.; Cuadra F., Juan Carlos de la; Gajardo, A.; Castillo Fuenzalida, Luis; Muñoz L., Hernán; Dagnino Sepúlveda, JorgeWe have performed a prospective, randomized, double-blind clinical study to assess the efficacy of ondansetron, droperidol, or both, in preventing postoperative emesis. We studied 242 patients undergoing biliary or gynaecological surgery under general anaesthesia. Shortly before induction of anaesthesia, patients received: saline i.v. (group 1, n=62); droperidol 2.5 mg i.v. (group 2, n=60); ondansetron 4 mg i.v. (group 3, n=57); or droperidol 2.5 mg with ondansetron 4 mg i.v. (group 4, n=63). Nausea occurred in 45%, 37%, 32% and 29% (P=0.234) and vomiting in 23%, 17%, 9% and 5% (P=0.016) of patients in groups 1, 2, 3 and 4, respectively, during the first 24 h. Groups 2 and 4 had greater sedation scores than group 1 during the first 3 h (P<0.01). We conclude that both droperidol and ondansetron showed a significant antiemetic effect, ondansetron was not significantly better than droperidol, and the combination of droperidol and ondansetron was better than droperidol but no better than ondansetron alone.
- ItemRevitalising medical education: The School of Medicine at the Pontificia Universidad Católica de Chile(2008) Sánchez Díaz, Ignacio; Riquelme Pérez, Arnoldo; Moreno Bolton, Rodrigo; Mena Concha, Beltrán; Dagnino Sepúlveda, Jorge; Grebe Barros, Gonzalo
- ItemSeventy five years of the Medical School of the Pontifical Catholic University of Chile(SOC MEDICA SANTIAGO, 2005) Grebe Barros, Gonzalo; Dagnino Sepúlveda, Jorge; Sánchez Díaz, Ignacio
- ItemThe trio from Vienna. From cocaine to local anesthesia(2011) Dagnino Sepúlveda, Jorge
- ItemWilliam Hunter (1718-1783) : his legacy three hundred years from his birthday(2019) Dagnino Sepúlveda, Jorge