Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introduction: Autologous transfusion has three modalities: autologous transfusion with predeposit, preoperative hemodilution (normovolemic or hypervolemic), and the system for autologous blood recovery (cell saver), whether intraoperative or postoperative.Objective: To show the effectiveness of the use of the autologous blood recovery system in highly complex surgical patients at Alcívar Hospital.Method: Nonexperimental, retrospective study, of indirect observation and with correlational analysis. The sample consisted of 112 patients who underwent surgery for cardiovascular, orthopedic and traumatological conditions, chosen based on inclusion and exclusion criteria. The cell saver system was used in 56 patients and 56 patients used homologous blood transfusions.Results: The cell saver system was beneficial in 93 % of patients; morbidity and mortality decreased, mainly in patients operated for any cardiovascular condition, while the cost-benefit ratio increased, due to the fact prioritization of economic resources. In traumatology and orthopedics, it was not so beneficial, since the amount of blood recovered fluctuated between 300 and 500 mL in conventional interventions, which motivated the use of blood products and increased the cost. In tumor resections and instrumentation of different spine segments, up to 800 mL of blood were recovered, which was significant. The complication rate was lower in patients who used the cell saver system (7 %), compared to patients who used homologous blood products (32 %). A shorter hospital stay was observed in the cell saver group (1-20 days), compared to those who used homologous blood products (over 10 days, while in 5 cases it was over 21 days).Conclusions: The use of the autologous blood recovery system is an effective procedure to infuse blood products with greater safety.

Introduction: Transducer calibration is very important for the accurate measurement of pressures during invasive hemodynamic monitoring of patients requiring close observation in the primary care units and in the operating room. Objective: To develop and validate a method of calibration of pressure transducers, which is simple, efficient and low-cost. Methods: An alternative manometric method, based on Pascal's law, was developed for the calibration of pressure transducers during invasive hemodynamic monitoring performed at the intensive care unit of the cardiovascular surgery department at Hermanos Ameijeiras Clinical-Surgical Hospital. This method was validated by its comparison with the recommended standard in a total of 215 patients who required invasive hemodynamic monitoring between January and June 2015. Results: With the alternative manometric method created, the same result was obtained as with the hydraulic method recommended by the literature. Conclusions: The alternative method created is accurate, efficient and cost-effective.

Introduction: Infectious endocarditis is a disease that involves the heart valves more frequently, but it can also occur on chordae tendineae, or the mural endocardium. The characteristic lesion, vegetation, consists of a mass of platelets, fibrin, microorganisms microcolonies, and few inflammatory cells.Objective: To describe the perioperative behavior, as well as the clinical anesthesiological evolution of a patient who presented cardiac arrest secondary to acute mitral regurgitation due to bacterial endocarditis.Clinical case: A young man with a diagnosis of infective endocarditis and mitral valve insufficiency with ruptured tendinous cords presented cardiorespiratory arrest requiring brain and cardiopulmonary resuscitation with spontaneous circulation recovery. He was taken to the emergency operating room for mitral valve replacement and chordae tendineae conservation. Satisfactory results were obtained, without pulmonary or neurological sequelae.Conclusions: The quick identification and treatment of bacterial endocarditis improves prognosis and prevents nefarious complications. Transesophageal echocardiography provides adequate spatial resolution and accuracy in its evaluation and gives the possibility for therapeutic improvement.

Introduction: The long QT syndrome is a channelopathy characterized by a serious alteration in ventricular repolarization. Objective: To determine the risk factors associated with prolonged QT interval in cardiovascular anesthesia. Methods: Descriptive, cross-sectional study from May 2014 to May 2016, in patients scheduled for cardiac surgery under extracorporeal circulation. The attributable risk and the confidence interval were evaluated for 95% and in variables with p value under 0.05. Results: 483 patients were included, with a mean age of 62 years, of whom 57 (12 %) had prolonged QTc. Advanced age (RA: 1.8, 95 % CI: 0.86-2.67), chronic renal failure (RA: 2.7, 95 % CI: 0.82-4.96), type 2 diabetes mellitus (RA: 1.7, 95 % CI: 1.01-2.15), ischemic heart disease (RA: 3.5, 95 % CI: 1.60-4.02), left ventricular hypertrophy (RA: 2.2, 95 % CI: 2.53-3.15), calcium-lactam antibiotics (RA: 1.5, 95 % CI: 0.92-2.98), balanced orotracheal general anesthesia (RA: 2.1, 95 % CI: 2.92-2.35), ondansetron (RA: 1.7, 95 % CI: 0.98-2.74), droperidol (RA: 1.8, 95 % CI: 2.18-3.94) ), extracorporeal circulation time (RA: 2.5, 95 % CI: 1.02-3.62), hypokalemia (RA: 1.4, 95 % CI: 1.03-2.91) and severe bradycardia (RA: 1.8, 95 % CI: 1.12-3.86) were associated with a high risk of QT prolongation. The complications were more significant in this group, with a mortality of 23%. Conclusions: Advanced age, chronic renal failure, type 2 diabetes mellitus, ventricular hypertrophy, and ischemic heart disease facilitate the prolongation of QT induced by calcium blockers. The longer time of extracorporeal circulation, the balanced anesthesia with isoflurane, the use of droperidol and ondansetron, bradycardia and postoperative hypokalemia are variables associated with the extension of the QT interval, with an increase in complications. Ventricular tachyarrhythmias and mortality were higher in this subgroup of patients.

Introduction: The implementation of an early postoperative recovery protocol guarantees lower morbidity, short postoperative stay, and patient satisfaction. Objectives: To evaluate the usefulness of epidural analgesia within an early recovery protocol in laparoscopic colorectal surgery. Method: A prospective and longitudinal descriptive and observational study was carried out with the objective of evaluating the usefulness of epidural analgesia within an early recovery protocol in laparoscopic colorectal surgery in patients operated at Hermanos Ameijeiras Surgical-Clinical Hospital in the period from May 2014 to December 2016. The sample consisted of 97 patients who underwent laparoscopic colorectal surgery with physical status II-III according to the ASA, of any gender, scheduled for elective laparoscopic colorectal surgery included in the protocol. Results: The average age was 70 years and the male sex predominated. The analgesia obtained was effective, absence of pain was achieved both at rest and in movement at all measurement times in more than 50 % of patients and, when pain appeared, it was considered mild. The requirements for rescue analgesia were 24.7 %. The complications were minimal. Tremors and hypotension appeared in 11.3 % and 9.3 % of cases, respectively. Hospital stay was less than three days in more than half of the patients. Conclusions: The implementation of an early postoperative recovery protocol increases the effectiveness and efficiency in perioperative care.

On July 19, 2016, the University of Azuay approves its project called "SOLIDARITY ACTIONS WITH THE DAMNIFIED PEOPLE OF ECUADOR EARTHQUAKE - 2016" which aims to improve the situation of the victims, from the potential of the academy, working from areas such as: culture, economic reactivation, innovation, alternatives for access to decent housing, internal and external communication between groups hosted in camps. These actions are proposed through intervention projects, establishing direct contact with the Samán Camp, located in the Canoa parish, San Vicente canton, in Manabí, shelter coordinated by the INTI Corporation. The proposed methodology proposes that each academic unit present to its Linking Coordination a project framed in the objectives of the "Solidarity Actions T-2016" Program, once these proposals were agreed with the academic boards, the University facilitated the transfer of equipment to the site for the survey the base information, execution of scheduled activities and delivery of results. Each of the projects had the participation of between 2 to 7 teachers and between 15 and 60 students, who in the framework of chairs or internships developed their projects. Today, four projects are underway: Internal, external communication and brand generation. Training in automotive maintenance. Design and manufacture of prototypes in bamboo cane. Housing projects and community equipment, in Canoa-Manabí.

The purpose of this essay was aimed at reflecting on professional training from the axiological configuration of social responsibility in university management; for which a review of the theoretical aspects that explain the implications of the constructs related to an academic vision of classroom management was made, consistent with the teacher's task beyond the instructional to facilitate the training of professionals required by the country to assume a proactive, critical and reflective attitude towards the search for the conscience of socially responsible worth. The axiology as a theory of value, in addition to the philosophical positioning, has an existential reference inherent to the professional training reflected in the behaviors demonstrated in the actions of citizen participation, solidarity and ethical behavior to assume the increasingly complex environments where economic problems prevail, social and environmental factors that hinder the development of societies. Thus, university social responsibility alludes to the consistent commitment to the training of future professionals and the ways in which they will work in companies from an ethical, responsible perspective that contributes to the common good and social justice. It was concluded from an axiological view that values such as fraternity, solidarity, and social responsibility should guide the academic work aimed at achieving honest and honest citizens committed to the society of which they are a part and to which they will turn their knowledge to improve their quality of life, trying to solve the problems that the knowledge society faces.

The knowledge arises from processes that relate experiences and information that is acquired through methodological and daily information systems, which impacts on creative ways of interpreting realities through cognitive processes, which involve a change in the way of being of people to be in society, socioformation provides methods that involve using students' experiences, modifying the dynamics of learning, achieving an understanding of a more diffuse reality, which globalization is the main protagonist; the event of the II International Congress of Evaluation of Performance Values 2017, held on October 6 and 7, in a virtual way, as an objective, research and dissemination proposals were promoted in the educational field, the experts propose to develop an evaluation from a socioformative concept, which impacts on the design of instruments, validation, evaluation, application of tests, generate systemic processes on the evaluation of learning; researchers from educational institutions and service providers promote methodologies that respond to these changes and impact the teacher and student for real educational efficiency; plans, programs, systems, theory, praxis, being, knowing how to live together are general elements that should be integrated into any educational process, presented in class plans that are promoters of sustainable training, especially that responds to the demands of the environment personnel, in the area of local population, as well as with an assimilation of response to the global process.

The use of systems that allow the measurement of processes within educational systems has been generalized in almost all countries of the world. The measurement allows determining in the first instance the performance conditions of the students and the administrative and related processes that are developed in it, in this sense the state education policies worldwide have generated a special interest in value-added models, This is why this article seeks to give a pedagogical look to this concept in higher education institutions, as an indicator of university social relevance. The main purpose is to find determining elements of a model that allows to integrate the learning strategies defined by the philosophical current of each institution to the results of the measurements of the added value. Within the results found through text mining, it was found that the concept of added value is associated with terms such as: high achievements, punctuation, models, measurements, contribution, difference. In addition, it is related to factors such as: education. Students, school and production. These factors constitute the fundamental elements for the definition of a value-added monitoring model in higher education institutions