Factores predictores de derrame pleural en pacientes adultos con dengue atendidos en una Unidad de Cuidados Intensivos durante el año 2022
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Fecha
2025
Autores
Rodríguez Rivas, Jesús Alberto
Rodríguez Arias, Marcela
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
Introducción: En la etapa crítica, los pacientes con dengue pueden experimentar
un tercer espacio en la pleura, lo que puede provocar un shock hipovolémico debido
a extravasación. Se examinan los factores de predictores para la aparición de
derrame pleural.
Objetivo: Analizar los factores que predicen el derrame pleural en adultos con
dengue atendidos en una unidad de cuidados intensivos en Barranquilla, (Colombia)
en el año 2022.
Materiales y métodos: Análisis retrospectivo de pacientes graves con dengue
ingresados en la unidad de cuidados intensivos en Barranquilla durante el año 2022.
Se analizaron diferentes factores que predicen el derrame pleural a través de
modelos de regresión logística binaria y regresión lineal, calculando las odds ratio y
los coeficientes con sus intervalos de confianza al 95%.
Resultados: Se incluyeron 204 pacientes a lo largo del periodo de estudio; de estos,
37 (18.1%) pacientes tuvieron derrame pleural. Los modelos de regresión logística
indicaron que la existencia de ascitis (OR: 4.56; IC 95%: 1.82 – 11.45), colecistitis
aguda alitiásica (OR: 3.21; IC 95%: 1.21 – 8.54), sepsis pulmonar (OR: 12.98; IC
95%: 1.19 – 141.1), transfusiones (OR: 3.73; IC 95%: 1.21 – 8.54) y un nadir de
plaquetas ≤20.000 No./mm3
(OR: 4.77; IC 95%: 2.26 – 10.08) fueron indicadores de
la presencia de derrame pleural.
Conclusiones: En los pacientes críticos con dengue, se identificaron signos de fuga
capilar (ascitis, colecistitis alitiásica) junto a condiciones clínicas (trombocitopenia
grave, uso hemoderivados, patologías estructurales pulmonares) como factores
predictivos de derrame pleural.
Introduction: In the critical phase, patients with dengue may experience a third space in the pleura, which can lead to hypovolemic shock due to extravasation. We examined predictive factors for the development of pleural effusion. Objectives: To analyze the factors that predict pleural effusion in adults with dengue who were treated in an intensive care unit in Barranquilla, Colombia, in 2022. Materials and methods: Retrospective analysis of severely ill patients with dengue admitted to the intensive care unit in Barranquilla during 2022. Different factors that predict pleural effusion were analyzed using binary logistic regression and linear regression models, calculating odds ratios and coefficients with their 95% confidence intervals. Results: A total of 204 patients were included throughout the study period; of these, 37 (18.1%) had pleural effusions. Logistic regression models indicated that the presence of ascites (OR: 4.56; 95% CI: 1.82–11.45), acute acalculous cholecystitis (OR: 3.21; 95% CI: 1.21–8.54), pulmonary sepsis (OR: 12.98; 95% CI: 1.19–141.1), transfusions (OR: 3.73; 95% CI: 1.21–8.54), and a nadir platelet count ≤20,000/mm3 (OR: 4.77; 95% CI: 2.26–10.08) were predictors of pleural effusions. Conclusions: In critically ill patients with dengue, signs of capillary leak (ascites, acalculous cholecystitis) were identified along with clinical conditions (severe thrombocytopenia, use of blood products, structural lung pathologies) as predictive factors of pleural effusion.
Introduction: In the critical phase, patients with dengue may experience a third space in the pleura, which can lead to hypovolemic shock due to extravasation. We examined predictive factors for the development of pleural effusion. Objectives: To analyze the factors that predict pleural effusion in adults with dengue who were treated in an intensive care unit in Barranquilla, Colombia, in 2022. Materials and methods: Retrospective analysis of severely ill patients with dengue admitted to the intensive care unit in Barranquilla during 2022. Different factors that predict pleural effusion were analyzed using binary logistic regression and linear regression models, calculating odds ratios and coefficients with their 95% confidence intervals. Results: A total of 204 patients were included throughout the study period; of these, 37 (18.1%) had pleural effusions. Logistic regression models indicated that the presence of ascites (OR: 4.56; 95% CI: 1.82–11.45), acute acalculous cholecystitis (OR: 3.21; 95% CI: 1.21–8.54), pulmonary sepsis (OR: 12.98; 95% CI: 1.19–141.1), transfusions (OR: 3.73; 95% CI: 1.21–8.54), and a nadir platelet count ≤20,000/mm3 (OR: 4.77; 95% CI: 2.26–10.08) were predictors of pleural effusions. Conclusions: In critically ill patients with dengue, signs of capillary leak (ascites, acalculous cholecystitis) were identified along with clinical conditions (severe thrombocytopenia, use of blood products, structural lung pathologies) as predictive factors of pleural effusion.
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Palabras clave
Dengue, Derrame pleural, Ascitis, Transfusión, Adultos
