Liver transplantation is the major treatment for end-stage liver disease. Postoperative care is a great challenge to reduce morbidity and mortality in patients. In this sense, management in the liver ICU allows hemodynamic management, coagulation monitoring, renal support, electrolyte disturbances, respiratory support and early weaning from mechanical ventilation and evaluation of the liver graft. Objective: The present study shows the results of the management of liver transplant patients in 20 years of experience in a transplant center in a low- to middle-income country. Materials and methods: The medical records of 273 adult patients in the ICU in the immediate postoperative liver transplant were reviewed, from March 20, 2000 to November 30, 2020, including the effect of the pandemic caused by COVID-19. Liver-kidney, retransplanted, SPLIT, and domino transplant patients wer...

Introducción: Desde el inicio de la pandemia por el COVID-19 se han utilizado distintos fármacos y medicamentos para la prevención y tratamiento de la infección por COVID-19. Asimismo, se han desarrollado diversas investigaciones que evalúan la eficacia y seguridad de estas intervenciones, muchas de las cuales han demostrado generar más daño que beneficio para el paciente, por tal motivo es necesario estandarizar el manejo del paciente adulto con COVID-19 en nuestro contexto. Objetivo: Proveer recomendaciones clínicas basadas en evidencia para el manejo del adulto con COVID-19. Métodos: Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El Para su elaboración se GEG decidió realizar una adaptación rápida de la Guía para el cuidado de pacientes adultos críticos con COVID-19 en las Américas de la Organización Panamericana...

Introduction: Since the beginning of the COVID-19 pandemic, different drugs and medications have been used for the prevention and treatment of COVID-19 infection. Likewise, various investigations have been carried out to evaluate the efficacy and safety of these interventions, many of which have been shown to generate more harm than benefit for the patient, for this reason it is necessary to standardize the management of adult patients with COVID-19 in our context. Objective: To provide evidence-based clinical recommendations for the management of adults with COVID-19. Methods: A guideline development group (GEG) was formed that included medical specialists and methodologists. For its elaboration, GEG decided to carry out a rapid adaptation of the Guide for the care of critical adult patients with COVID-19 in the Americas of the Pan American Health Organization (PAHO) as well as to carry...

Introducción: El presente artículo resume la guía de práctica clínica (GPC) para la prevención y manejo de la injuria renal aguda en el Seguro Social del Perú (EsSalud). Objetivo: Proveer recomendaciones clínicas basadas en evidencia para la prevención y manejo de la injuria renal aguda en EsSalud. Métodos: Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El GEG formuló 6 preguntas clínicas a ser respondidas por la presente GPC. Se realizó búsquedas sistemáticas de revisiones sistemáticas y –cuando fue considerado pertinente– estudios primarios en PubMed durante el 2022. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de tr...

Introduction: This article summarizes the clinical practice guideline (CPG) for the prevention and management of acute kidney injury in the Social Security of Peru (EsSalud). Objective: Provide clinical recommendations based on evidence for the prevention and management of acute kidney injury in EsSalud. Methods: A guideline development group (GEG) was formed that included medical specialists and methodologists. The GEG formulated 6 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and -when considered relevant- primary studies were carried out in PubMed during 2022. Evidence was selected to answer each of the clinical questions posed. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In regular work meetings, the GEG used the GRADE methodology to review the e...