Morbimortalidad asociada a transfusiones de glóbulos rojos en una unidad de cuidados intensivos pediátricos de Bogotá

Determinar si las transfusiones de glóbulos rojos en niños en cuidados intensivos se asocian a aumento de la morbimortalidad. Materiales y Métodos: Estudio observacional analítico de cohorte. Se incluyeron niños con anemia de 1 mes a 18 años de edad en un periodo de 10 meses. Resultados: 134 niños con anemia fueron incluidos. En el 51.5% la anemia se desarrolló posterior a su ingreso. De éstos, 66 niños recibieron una transfusión de glóbulos rojos y la mediana de hemoglobina pretransfusión fue de 7.5 g/dl. El 6% de los pacientes transfundidos presentó una Reacción adversa. Entre el grupo de pacientes expuesto a transfusión y los no expuestos existió diferencia significativa en la hemoglobina de ingreso, cantidad de sangre extraída y edad en el análisis bivariado. Los pacientes transfundidos tuvieron mayor mortalidad (15.2% vs. 2.9%, p =0.013). El desarrollo de falla multiorgánica también fue más frecuente en el grupo transfundido (62.1% vs. 16.2%, p < 0.001). La mediana de los días de estancia en la UCI y el tiempo de ventilación mecánica fue mayor en los niños transfundidos que en los no transfundidos, 8 vs. 4 días p< 0.001, y 6 vs. 3 días p<0.001 respectivamente. Un análisis multivariado mostró asociación de transfusión de glóbulos rojos con mortalidad y falla multiorgánica. Conclusión: Las transfusiones de glóbulos rojos se asocian con un aumento en la Mortalidad y en el desarrollo de falla multiorgánica. La estancia en la UCI y el tiempo de ventilación mecánica fue mayor en los niños transfundidos.

Morbimortalidad asociada a transfusiones de glóbulos rojos. Unidad de Cuidados Intensivos, Clínica Infantil Colsubsidio

Objetivos: Determinar si las transfusiones de glóbulos rojos en niños en cuidados intensivos se asocian a aumento de la morbimortalidad. Materiales y Métodos: Estudio observacional analítico de cohorte. Se incluyeron niños con anemia de 1 mes a 18 años de edad en un periodo de 13 meses. Resultados: 156 niños con anemia fueron incluidos. En el 51.5% la anemia se desarrolló posterior a su ingreso. De éstos, 77 niños recibieron una transfusión de glóbulos rojos y la mediana de hemoglobina pretransfusión fue de 7.5 g/dl. El 6.5% de los pacientes transfundidos presentó una Reacción adversa. Entre el grupo de pacientes expuesto a transfusión y los no expuestos existió diferencia significativa en la hemoglobina de ingreso, cantidad de sangre extraída y edad en el análisis bivariado. Los pacientes transfundidos tuvieron mayor mortalidad (12.9% vs. 2.5%, p =0.014). El desarrollo de falla multiorgánica también fue más frecuente en el grupo transfundido (57.1% vs. 13.9%, p < 0.001). La mediana de los días de estancia en la UCI y el tiempo de ventilación mecánica fue mayor en los niños transfundidos que en los no transfundidos, 8 vs. 4 días p< 0.001, y 6 vs. 3 días p<0.001 respectivamente. Un análisis multivariado mostró asociación de transfusión de glóbulos rojos con mortalidad y falla multiorgánica. Conclusión: Las transfusiones de glóbulos rojos se asocian con un aumento en la Mortalidad y en el desarrollo de falla multiorgánica. La estancia en la UCI y el tiempo de ventilación mecánica fue mayor en los niños transfundidos.

Neogene and Quaternary paleoenvironmental history at DSDP Leg 71 Holes

The Neogene and Quaternary sedimentary record of Leg 71 and previously drilled sequences from the Southern Ocean reveal evidence of a major late Miocene change of oceanic and glacial conditions in the southern high latitudes during paleomagnetic Chron 9. The characteristics of late Miocene sedimentation and in particular the study of erosional patterns and ice-rafted debris suggest the following conclusions. 1) In the late Miocene, the Polar Front first migrated to the northern latitudes of the Southern Ocean and surface water temperatures became similar to those of today. 2) Extensive ice shelves or ice tongues were not present along the Antarctic margin until late Chron 9 (about 9.0 Ma). 3) Before Chron 9, West Antarctica was occupied by an archipelago and the West Antarctic Sea. 4) Extensive ice shelves formed in the West Antarctic region, eventually coalescing and thickening to form the grounded West Antarctic ice sheet by Chron 9. 5) The newly formed West Antarctic ice sheet was probably unstable and frequently became an ungrounded ice shelf, thus accounting for the scarcity of late Miocene ice-rafted debris. 6) Extensive erosion or nondeposition of sediment was probably the result of increased Antarctic Bottom Water (AABW) formation in the West Antarctic region during the initial formation of extensive West Antarctic ice shelves and during periods when the West Antarctic ice sheet was ungrounded. 7) In the Southwest Atlantic, AABW velocity waned during the latest Miocene. During the late Gilbert Chron a major and permanent change occurred in the pattern of ice-rafting to the South Atlantic, and after 4.35 Ma the increased IRD accumulation rate and frequency of major episodes of IRD accumulation suggest increased stability of the West Antarctic ice sheet. In addition, radiolarian faunas of Hole 514 record at least eight migrations of the Polar Front to the north of the site during the past 4.07 m.y. An apparent increase in the frequency of Polar Front migrations occurred about 2.7-2.6 Ma, possibly in response to oceanic change induced by fluctuations in glacial conditions of the Northern Hemisphere.

Occurrence of hiatuses PH and NH 1 through NH 7 in DSDP holes

Miocene paleoceanographic evolution exhibits major changes resulting from the opening and closing of passages, the subsequent changes in oceanic circulation, and development of major Antarctic glaciation. The consequences and timing of these events can be observed in variations in the distribution of deep-sea hiatuses, sedimentation patterns, and biogeographic distribution of planktic organisms. The opening of the Drake Passage in the latest Oligocene to early Miocene (25-20 Ma) resulted in the establishment of the deep circumpolar current, which led to thermal isolation of Antarctica and increased global cooling. This development was associated with a major turnover in planktic organisms, resulting in the evolution of Neogene assemblages and the eventual extinction of Paleogene assemblages. The erosive patterns of two widespread hiatuses (PH, 23.0-22.5 Ma; and NH 1, 20-18 Ma) indicate that a deep circumequatorial circulation existed at this time, characterized by a broad band of carbonate-ooze deposition. Siliceous sedimentation was restricted to the North Atlantic and a narrow band around Antarctica. A major reorganization in deep-sea sedimentation and hiatus distribution patterns occurred near the early/middle Miocene boundary, apparently resulting from changes in oceanic circulation. Beginning at this time, deep-sea erosion occurred throughout the Caribbean (hiatus NH 2, 16-15 Ma), suggesting disruption of the deep circumequatorial circulation and northward deflection of deep currents, and/or intensification of the Gulf Stream. Sediment distribution patterns changed dramatically with the sudden appearance of siliceous-ooze deposition in the marginal and east equatorial North Pacific by 16.0 to 15.5 Ma, coincident with the decline of siliceous sedimentation in the North Atlantic. This silica switch may have been caused by the introduction of Norwegian Overflow Water into the North Atlantic acting as a barrier to outcropping of silica-rich Antarctic Bottom Water. The main aspects of the present oceanic circulation system and sediment distribution pattern were established by 13.5 to 12.5 Ma (hiatus NH 3), coincident with the establishment of a major East Antarctic ice cap. Antarctic glaciation resulted in a broadening belt of siliceous-ooze deposition around Antarctica, increased siliceous sedimentation in the marginal and east equatorial North Pacific and Indian Oceans, and further northward restriction of siliceous sediments in the North Atlantic. Periodic cool climatic events were accompanied by lower eustatic sea levels and widespread deep-sea erosion at 12 to 11 Ma (NH 4), 10 to 9 Ma (NH 5), 7.5 to 6.2 Ma (NH 6), and 5.2 to 4.7 Ma (NH 7).

Chemical composition of bottom sediments and rocks from DSDP Holes 3-14 through 64-477

Data on analyses of chemical composition of DSDP samples of bottom sediments and rocks carried out in P.P. Shirshov Institute of Oceanology are reported. Basal sediments and sedimentary rocks prevail in the sample set.

Silicoflagellates of ODP Leg 119 samples

The occurrence of Quaternary and Oligocene silicoflagellates at two Ocean Drilling Program (ODP) Leg 119 Holes (736A and 744A) on the Kerguelen Plateau in the Southern Ocean was investigated to compare species distributions to Northern Hemisphere floras. This abstract gives the data determined (Tables 1 and 2) for 24 samples and few preliminary remarks. Quaternary assemblages of Hole 736A are noteworthy for the absences of key North Pacific zonal guide species such as Bachmannocena quadrangula, Dictyocha aculeata, Dictyocha subarctios, and Distephanus octangulatus (Bukry and Monechi, 1985). Other species such as Distephanus floridus, Distephanus speculum elongatus, and Mesocena octagona show limited ranges in Hole 736A and may help to subdivide the Quaternary locally. The late Oligocene assemblages of Hole 744A contain widely distributed species of Distephanus and Naviculopsis, which permit correlation to lower latitude assemblages. They also contain the high-latitude acme of Distephanus raupii which was first noted at Deep Sea Drilling Project (DSDP) Hole 278 (56°3.42'S, 160°04.29'E, water depth 3689 m) by Perch-Nielsen (1975) and Bukry (1975). Study of Hole 744A assemblages suggests that D. raupii developed from pentagonal Dictyocha deflandrei deflandrei. A final note on the Hole 744A assemblages is the brief late Oligocene acme (25%) of Dictyocha sp. aff. D. spinosa in Sample 119-744A-13H-4, 65-67 cm, which provides a direct correlation to the acme (16%) in DSDP Sample 29-278-31R-CC (Perch-Nielsen, 1975) in the Southern Ocean. Most of the taxonomy used in the tables is documented in earlier publications of the DSDP Initial Reports (see Bukry in Volumes 16, 35, 37, 40, 44, 49, 54, 67, 68, 69, 81, and 95). Also, see Loeblich et al. (1968) and Perch-Nielsen (1985) for extensive taxonomy and illustrations.

Paleoelevations in the Pacific Ocean 35 million years ago

Data from deep sea drilling, linear magnetic anomalies and bathymetric measurements together with age and morphometric characteristics of seamounts have been used to construct a paleobathymetric map of the oceans 35 million years ago. A brief analysis of these results is presented.