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4 GUÍAS NACIONALES DE NEONATOLOGÍA
ÍNDICE
Página

GENERALIDADES

Situación epidemiológica actual. 13

Criterios de admisión. 19
Atención inmediata. 21
Reanimación neonatal. 31
Enfermería del prematuro. 39
Termorregulación. 49
Transporte neonatal. 53
 
PROBLEMAS NUTRICIONALES Y METABÓLICOS  
 
Alimentación enteral. 65
Alimentación parenteral. 73
Drogas y lactancia. 87
Trastornos de calcio, fósforo y magnesio. 97
Hipoglicemia. 103
Hiperglicemia. 109
Hijo de madre diabética. 113
Enfermedad óseo-metabólica. 119
Errores innatos del metabolismo. 125
 
PROBLEMAS RESPIRATORIOS  
 
Pulmón húmedo. 135
SDR adaptativo. 135
Membrana hialina. 137
Bronconeumonía. 141
Síndrome aspirativo meconial. 145
Hipertensión pulmonar persistente. 149
Rupturas alveolares. 155
Hemorragia pulmonar. 159
Apnea del prematuro. 163
Displasia broncopulmonar. 169
Muerte súbita. 175
Ventilación mecánica convencional. 181
Ventilación de alta frecuencia. 193
 
PROBLEMAS CARDIOVASCULARES  
 
Shock. 203
Cardiopatías congénitas. 213
Ductus arterioso persistente. 223
Hidrops fetal. 227
PROBLEMAS NEUROLÓGICOS

Asfixia neonatal. 235

Hemorragia intracraneana. 245
Convulsiones neonatales. 251
Disrrafia espinal. 257

PROBLEMAS HEMATOLÓGICOS E ICTERICIA

Alteraciones de la coagulación. 265

Anemia. 271
Poliglobulia. 277
Hiperbilirrubinemia. 281

INFECCIONES

Infección connatal. 295

Infecciones virales connatales. 301
Infecciones nosocomiales. 313
Infección por hongos. 319
Infecciones parasitarias connatales. 323
Lúes congénita. 327
Hijo de madre VIH. 335
Enterocolitis necrotizante. 339

PATOLOGÍA RENAL E HIDROELECTROLÍTICA

Terapia de líquidos. 347

Trastornos renales. 353
Alteraciones nefrourológicas fetales. 365
 
PROBLEMAS ENDOCRINOS  
 
Hiperplasia suprarrenal. 377
Trastornos tiroideos. 381
PROBLEMAS QUIRÚRGICOS

Gastrosquisis y onfalocele. 387

Hernia diafragmática. 393
Atresia esofágica. 397

PROBLEMAS OFTALMOLÓGICOS

Retinopatía del prematuro. 403 

 Página

MISCELÁNEOS.

Malformaciones congénitas. 411

Traumatismo del parto. 415
Kinesioterapia en el RN. 421
Drogas ilícitas y embarazo. 427
Sedación. 433

ASPECTOS BIOSICOSOCIALES

Enfrentamiento del duelo. 441

Aspectos éticos. 447
PROCEDIMIENTOS

Intubación endotraqueal. 453

Punción lumbar. 455
Cateterismo de vasos umbilicales. 457
Toracotomia. 459

ANEXOS

Listado de diagnósticos y CIE-10.

Tablas de presión arterial. 463 
Tablas de factores de coagulación.
Valores serie roja. 
8 GUÍAS NACIONALES DE NEONATOLOGÍA
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El Ministerio de Salud se ha planteado Objetivos Sanitarios para la década,

en relación a la mortalidad infantil la meta para el período 2000-2010 es
reducirla en un 25% a nivel nacional, lo que significa alcanzar una tasa al
2010 de 7.5 por 1000 nacidos vivos.

ˆ>}˜Ã̈VœÊ`iÊ-ˆÌÕ>Vˆ˜ÊœÀÌ>ˆ`>`ʘv>˜Ìˆ

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14 GUÍAS NACIONALES DE NEONATOLOGÍA
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17
18 GUÍAS NACIONALES DE NEONATOLOGÍA
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Criterios de Ingreso:
q
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19
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Criterios de Egreso
q
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q
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20 GUÍAS NACIONALES DE NEONATOLOGÍA

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Objetivos principales:
v
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22 GUÍAS NACIONALES DE NEONATOLOGÍA

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Acciones en periodo de transición:

q
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EF
TJHOPT
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UPOP
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DPMPS
IBTUB
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24 GUÍAS NACIONALES DE NEONATOLOGÍA

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28 GUÍAS NACIONALES DE NEONATOLOGÍA

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32 GUÍAS NACIONALES DE NEONATOLOGÍA

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34 GUÍAS NACIONALES DE NEONATOLOGÍA


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35
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5. Conducta a seguir en neonatos muy severamente asfixiados.

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36 GUÍAS NACIONALES DE NEONATOLOGÍA

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37
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38 GUÍAS NACIONALES DE NEONATOLOGÍA

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40 GUÍAS NACIONALES DE NEONATOLOGÍA
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EFTBSSPMMBOEP
VO

DVBESP
GFCSJM
QPS
JOGFDDJwO
P
QPS
EFTIJESBUBDJwO
&M
BOgMJTJT
EF
MB
DVSWB
EF
UFNQFSBUVSB

EFM
OJvP
EFCF
IBDFSTF
DPOTJEFSBOEP
FM
BNCJFOUF
UnSNJDP
SFBM
Z
FM
RVF
UFwSJDBNFOUF
MF

DPSSFTQPOEF
KVOUP
DPO
MBT
DPOEJDJPOFT
BNCJFOUBMFT

&M
VTP
EF
MB
DVOB
SBEJBOUF
EFCF
DPOTJEFSBSTF
TwMP
QPS
QFSJPEPT
DPSUPT

&TUB
QSFTFOUB
DJFSUBT
EFTWFOUBKBT
q
&T
EJGrDJM
NBOUFOFS
MPT
OJvPT
FO
VO
BNCJFOUF
EF
OFVUSBMJEBE
UnSNJDB

q
1VFEF
IBCFS
HSBOEFT
QnSEJEBT
JOTFOTJCMFT
EJGrDJMFT
EF
NBOFKBS
FO
QSFNBUVSPT

FYUSFNPT
5BOUP
MB
BUFODJwO
JONFEJBUB
DPNP
EJWFSTPT
QSPDFEJNJFOUPT
TPO
NgT
GgDJMFT
EF
FGFD
UVBS
FO
EJDIBT
DVOBT

%FCJFSB
DPOTJEFSBSTF
FM
VTP
EF
MB
JODVCBEPSB
QBSB
FM
USBCBKP
TJTUFNgUJDP

q
&T
DPOWFOJFOUF
WFTUJS
BM
OJvP
MP
BOUFT
QPTJCMF
EFOUSP
EF
MB
JODVCBEPSB
NBOUFOJFO
EP
TV
NPOJUPSFP
FTUSJDUP

q
&O
QSFNBUVSPT
EF
FYUSFNP
CBKP
QFTP
FT
QMBOUFBCMF
BHSFHBS
IVNFEBE
BNCJFOUBM

FO
MB
JODVCBEPSB
FTQFDJBMNFOUF
FO
MB
QSJNFSB
TFNBOB
EF
WJEB
MP
RVF
UBNCJnO

BZVEB
FO
MB
UFSNPSSFHVMBDJwO
EF
FTUF
HSVQP
EF
OJvPT
-PT
USBTUPSOPT
EF
MB
UFSNPSSFHVMBDJwO
TPO
q
)JQPUFSNJB
MB
QnSEJEB
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EF
DBMPS
FO
VO
3/
EF
CBKP
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TF
NBOJ¾FTUB
FO
VO
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BVNFOUP
EF
QFTP
Z
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FYDFTJWP
EF
0
4J

MB
IJQPUFSNJB
FT
NPEFSBEB
TF
QSPEVDJSg
BDJEPTJT
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NFUBCPMJTNP
BOBFSPCJP
F

50 GUÍAS NACIONALES DE NEONATOLOGÍA

 IJQPHMJDFNJB
4J
MB
IJQPUFSNJB
FT
TFWFSB
DPNP
QVFEF
PDVSSJS
FO
VO
QBSUP
GVFSB
EF

MB
NBUFSOJEBE
MB
UFNQFSBUVSB
CBKB
MPT


QVFEF
BQBSFDFS
IJQPUFOTJwO
CSBEJ
DBSEJB
CSBEJQOFB
JSSFHVMBS
IJQPBDUJWJEBE
EJTNJOVDJwO
EF
SF¿FKPT
TVDDJwO
JOTV¾
DJFOUF
EJTUFOTJwO
BCEPNJOBM
P
WwNJUPT
q
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QVFEF
EFCFSTF
B
VO
BNCJFOUF
SFMBUJWBNFOUF
DgMJEP
JOGFDDJPOFT
EFT
IJESBUBDJwO
EJTGVODJwO
EFM
4/$
P
SFBDDJwO
B
NFEJDBNFOUPT

BIBLIOGRAFIA:

4BVFS
1++
FU
BM
/FX
TUBOEBSET
GPS
OFVUSBM
UIFSNBM
FOWJSPONFOU
PG
IFBMUIZ
WFSZ
MPX

CJSUIXFJHIU
JOGBOUT
JO
XFFL
POF
PG
MJGF
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%JT
$IJME



4DPQFT
+
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*
3BOHF
PG
JOJUJBM
UFNQFSBUVSFT
JO
TJDL
BOE
QSFNBUVSF
OFXCPSO
CB
CJFT
"SDI
%JT
$IJME


5SBUBEP
EF
OFPOBUPMPHrB
EF
"WFSZ
1BSUF
7*
3FHVMBDJwO
EF
MB
UFNQFSBUVSB
FO
FM
MBDUBO
UF
QSFNBUVSP

›
&EJDJwO
FO
FTQBvPM



$VJEBEPT
JOUFOTJWPT
OFPOBUBMFT
EF
"VHVTUP
4PMB
Z
+PSHF
6SNBO
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51
TEMPERATURAS DE AMBIENTE TÉRMICO NEUTRO
Según edad y peso
&EBE
Z
1FTP
5FNQFSBUVSB
$

IPSBT

.FOPS
B
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.BZPS
B

H
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TFN
EF
HFTUBDJwO
 

 

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B
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B

H
Z


TFN
EF
HFTUBDJwO
 

 

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.FOPS
B
H
 

 


 

 


 

 

.BZPS
B

H
Z


TFN
EF
HFTUBDJwO
 

 

IPSBT

.FOPS
B
H
 

 


 

 


 

 

.BZPS
B

H
Z


TFN
EF
HFTUBDJwO
 

 

IPSBT

.FOPS
B
H
 

 


 

 


 

 

.BZPS
B

H
Z


TFN
EF
HFTUBDJwO
 

 

IPSBT

.FOPS
B
H
 

 


 

 


 

 

.BZPS
B

H
Z


TFN
EF
HFTUBDJwO
 

 

IPSBT

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B
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B

H
Z


TFN
EF
HFTUBDJwO
 

 

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.FOPS
B

 

 


 

 

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B

H
Z


TFN
EF
HFTUBDJwO


ErBT
 

 


ErBT
 

 


ErBT
 

 


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ErBT
 

 

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.FOPS
B

 

 


 

 

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B

H
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TFN
EF
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B

 

 


 

 

TFN

.FOPS
B

 

 


 

 

TFN

.FOPS
B

 

 


 

 

TFN

.FOPS
B

 

 


 

 

52 GUÍAS NACIONALES DE NEONATOLOGÍA

 42!.30/24%
.%/.!4!,$%2%3#!4%

&T
VO
TJTUFNB
PSHBOJ[BEP
QBSB
FM
USBTMBEP
EF
3FDJnO
/BDJEPT
RVF
SFRVJFSBO
QSPDF
EJNJFOUPT
EJBHOwTUJDPT
ZP
UFSBQnVUJDPT
FO
DFOUSPT
EF
NBZPS
DPNQMFKJEBE
Z
FTQFDJBMJ[B
DJwO
P
RVF
EJTQPOHBO
EF
MB
UFDOPMPHrB
SFRVFSJEB

Objetivo General:
%JTNJOVJS
MB
NPSCJNPSUBMJEBE
OFPOBUBM
B
USBWnT
EF
VOB
BUFODJwO
PQPSUVOB
Z
FTQFDJBMJ
[BEB
FO
BRVFMMPT
3/
HSBWFNFOUF
FOGFSNPT
"RVFMMPT
FNCBSB[PT
DPO
EJBHOwTUJDP
QSFOBUBM
EF
BMUP
SJFTHP
EFCFSgO
TFS
USBTMBEBEPT

PQPSUVOBNFOUF
QSFWJP
B
TV
SFTPMVDJwO

Objetivo específico:
3FBMJ[BS
FM
USBTMBEP
EFM
3/
FO
GPSNB
wQUJNB
EF
NPEP
UBM
RVF
OP
TJHOJ¾RVF
VO
EFUFSJP
SP
BEJDJPOBM
B
TV
DPOEJDJwO
QBUPMwHJDB
QSFFYJTUFOUF

Características del Transporte:

q
7rB
5FSSFTUSF
q
7rB
"nSFB
q
$PO
WFOUJMBDJwO
NFDgOJDB
q
4JO
WFOUJMBDJwO
NFDgOJDB
&M
UJQP
EF
USBOTQPSUF
TFMFDDJPOBEP
EFQFOEFSg
EF
MB
EJTUBODJB
FOUSF
FM
DFOUSP
EFSJWBEPS

Z
FM
DFOUSP
EF
SFGFSFODJB
$VBOEP
SFRVJFSF
WFOUJMBDJwO
NFDgOJDB
FT
GVOEBNFOUBM
BTFHVSBS
GVFOUFT
EF
PYJHFOP

Z
BJSF
DPNQSJNJEP
EVSBOUF
FM
UJFNQP
FTUJNBEP
EF
USBOTQPSUF
NgT
VO
SBOHP
EF
TFHVSJEBE

EFTUJOBEP
B
QSFWFS
DVBMRVJFS
JODJEFOUF
RVF
SFRVJFSB
VO
NBZPS
DPOTVNP
P
RVF
SFUBSEF
FM

UJFNQP
EF
USBOTQPSUF
NgT
BMMg
EF
MP
QMBOJ¾DBEP
SFDPSEBS
RVF
MPT
CBMPOFT
&
EF
0
EJTQPOJ
CMFT
FO
OVFTUSPT
TFSWJDJPT
UJFOFO
VO
UJFNQP
NgYJNP
EF
EVSBDJwO
EF

NJOVUPT


53
 &O
DBTP
EF
SFRVFSJS
EF
USBOTQPSUF
BnSFP
TF
TVHJFSF
DPOTVMUBS
FO
BRVFMMBT
JOTUJUVDJP
OFT
DPO
FYQFSJFODJB
Z
QFSTPOBM
FOUSFOBEP
DPNP
q
'VFS[B
"nSFB
EF
$IJMF
q
1SFGFDUVSB
"FSPQPMJDJBM
EF
$BSBCJOFSPT
EF
$IJMF

ORGANIZACIÓN DEL SISTEMA DE TRANSPORTE:


4JTUFNB
EF
DPNVOJDBDJPOFT
WJUBM
FO
FM
nYJUP
EF
VO
USBTMBEP
SFRVJFSF
EF
VO
DFOUSP

DPPSEJOBEPS
VO
FRVJQP
EJTQPOJCMF
MBT

IPSBT
EFM
ErB
Z
VO
TJTUFNB
EF
JOGPSNBDJwO
Z

SFHJTUSP
F¾DJFOUFT


1FSTPOBM
DBQBDJUBEP
FRVJQP
EF
USBOTQPSUF



$POTUJUVJEP
QPS

q
.nEJDP
DPPSEJOBEPS
DBQB[
EF
BDFQUBS
P
SFDIB[BS
VOB
TPMJDJUVE
EF
USBOTQPSUF
Z
B

TV
WF[
TVHFSJS
NBOFKP
JOJDJBM
QBSB
MB
FTUBCJMJ[BDJwO
EF
VO
3/
HSBWF

q
.nEJDP
EF
USBOTQPSUF
FT
FM
MrEFS
EFM
FRVJQP
EFCF
UFOFS
FYQFSJFODJB
FO
DVJEBEP

JOUFOTJWP
OFPOBUBM
QBSB
DPPSEJOBS
MB
FTUBCJMJ[BDJwO
NBOFKP
Z
NPOJUPSJ[BDJwO
EFM

QBDJFOUF
EVSBOUF
FM
USBOTQPSUF

q
.BUSPOB
P
FOGFSNFSB
EF
USBOTQPSUF
EFCF
FTUBS
DBQBDJUBEB
FO
DVJEBEP
JOUFOTJWP

OFPOBUBM
DPO
MBT
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Z
IBCJMJEBEFT
OFDFTBSJBT
QBSB
FM
DVJEBEP
EF
VO
3/

DSrUJDBNFOUF
FOGFSNP

q
1BSBNnEJDP
EF
USBOTQPSUF
BTJTUF
BM
SFTUP
EF
MPT
NJFNCSPT
EFM
FRVJQP
FO
MB
FTUB
CJMJ[BDJwO
Z
NBOFKP
EFM
QBDJFOUF
EVSBOUF
FM
USBOTQPSUF
q
1FSTPOBM
EF
NPWJMJ[BDJwO
B
DBSHP
EFM
DVJEBEP
Z
NBOUFODJwO
FO
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DPOEJ
DJPOFT
EFM
WFIrDVMP
EF
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DPO
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BEJFTUSBNJFOUP
FO
USBTMBEP
EF

QBDJFOUFT
DSrUJDPT
Z
DVJEBEP
EF
FRVJQPT
F
JOTVNPT


&RVJQBNJFOUP
F
JOTVNPT
B

*ODVCBEPSB
EF
USBOTQPSUF
…
DPO
CBUFSrB
BVUwOPNB
Z
DBQBDJEBE
EF
DPOFYJwO
B
SFE
FMnDUSJDB
¾KB
Z
NwWJM


…
WFOUJMBEPS
NFDgOJDP
EF
USBOTQPSUF
TJ
QPS
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TF
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…
NPOJUPS
EF
TJHOPT
WJUBMFT
Z
TBUVSBDJwO

…
DJMJOESPT
EF
PYrHFOP
Z
BJSF
DPNQSJNJEP
JODPSQPSBEPT
…
CPNCBT
EF
JOGVTJwO
DPOUJOVB
…
TJTUFNBT
EF
¾KBDJwO
EFM
3/
B
MB
JODVCBEPSB
Z
EF
MB
JODVCBEPSB
BM
NwWJM
C


&RVJQPT
QBSB
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…
TJTUFNB
EF
WFOUJMBDJwO
NBOVBM
Z
BTQJSBDJwO
…
BDDFTPT
WFOPTPT
P
BSUFSJBMFT

…
JOUVCBDJwO
FOEPUSBRVFBM

54 GUÍAS NACIONALES DE NEONATOLOGÍA

 …
ESFOBKF
QMFVSBM
FUD
D

*OTVNPT
Z
GgSNBDPT

…
%FCJEBNFOUF
PSEFOBEPT
QSPUFHJEPT
F
JEFOUJ¾DBEPT
TFH|O
MJTUBEP
BEIPD

BOFYP


E

4JTUFNB
EF
SFHJTUSP

…
'PSNVMBSJPT
QBSB
SFHJTUSP
EF
EBUPT
DMrOJDPT
Z
BENJOJTUSBUJWPT
BOFYP


F

0USPT
BDDFTPSJPT

…
"MBSHBEPSFT
FODIVGFT
FYUFOTJPOFT
EF
BJSF
Z
PYrHFOP
EF
BDPQMF
SgQJEP


7FIrDVMP
EF
USBOTQPSUF
BnSFP
ZP
UFSSFTUSF


&TUF
EFCF
TFS
BNQMJP
EJTQPOFS
EF
BEFDVBEB
JMVNJOBDJwO
F
JOUFSJPS
DMBSP
TJTUFNB
EF

DBMFGBDDJwO
ZP
BJSF
BDPOEJDJPOBEP
TJTUFNB
EF
¾KBDJwO
QBSB
MB
JODVCBEPSB
EF
USBOTQPSUF

TJTUFNB
EF
DPNVOJDBDJPOFT
FRVJQBEB
DPO
CBMPOFT
EF
PYrHFOP
Z
BJSF
DPNQSJNJEP
DPO

FODIVGFT
QBSB
DPOFYJwO
B
CBUFSrBT
EF
WFIrDVMP
DPO
TJTUFNB
EF
TPQPSUF
QBSB
¿FCPDMJTJT
Z

DJOUVSPOFT
EF
TFHVSJEBE
QBSB
MPT
NJFNCSPT
EFM
FRVJQP
NnEJDP

Consideraciones especiales respecto al transporte aéreo:

B

&GFDUP
EF
MB
BMUVSB
TPCSF
MB
1SFTJwO
CBSPNnUSJDB
B
NBZPS
BMUVSB
EJTNJOVZF
MB
QSF
TJwO
CBSPNnUSJDB
QPS
MP
DVBM
B
TV
WF[
EJTNJOVZF
MB
QSFTJwO
QBSDJBM
EF
PYrHFOP
QPS

MP
DVBM
EFCFO
SFBMJ[BSTF
MPT
BKVTUFT
OFDFTBSJPT
FO
MB
'J0
QBSB
MPHSBS
TBUVSBDJP
OFT
BEFDVBEBT
"OFYP


C

&GFDUP
EF
MB
1SFTJwO
CBSPNnUSJDB
TPCSF
FM
WPMVNFO
EF
HBTFT
-FZ
EF
#PZMF

B
VOB

UFNQFSBUVSB
DPOTUBOUF
B
NFEJEB
RVF
EJTNJOVZF
MB
QSFTJwO
CBSPNnUSJDB
BVNFOUB

FM
WPMVNFO
EFM
HBT
FO
GPSNB
QSPQPSDJPOBM
*NQPSUBOUF
FO
DBTPT
EF
FTDBQF
BnSFP

ESFOBKF
EF
OFVNPUwSBY

Z
EF
EJTUFOTJwO
BCEPNJOBM
EFTDPNQSFTJwO
HgTUSJDB

D

*NQBDUPT
EF
GVFS[B
EF
BDFMFSBDJwO
Z
EFTBDFMFSBDJwO
3/
DPO
DPNQSPNJTP
IFNP
EJOgNJDP
EFCF
WJBKBS
DPO
TV
DBCF[B
PSJFOUBEB
IBDJB
MB
QBSUF
QPTUFSJPS
EF
MB
BFSP
OBWF
Z
B
MB
JOWFSTB
3/
DPO
EBvP
IJQwYJDPJTRVnNJDP
w
)*$
MP
IBSg
DPO
TV
DBCF[B

PSJFOUBEB
IBDJB
MB
QBSUF
BOUFSJPS

DEFINICIÓN DE RESPONSABILIDADES DE LOS EQUIPOS

PROFESIONALES QUE INTERVIENEN EN UN TRANSPORTE
NEONATAL

&RVJQP
EFM
DFOUSP
BTJTUFODJBM
SFGFSFOUF
q
"QPSUB
BOUFDFEFOUFT
QFSJOBUBMFT
Z
EFM
3/
q
%JBHOwTUJDPT
QSFTVOUJWPT
Z
TFWFSJEBE
EFM
DVBESP
QBUPMwHJDP
SJFTHPT
Z
SFRVFSJ
NJFOUPT

q
*OGPSNB
FYgNFOFT
Z
USBUBNJFOUPT
FGFDUVBEPT

55
 q
&T
SFTQPOTBCMF
EFM
NBOFKP
Z
FTUBCJMJ[BDJwO
EFM
3/
IBTUB
RVF
TF
IBHB
FGFDUJWP
FM

USBOTQPSUF
q
0CUJFOF
FM
DPOTFOUJNJFOUP
JOGPSNBEP
EF
MPT
QBESFT
QBSB
USBTMBEP
Z
QSPDFEJNJFO
UPT
FO
FM
DFOUSP
EF
EFTUJOP

q
$FSUJ¾DBDJwO
QSFWJTJPOBM

&RVJQP
EFM
DFOUSP
BTJTUFODJBM
SFDFQUPS
q
4VHJFSF
JOEJDBDJPOFT
QSFMJNJOBSFT
QPS
UFMnGPOP
QBSB
MB
FTUBCJMJ[BDJwO
EFM
3/
q
*OGPSNB
TPCSF
USgNJUFT
BENJOJTUSBUJWPT
QBSB
MB
BENJTJwO
EFM
3/
JEFBM
FOWJBS
GBY

q
$PPSEJOB
MBT
BDDJPOFT
DPO
FM
FRVJQP
EF
USBOTQPSUF
OFPOBUBM
q
*OGPSNB
BM
DFOUSP
BTJTUFODJBM
SFGFSFOUF
TPCSF
UJFNQP
FTUJNBEP
QBSB
FGFDUVBS
FM

USBOTQPSUF
q
1SFQBSB
MB
VOJEBE
EF
6$*
OFPOBUBM
QBSB
SFDFQDJwO
EFM
QBDJFOUF
EF
BDVFSEP
B
QB
UPMPHrB
Z
TFWFSJEBE
JOGPSNBEBT
q
$PPSEJOB
MBT
FWBMVBDJPOFT
EF
TVCFTQFDJBMJEBE
TFH|O
MB
QBUPMPHrB
EFM
3/

EQUIPO DE TRANSPORTE NEONATAL:


1SFQBSBDJwO
QBSB
FM
USBOTQPSUF
q
7FSJ¾DB
RVF
FM
FRVJQBNJFOUP
FTUF
DPNQMFUP
Z
GVODJPOF
BEFDVBEBNFOUF
q
*ODPSQPSB
FRVJQPT
F
JOTVNPT
EF
BDVFSEP
B
MPT
SFRVFSJNJFOUPT
JOEJWJEVBMFT
JOGPS
NBEPT
QBSB
FM
QBDJFOUF
q
1SPHSBNB
UFNQFSBUVSB
EF
MB
JODVCBEPSB
EF
BDVFSEP
B
BOUSPQPNFUSrB
JOGPSNBEB

EFM
3/
q
7FSJ¾DB
BEFDVBEB
EJTQPOJCJMJEBE
EF
SFHJTUSPT
OFDFTBSJPT
EVSBOUF
FM
USBOTQPSUF

¾DIB
EF
USBOTQPSUF
IPKB
EF
GgSNBDPT
DPO
EPTJT
Z
EJMVDJwO
IPKB
EF
JODJEFOUFT

GPSNVMBSJP
EF
DPOTFOUJNJFOUP
JOGPSNBEP
SFHJTUSP
EF
NBOUFODJwO
EF
FRVJQPT



&WBMVBDJwO
JOJDJBM
Z
FTUBCJMJ[BDJwO
EFM
3/
q
7FSJ¾DB
JEFOUJ¾DBDJwO
EFM
3/
BM
MMFHBS
q
$POUSPMB
FTUBCJMJ[BDJwO
UnSNJDB
EFM
3/
q
7FSJ¾DB
QFSNFBCJMJEBE
EF
WrB
BnSFB
Z
DPOEJDJwO
SFTQJSBUPSJB
q
$POUSPMB
ZP
JOTUBMB
BDDFTPT
WFOPTPT
Z
BSUFSJBMFT
QBSB
BENJOJTUSBDJwO
EF
¿VJEPT
Z

GgSNBDPT

q
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QPSUBEPSB
7*)

3FDJnO
OBDJEP
DPO
IJQPHMJDFNJB
P
HMJDFNJBT
MrNJUFT

3FDJnO
OBDJEP
DPO
QnSEJEBT
BHVEBT
EF
BHVB
IJQFSUFSNJB
IJQFSOBUSFNJB
QVFEF

VTBSTF
TPMVDJwO
HMVDPTBEB


3FDJnO
OBDJEP
QSFNBUVSPT
P
CBKP
QFTP
EF
OBDJNJFOUPT
RVF
QPS
TV
DPOEJDJwO
DMrOJDB
MP

SFRVJFSBO

3FDJnO
OBDJEP
DPO
FOGFSNFEBEFT
NFUBCwMJDBT

.BESF
DPO
FOGFSNFEBE
NFOUBM
TFWFSB
P
DPNQSPNJTP
EF
DPODJFODJB

.BESF
FO
USBUBNJFOUP
DPO
DJUPUwYJDPT
SBEJP
GgSNBDPT
P
BEJDDJwO
BDUJWB
B
ESPHBT
JMF
HBMFT

.BESF
CBDJMrGFSB
BDUJWB
JOGFDDJPOFT
WJSBMFT
UBMFT
DPNP
WBSJDFMB
IFSQFT
TJNQMF
EF
MB

NBNB
NPOPOVDMFPTJT
JOGFDDJPTB

0USPT
SFUSPWJSVT
Z
"3/
WJSVT
OP
QSFTFOUFT
FO
FM
QBrT

66 GUÍAS NACIONALES DE NEONATOLOGÍA


 /

$ Ê / ,
Ê Ê, Ê"-*/
<
"

Recién nacido de término sin factores de riesgo asociados:

q
-BDUBODJB
NBUFSOB
q
4J
MB
MBDUBODJB
EJSFDUB
OP
FT
QPTJCMF
BENJOJTUSF
MFDIF
NBUFSOB
FYUSBrEB
P
GPSNVMB

QBSB
MBDUBOUF
q
0GSFDFS
SBOHPT
EF
WPM|NFOFT
EFTEF
FM
QSJNFS
BM
TFYUP
ErB
EF

°









°


°



NM,HErB
1PTUFSJPSNFOUF
TJ
MB
DPOEJDJwO

MP
QFSNJUF
PGSFDFS
BE
MJCJUVN
VOB
GwSNVMB
DPO

B

,DBMEM

Recién nacido de término con factores de riesgo asociados:

q
-PT
GBDUPSFT
EF
SJFTHP
TPO
BT¾YJB
TFWFSB
DBSEJPQBUrB
EF
CBKP
¿VKP
QPMJHMPCVMJB

TJOUPNgUJDB
TFWFSB
BMUFSBDJwO
EFM
EPQQMFS
GFUBM
DPNQSPNJTP
IFNPEJOgNJDP
OP

DPOUSPMBEP
NJFMPNFOJOHPDFMF
DPO
QBSBQBSFTJB
TJHOJ¾DBUJWB
TPTQFDIB
EF
FOUF
SPDPMJUJT
OFDSPUJ[BOUF

q
&O
FTUPT
DBTPT
TF
EFCF
NBOUFOFS
TJO
BMJNFOUBDJwO
QPS

IPSBT
5SBOTDVSSJEP

FTF
QFSrPEP
JOJDJBS
BQPSUF
FOUFSBM
EF
MFDIF
NBUFSOB
P
GwSNVMB
QBSB
MBDUBOUF
FO

WPMVNFO
EF

NM
,HErB
Z
BVNFOUBS
FO

NM
,HErB
QPTUFSJPSNFOUF
DPO
FT
USJDUP
DPOUSPM
EF
UPMFSBODJB
EJTUFOTJwO
SFTJEVP
SFHVSHJUBDJwO

Recién nacido de bajo peso de nacimiento:

$VgOEP
q
&M
SFDJnO
OBDJEP
EF
CBKP
QFTP
EF
OBDJNJFOUP
RVF
OP
UFOHB
GBDUPSFT
EF
SJFTHP
TF

BQMJDBO
MPT
NJTNPT
DSJUFSJPT
EFTDSJUPT
QBSB
FM
SFDJnO
OBDJEP
EF
UnSNJOP

QVFEF
BMJ
NFOUBSTF
EFTEF
FM
QSJNFS
ErB
EF
WJEB
4J
UJFOF
GBDUPSFT
EF
SJFTHP
EJGFSJS
QPS

IST
$VgOUP
q
*OJDJBS
DPO

NM
LHErB
Z
BVNFOUBS
EJBSJBNFOUF
FO
WPM|NFOFT
TJNJMBSFT
IBT
UB

NMLHErB
%FTQVnT
EF
MPT

B

ErBT
EF
WJEB
QVFEF
BVNFOUBSTF
FM
WP
MVNFO
HSBEVBMNFOUF
IBTUB

°

NMLHErB
TFH|O
OFDFTJEBE
UPMFSBODJB
Z

BVTFODJB
EF
DPOUSBJOEJDBDJPOFT
&O
DBTP
EF
OJvPT
DPO
SFUBSEP
EF
DSFDJNJFOUP

TFWFSP
FO
QFSrPEPT
EF
DSFDJNJFOUP
SFDVQFSBDJPOBM
QVFEFO
OFDFTJUBSTF
WPM|NF
OFT
NBZPSFT
q
*OEJWJEVBMJDF
FM
SFRVFSJNJFOUP
FO
QSFNBUVSPT
FYUSFNPT
RVF
ZB
UJFOF
NgT
EF


TFNBOBT
EF
FEBE
DPSSFHJEB
Z
FO
FM
SFDJnO
OBDJEP
EF
UnSNJOP
TFH|O
TVT
TFvBMFT

EF
IBNCSF
Z
TBDJFEBE
$wNP
q
"ENJOJTUSBS
FO
CPMP
MFOUP
DBEB

IPSBT
QPS
TPOEB
OBTPHgTUSJDB
TJ
FT
QPTJCMF
P

QPS
TPOEB
PSPHgTUSJDB
TJ
IBZ
EJ¾DVMUBE
SFTQJSBUPSJB
P
FT
NFOPS
EF

H
q
&TUJNVMBS
TVDDJwO
EVSBOUF
FM
QFSrPEP
EF
BMJNFOUBDJwO

67
 q
4J
UJFOF

P
NgT
TFNBOBT
EF
FEBE
HFTUBDJPOBM
FWBM|F
BMJNFOUBDJwO
QPS
TVDDJwO
q
&M
QSFUnSNJOP
EF
NVZ
CBKP
QFTP
EF
OBDJNJFOUP
QVFEF
JOJDJBS
MB
TVDDJwO
EJSFDUB
BM

QFDIP
JOJDJBMNFOUF
FYUSBrEP
EF
MFDIF
B
MBT

°

TFNBOBT
EF
FEBE
QPTUDPO
DFQDJPOBM
"Tr
TF
FTUJNVMB
MB
MBDUBODJB
Z
TF
QSFQBSB
FM
BNBNBOUBNJFOUP
EJSFDUP
q
$POTJEFSF
FM
VTP
EF
BMJNFOUBDJwO
FOUFSBM
DPOUJOVB
FO
MPT
DBTPT
EF
QFSTJTUFOUF

NBMB
UPMFSBODJB
BM
BVNFOUP
EF
WPMVNFO
FO
DBTP
EF
EJTQMBTJB
CSPODPQVMNPOBS

TFWFSB
P
DBSEJPQBUrB
DPO
JOTV¾DJFODJB
DBSErBDB
DPOHFTUJWB
2Vn

q
-FDIF
NBUFSOB
FYUSBrEB
EF
TV
QSPQJB
NBESF

q
-FDIF
NBUFSOB
EPOBEB
QBTUFVSJ[BEB
q
'wSNVMB
MgDUFB
QBSB
QSFNBUVSP

$VgOEP
TVTQFOEFS
BQPSUF
FOUFSBM
q
3FTJEVPT
CJMJPTPT
IFNgUJDPT
P
QPSSgDFPT
FO
DVBMRVJFS
WPMVNFO
NM

q
3FTJEVP
BMJNFOUBSJP
NBZPS
B


EF
BMJNFOUBDJwO
SFDJCJFOEP
NgT
EF

NM

QPS
WF[
q
7wNJUPT
q
%FQPTJDJPOFT
DPO
TBOHSF
P
FOUFSPDwMJDBT
q
4PTQFDIB
EF
&OUFSPDPMJUJT
OFDSPUJ[BOUF
q
/JvP
FOGFSNP
DPO
BMJNFOUBDJwO
DPO
DIVQFUF
P
QFDIP
RVF
SFDIB[B
JOFTQFSBEB
NFOUF
MB
BMJNFOUBDJwO

6TP
EF
MFDIF
NBUFSOB
q
-FDIF
NBUFSOB
EF
TV
QSPQJB
NBESF
GSFTDB
SFGSJHFSBEB
P
DPOHFMBEB
q
3FDVFSEF
RVF
FM
BQPSUF
EF
QSPUFrOBT
DBMDJP
Z
GwTGPSP
FT
IBCJUVBMNFOUF
JOTV¾DJFO
UF
QBSB
FM
QSFNBUVSP
EF
NVZ
CBKP
QFTP
EF
OBDJNJFOUP
4VQMFNFOUBS
DPO
GPSUJ¾DBO
UF
QBSB
MFDIF
NBUFSOB
BM
BENJOJTUSBS

NM

,HErB
P
NgT
*OJDJBMNFOUF
BENJOJT
USBS
BM

P

TPCSFT
FO
NM
q
%FTEF
MB
›
TFNBOB
VTBS
BM


P

TPCSFT
FO

NM
q
$POUSPMBS
FWPMVDJwO
OVUSJDJPOBM
q
3FDVFSEF
MBT
WBSJBDJPOFT
JOEJWJEVBMFT
EF
DPNQPTJDJwO
EF
MFDIF
NBUFSOB
Z
MB
OF
DFTJEBE
EF
IPNPHFOJ[BS
QPS
BHJUBDJwO
MB
NF[DMB
BOUFT
EF
BENJOJTUSBSMB
4J
IBZ

SFTUSJDDJwO
EF
BQPSUF
EF
WPMVNFO
P
BVNFOUP
EFM
HBTUP
FOFSHnUJDP
CBTBM
DPNP

FO
MB
EJTQMBTJB
CSPODPQVMNPOBS
P
MB
JOTV¾DJFODJB
DBSErBDB
DPOHFTUJWB
BENJOJTUSF

TVQMFNFOUP
FOFSHnUJDP
BEFNgT
EFM
GPSUJ¾DBOUF
Z
FWFOUVBMNFOUF
VUJMJDF
MB
BMJNFO
UBDJwO
FOUFSBM
DPOUJOVB
q
4J
FT
OFDFTBSJP
TVQMFNFOUBS
TPEJP
VTBS
OBUSFNJB


N&RM


N&R
LHErB

P
;JOD
VTBS
NHLHErB

68 GUÍAS NACIONALES DE NEONATOLOGÍA

4VQMFNFOUP
EF
¾FSSP

"QPSUBS
EFTEF
MBT

B

TFNBOBT
EF
FEBE
QPTUOBUBM
3FTUF
MB
DBOUJEBE
RVF
BQPSUB
MB

GwSNVMB
B
MB
TJHVJFOUF
SFDPNFOEBDJwO


1FTP
"QPSUF
UPUBM




HST
NHLHErB


HST

NHLHErB


HST

NHLHErB
"QPSUF
NgYJNP
DPNP
TVQMFNFOUP

NHErB
.BOUFOFS
EVSBOUF
QSJNFS
BvP
EF
WJEB

CONTROL NUTRICIONAL DEL RN DE BAJO PESO DE NACIMIENTO:

"OUSPQPNFUSrB
q
3FHJTUSBS
FWPMVDJwO
BOUSPQPNnUSJDB
FO
DVSWBT
EF
SFGFSFODJB
&ISFODSBO[
FU
BM

q
3FDVQFSBDJwO
EFM
QFTP
EF
OBDJNJFOUP
B
MPT

…

ErBT
EF
WJEB
FO
3/5
…

ErBT


H
…

ErBT


H
…

ErBT


H
q
*ODSFNFOUP
EF

H
LHErB
EFTEF
SFDVQFSBDJwO
EF
1/
FO
NFOPS
EF

H
q
*ODSFNFOUP
EF
UBMMB

DNTFNBOB
q
*ODSFNFOUP
EF
$$

DNTFNBOB

ÊOEJDFT
CJPRVrNJDPT
DPOUSPM
RVJODFOBM

q
#6/

NHEM
4VQMFNFOUBS
QSPUFrOBT
DPO
WBMPSFT
CBKP

NHEM
q
"MC|NJOB
 
HEM
q
/B

N&R-
q
#&


q
1

NHEM
4VQMFNFOUBS
DPO
DJGSBT
NFOPSFT
B

NH
EM
q
$B

NHEM
q
'PTGBUBTBT
"MDBMJOBT
WBMPS
OPSNBM
IBTUB

WFDFT
FM
WBMPS
EF
SFGFSFODJB
EFM
MBCPSB
UPSJP
4PCSF
FTUF
OJWFM
TVHJFSF
PTUFPQFOJB
#BKP
FM
OJWFM
OPSNBM
TVHJFSF
En¾DJU
EF

;JOD
q
4FSJF
SPKB
WFS
OPSNB
EF
BOFNJB

69
 Composición de Leches para Prematuros. Por cada 100 ml.

70




'PSNVMBT
NPEJ¾DBEBT
QBSB
QSFNBUVSPT


'PSUJ¾DBOUFT
QBSB
MFDIF
NBUFSOB

/VUSJFOUFT
3FDPNFOEBDJwO
-FDIF
.BUFSOB

&OGB$BSF

4JNJMBD

4
1SFN

1SFOBO

4JNJMBD

4

4."
'.

&OGBNJM


,HErB
1PS
DBEB

NM
-*1*-
4QFDJBM
$BSF


/BUVSBM
$BSF


G

NM
&OFSHrB
,DBM











1SPUFrOBT
H

 
 
 
 
 
 
 
 
 
 
-rQJEPT
H

  
 
 
 
 
 
 
 
 

$BSCPIJESBUPT
H

 
 
 
 
 
 
 
 
 
 
$BMDJP
NH











'wTGPSP
NH











4wEJP
NH











1PUBTJP
NH











$MPSP
NH












GUÍAS NACIONALES DE NEONATOLOGÍA

.BHOFTJP
NH

 
 

 

 
 
 
 
 
)JFSSP
NH

  
 
 
 
 
 
 
 
 
 
$JOD
VH











$PCSF
VH











.BOHBOFTP
VH

 
 
 
 
 
 
 

 
 
:PEP


 

 





7JU
"
6*











7JU
%
6*



 







7JU
$
NH

 
 
 

 



 

7JU
&
6*

 
 
 
 
 
 
 

 

7JU
#

VH


 






 

7JU
#

VH











7JU
#

VH











7JU
#

VH

 
 
 
 
 
 
 
 
 
 
/JBDJOB
NH

  
 
 

 
 

 
 
 
'PMBUP
NH


 
 




 
 
 
#JPUJOB
VH

 
 
 

 
 


 
 
"D
1BOUPUn
NH

  
 
 
 
 
 
 
 
 
 
"D
-JOPMFJDP
NH











BIBLIOGRAFÍA

,MFJO
$+
/VUSJUJPO
3FRVJSFNFOUT
GPS
QSFUFSN
*OGBOU
'PSNVMBT
+
/VUS
4
4

;JFHMFS
&&
5IVSFFO
1+
$BSMTPO
4+
"HHSFTJWF
OVUSJUJPO
PG
UIF
WFSZ
MPX
CJSUIXFJHIU

JOGBOU
$MJO
1FSJOBUPM


4IBOMFS
3+
4IVMNBO
3+
-BV
$
FU
BM
'FFEJOH
TUSBUFHJFT
GPS
QSFNBUVSF
JOGBOUT
SBO
EPNJ[FE
USJBM
PG
HBTUSPJOUFTUJOBM
QSJNJOH
BOE
UVCFGFFEJOH
NFUIPET
1FEJBUSJDT



&ISFOLSBO[
3"
:PVOFT
/
-FNPOT
+
FU
BM

-POHJUVEJOBM
HSPXUI
PG
IPTQJUBMJ[FE
WFSZ

MPX
CJSUI
XFJHIU
JOGBOUT
1FEJBUSJDT


4IBOMFS
3+
)VSTU
/.
-BV
$
5IF
VTF
PG
IVNBO
NJML
BOE
CSFBTUGFFEJOH
JO
QSFNBUVSF

JOGBOUT
$MJO
1FSJOBU


71
72 GUÍAS NACIONALES DE NEONATOLOGÍA
 .542)#)œ.
0!2%.4%2!,

-B
BENJOJTUSBDJwO
QBSFOUFSBM
EF
BHVB
HMVDPTB
Z
FMFDUSPMJUPT
GPSNB
QBSUF
EF
MBT
NFEJ
EBT
IBCJUVBMFT
EF
BUFODJwO
EFM
SFDJnO
OBDJEP
FOGFSNP
"HSFHBOEP
BNJOPgDJEPT
MrQJEPT

Z
WJUBNJOBT
TF
PCUJFOF
MB
OVUSJDJwO
QBSFOUFSBM
UPUBM
&M
SJFTHP
EF
MB
OVUSJDJwO
QBSFOUFSBM
BV
NFOUB
DPO
MB
DPNQMFKJEBE
EF
MB
NF[DMB
&M
CBMBODF
EF
SJFTHPCFOF¾DJP
EFCF
DPOTJEFSBSTF

DVJEBEPTBNFOUF
FO
DBEB
QBDJFOUF

˜`ˆV>Vˆœ˜iÃ\
q
1BUPMPHrB
HBTUSPJOUFTUJOBM


3FDJnO
OBDJEP
EF
DVBMRVJFS
QFTP
DPO
QBUPMPHrB
HBTUSPJOUFTUJOBM
RVF
SFRVJFSB
FWJ
UBS
FM
BQPSUF
FOUFSBM
QPS
NgT
EF

ErBT
q
3FDJnO
OBDJEP
EF
NVZ
CBKP
QFTP
EF
OBDJNJFOUP


3/


H
EFTEF
FM
OBDJNJFOUP

3/

H
DPO
TFWFSP
SFUBSEP
EF
DSFDJNJFOUP
JOUSBVUFSJOP
P
DPO
QSPCMFNBT

EF
UPMFSBODJB
BMJNFOUBSJB
RVF
OP
SFDJCBO
BQPSUF
FOUFSBM
QPS
NgT
EF

ErBT
q
3FDJnO
OBDJEP
NBZPS
EF

HST


$PO
QSPCMFNBT
EF
UPMFSBODJB
BMJNFOUBSJB
RVF
OP
SFDJCBO
BQPSUF
FOUFSBM
QPS
NgT

EF

ErBT
P
RVF
TF
QSFWFB
VO
BVNFOUP
NVZ
MFOUP
EF
MB
BMJNFOUBDJwO

iâV>Ã\Ê
q
5SFT
FO
VOP
-PT
MrQJEPT
TF
NF[DMBO
FO
VO
NJTNP
NBUSB[
DPO
HMVDPTB
BNJOPgDJ
EPT
Z
NJOFSBMFT
-JNJUB
MB
DPODFOUSBDJwO
EF
HMVDPTB
B

P
NFOPT
q
%PT
FO
VOP
-PT
MrQJEPT
TF
DPMPDBO
FO
JOGVTJwO
JOEFQFOEJFOUF
EF
MB
NF[DMB
EF

HMVDPTB
BNJOPgDJEPT
Z
NJOFSBMFT
-PT
MrQJEPT
QVFEFO
DPOFDUBSTF
DPO
MMBWF
FO

²:³
BM
SFTUP
EF
MB
JOGVTJwO

73
6‰>ÃÊ`iÊ>`“ˆ˜ˆÃÌÀ>Vˆ˜\Ê

1FSJGnSJDB
SFRVJFSF
BEFDVBEPT
BDDFTPT
WFOPTPT
q
4F
SFDPNJFOEB
QBSB
OVUSJDJwO
QBSFOUFSBM
EF
DPSUB
EVSBDJwO
Z
CBKB
DPODFOUSBDJwO

-B
DPODFOUSBDJwO
NgYJNB
EF
HMVDPTB
FT
BM
 
DPO

EF
BNJOPgDJEPT
0TNP
MBSJEBE
NgYJNB

N0TNM
q
$POWJFOF
DPMPDBS
MPT
MrQJEPT
QPS
MB
NJTNB
WrB
DPO
MMBWF
FO
²:³
QPS
FM
FGFDUP
WFOP
QSPUFDUPS
EF
MPT
NJTNPT
TJ
TF
VTBO
NF[DMBT
EPT
FO
VOP
$FOUSBM

q
&M
DBUnUFS
QFSDVUgOFP
FT
MB
WrB
NgT
SFDPNFOEBEB

q
&YDFQDJPOBMNFOUF
QVFEF
VTBSTF
DBUnUFS
WFOPTP
VNCJMJDBM
MPT
QSJNFSPT
ErBT
EF

WJEB

*",/ Ê Ê

," 1/, / -


Volumen de líquidos:
&O
QSPNFEJP
VO
3/
SFRVJFSF
BQSPYJNBEBNFOUF

DDLHErB
EFTQVnT
EFM
UFS
DFSP
B
DVBSUP
ErB
EF
WJEB
3FDVFSEF
RVF
FO
PDBTJPOFT
FM
3/
EF
FYUSFNP
CBKP
QFTP
BM

OBDFS

HS
UJFOF
HSBOEFT
QFSEJEBT
JOTFOTJCMFT
Z
QVFEF
SFRVFSJS
NgT
EF

DDLH
ErB
&WBM|F
DPO
CBMBODF
IBTUB
RVF
TF
FTUBCJMJDF
-B
/1
OP
EFCF
VTBSTF
QBSB
SFFNQMB[BS
QnSEJEBT
BHVEBT
QPS
FM
SJFTHP
EF
QSPEVDJS

EFTFRVJMJCSJPT
IJESPFMFDUSPMrUJDPT
EFCJEP
B
MB
BMUB
DPODFOUSBDJwO
EF
HMVDPTB
QSPUFrOBT

MrQJEPT
FMFDUSPMJUPT
Z
NJOFSBMFT
RVF
TF
VTBO
FO
FTUBT
TPMVDJPOFT

Energía:
-PT
SFRVFSJNJFOUPT
EF
FOFSHrB
EF
VO
3/
EFQFOEFO
EF
TV
NBEVSF[
FEBE
QPTUOBUBM

WFMPDJEBE
EF
DSFDJNJFOUP
BNCJFOUF
UnSNJDP
BDUJWJEBE
FTUSnT
Z
SVUB
EF
BENJOJTUSBDJwO

FOUFSBM
WTQBSFOUFSBM


1BSFOUFSBM
&OUFSBM

#BTBM



LDBMLHE


"DUJWJEBE


LDBMLHE


&TUSnT
5nSNJDP



LDBMLHE


1FSEJEBT
GFDBMFT


LDBMLHE


$SFDJNJFOUP

LDBMLHE


"DUJW
EJOgNJDB
FTQFG



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FO
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80 GUÍAS NACIONALES DE NEONATOLOGÍA

 )JQFSNBHOFTFNJB
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Deficiencias de oligonutrientes:

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81
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Manejo para minimizar el riesgo:

q
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82 GUÍAS NACIONALES DE NEONATOLOGÍA

Tratamiento:
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CONTROL DE ALIMENTACIÓN PARENTERAL

›
TFNBOB 
TFNBOB
1FTP %JBSJP %JBSJP
5BMMB 4FNBOBM 4FNBOBM
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83
RECOMENDACIONES DE APORTE DIARIO DE NUTRIENTES:

$PNQPOFOUF "QPSUF
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N&R
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NH
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NH

.BHOFTJP 
NH
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VH
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VH
4FMFOJP 
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Composición de las soluciones de minerales por ml

N&RNM .HNM
/B
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EF
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NH
EF
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,
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,
 
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EF
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84 GUÍAS NACIONALES DE NEONATOLOGÍA

Composición de las soluciones de vitaminas por ml
$PNQPOFOUF $FSOBWJU
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85
86 GUÍAS NACIONALES DE NEONATOLOGÍA
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Factores maternos
q
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q
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87
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Factores del Neonato

q
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q
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88 GUÍAS NACIONALES DE NEONATOLOGÍA

Factores de la droga:
q
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q
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q
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q
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q
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q
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q
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q
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¾TJPMwHJDB
EFM
3/
FO
TV
DBQBDJEBE
EF
BCTPSCFS
NFUBCPMJ[BS
Z
FYDSF
UBS
MB
TVTUBODJB

GUÍAS GENERALES Y RECOMENDACIONES

SEGÚN CONDICIONES ESPECÍFICAS:

Rinitis alérgicas:
B

1TFVEPFGFESJOB
FT
FYDSFUSBEB
FO
MB
MFDIF
NBUFSOB
FO
QFRVFvB
DBOUJEBE
EF

BDVFSEP
B
MB
""1
"NFSJDBO
"DBEFNZ
PG
1FEJBUSJDT

TV
VTP
FT
DPNQBUJCMF
DPO

MB
MBDUBODJB
BVORVF
FTUB
QVFEF
EJTNJOVJS
MB
QSPEVDDJwO
MgDUFB
&WJUBS
EVSBOUF
MBT

QSJNFSBT

TFNBOBT
IBTUB
RVF
MB
MBDUBODJB
FTUn
CJFO
FTUBCMFDJEB
C

%JGFOJMIJESBDJOB
TF
FODVFOUSB
FO
MB
MFDIB
FO
NFOPS
DBOUJEBE
DVBMRVJFSB
EF
FTUPT

NFEJDBNFOUPT
QVFEF
DBVTBS
MFUBSHJB
P
JSSJUBCJMJEBE
FO
OFPOBUP
TF
SFEVDF
BM
SJFT
HP
EF
UPNBSMP
JONFEJBUBNFOUF
EFTQVnT
EF
IBCFS
BNBNBOUBEP
1VFEF
EJTNJOVJS

MB
QSPEVDDJwO
EF
MFDIF
FTQFDJBMNFOUF
DVBOEP
TF
VTB
DPNCJOBEB
DPO
QTFVEP
FGFESJOB

89
 D

-PT
OVFWPT
BOUJIJTUBNrOJDPT
OP
TFEBOUFT
UJFOFO
QPDPT
FGFDUPT
FO
4/$
1BSB
USB
UBNJFOUPT
EF
MBSHP
UJFNQP
BMUFSOBUJWBT
TFHVSBT
TPO
DSPNJHMJDBUP
EJTPEJDP
Z
FTUF
SPJEFT
OBTBMFT

Asma
B

&TUFSPJEFT
JOIBMBUPSJPT
QBSB
FM
USBUBNJFOUP
EFM
BTNB
QFSNJUF
OJWFMFT
NVZ
CBKPT
FO

QMBTNB
NBUFSOP
Z
OP
TF
SFMBDJPOBO
DPO
MB
MBDUBODJB
NBUFSOB
¿VUJDBTPOB

C

&TUFSPJEFT
PSBMFT
1SFEOJTPOB
Z
QSFEOJTPMPOB
BUSBWJFTBO
MB
CBSSFSB
MBDUBSJB
QPCSF
NFOUF
Z
FT
TFHVSB
DVBOEP
TF
VTB
FO
UJFNQP
DPSUP
$VBOEP
MB
EPTJT
EJVSOB
FYDFEF


NH
TF
QSF¾FSF
QSFEOJTPMPOB
QPSRVF
QSFTFOUB
VO
TPMP
QFBL
TnSJDP
EF
BDUJWJEBE

B
EJGFSFODJB
EF
QSFEOJTPOB
RVF
UJFOF

QFBL


-B
FYQPTJDJwO
EFM
3/
QVFEF
TFS
NrOJNB
TJ
TF
QPTUFSHB
MBDUBODJB
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IST
EFT
QVnT
EF
EBS
FM
NFEJDBNFOUP

Cardiovascular
B

%JVSnUJDPT
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CMPRVFBEPSFT
MJQPTPMVCMFT
TPO
GgSNBDPT
EF
FMFDDJwO
QBSB
MB
IJQFS
UFOTJwO
NBUFSOB
Z
TPO
TFHVSPT
QBSB
MB
MBDUBODJB
NBUFSOB
DPO
BMHVOBT
QSFDBVDJP
OFT
FWJUBS
BMUBT
EPTJT
EF
VO
NFEJDBNFOUP
VTBOEP
PUSP
NFEJDBNFOUP
P
DPNCJ
OgOEPMP
#BKBT
EPTJT
EF
EJVSnUJDPT
UJB[rEJDPT
TPO
FYDSFUBEPT
FO
FTDBTB
DBOUJEBE

FO
MB
MFDIF
NBUFSOB
QFSP
OP
TVQSJNFO
MB
MBDUBODJB
#MPRVFBEPSFT
IJESPTPMVCMFT

DPNP
FM
BUFOPMPM
TF
USBOTQPSUBO
DPO
GBDJMJEBE
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BMUPT
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FGFDUP
FO
FM
OFPOBUP

C

/JGFEJQJOP
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WFSBQBNJM
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FYDSFUSBEPT
FO
MB
MFDIF
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DBOUJEBEFT
NF
OPSFT
RVF
TV
OJWFM
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OJvPT
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FT
FM
NFOPT
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MPT
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DBOBMFT
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DBMDJP
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MPT
OJWFMFT
TPO
MPT
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FTUF
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GgSNBDP
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BMUFSOBUJWPT
NgT
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$BQUPQSJM
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FTDBTB
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MB
MFDIF
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3/
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TFOTJCMF
B
MPT
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MB
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BM
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)JESBMB[JOB
FT
TFHVSB
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TF
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FO
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TJ
FT

VTBEB
QPS
DPSUP
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EFTQVnT
EFM
QBSUP
F

1SPQBOPMPM
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MBCFUBMPM
TPO
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FO
QFRVFvBT
DBOUJEBEFT
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"UFOPMPM
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MVHBS
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IJQPUFOTJwO
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FO
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OFPOBUP

90 GUÍAS NACIONALES DE NEONATOLOGÍA

Diabetes
B

*OTVMJOB
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FO
MB
MFDIF
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Z
TV
VTP
FT
TFHVSP
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MB
MBDUBO
DJB
NBUFSOB
C

-PT
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EF
QSJNFSB
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DPO
MB
MBDUBODJB
NBUFSOB
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HFOFSBDJwO
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DPNP
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QBTJWJEBE

Epilepsia
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MFDIF
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FM
VTP

EF
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MB
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3/
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'FOJUPJOB
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TPO
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DPO
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-B
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FM
gDJEP
WBMQSPJDP
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TVT
EFSJWBEPT
DPNQBUJCMFT
DPO
MB
MBDUBODJB
NBUFSOB

GUÍAS GENERALES Y RECOMENDACIONES SEGÚN

GRUPOS DE MEDICAMENTOS:

Antibióticos:
1FOJDJMJOB
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$FGBMPTQPSJOBT
TPO
DPNQBUJCMFT
DPO
MBDUBODJB
NBUFSOB
FYJTUF
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FO
MB

¿PSB
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UBNCJnO
FT
DPNQBUJCMF
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NBUFSOB
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TVMGP
OBNJEBT
QVFEFO
DBVTBS
BOFNJB
IFNPMJUJDB
FO
FM
OJvP
DPO
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EF
HMVDPTB
GPTGBUP
EF

EFTIJESPHFOBTB
-PT
BNJOPHMJDwTJEPT
BENJOJTUSBEPT
EVSBOUF
MB
MBDUBODJB
NBUFSOB
TF
FODVFOUSBO
FO

QFRVFvBT
DBOUJEBEFT
FO
FM
OFPOBUP
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BEFNgT
UJFOFT
VOB
QPCSF
BCTPSDJwO
PSBM

5FUSBDJDMJOB
EJTDVUJCMF
TV
VTP
FO
MBDUBODJB
0USPT
BOUJCJwUJDPT
TF
QSF¾FSFO
FTQFDJBM
NFOUF
QBSB
UJFNQPT
QSPMPOHBEPT

&SJUSPNJDJOB
QBTB
EF
MB
MFDIF
BM
QMBTNB
FO
GPSNB
WBSJBCMF
TJO
FNCBSHP
MBT
DBOUJEB
EFT
FO
MB
MFDIF
TPO
NgT
QFRVFvBT
RVF
MBT
EPTJT
VTBEBT
FO
OJvPT
1SFQBSBDJPOFT
WBHJOBMFT
UwQJDBT
QBSB
MB
NBESF
QSPEVDFO
NVZ
CBKB
DPODFOUSBDJPOFT

FO
FM
TVFSP
$PUSJNB[PM
P
NJDPOB[PM
DPNP
UFSBQJB
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BOUJG|OHJDB
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CBKB
DPODFOUSBDJwO
TnSJDB
'MVDPOB[PM
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JOEJDBEP
FO
JOGFDDJPOFT
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EFM
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FO
MB

MFDIF
NBUFSOB
TF
BCTPSCF
TPMP
VO

EF
MB
EPTJT
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2VJOPMPOBT
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IBO
TJEP
CJFO
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VTBSTF
FO
DBTP
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CFOF¾DJP

91
Antidepresivos:
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BOUJEFQSFTJWPT
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UJFOFO
VO
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OJOH|O
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TPCSF
MB
MBDUBODJB

"NJUSJQUJMJOB
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MB
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TPO
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EF
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MB
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B
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IPSBT
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NrOJNPT

EFUFDUBCMFT
FO
FM
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%PTJT
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NH
BM
ErB
DPO
VO
NgYJNP
EF

NH

0USPT
GgSNBDPT
EF
MB
NJTNB
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DPNP
¿VPYFUJOB
UBNCJnO
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FNCBSB[P
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NH
P

NFOPT
MB
DPODFOUSBDJwO
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FO
FM
OFPOBUP
FT
CBKB
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QSPMPOHBEB
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EFM
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B

IST
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NBUFSOB
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Analgésicos
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TV
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MB
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B
MB
MFDIF
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gDJEP
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EF
MB
BMUFSBDJwO
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CBSSFSB
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TF
IBO
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DBTPT
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EF
BDJEPTJT
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NBOUBEPT
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FYDSFUBEP
FO
QFRVFvBT
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MB
MFDIF
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FYJTUJFO
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MBSHB
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EF
VTP
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FTUB
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MBD
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QPS
MB
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Z
FT
VOB
CVFOB
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EF
BOBMHFTJB
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MB
MBDUBODJB

AINES (anti inflamatorios no esteroidales):

*CVQSPGFOP
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MB
FMFDDJwO
QSFGFSJEB
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MB
MFDIF
Z
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TJEP
CJFO
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QVFEFO
BDVNVMBS
TF
FO
FM
MBDUBOUF
FO
FM
VTP
QSPMPOHBEP

92 GUÍAS NACIONALES DE NEONATOLOGÍA

Analgésicos narcóticos:
.PS¾OB
FT
VO
NFUBCPMJUP
BDUJWP
EF
MB
DPEFrOB
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FO
MB
MFDIF
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FO
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FO
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3/
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TFS
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QPTU
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FO
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BNBNBOUBOEP
Z
MB
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WJEB
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FT
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FM
3/

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93
 5BCMB

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94 GUÍAS NACIONALES DE NEONATOLOGÍA

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104 GUÍAS NACIONALES DE NEONATOLOGÍA

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108 GUÍAS NACIONALES DE NEONATOLOGÍA

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110 GUÍAS NACIONALES DE NEONATOLOGÍA

 
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Trastornos específicos observados

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…
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…
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Z
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…
1PMJDJUFNJB
…
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QFSJOBUBM
Z
USBVNB
EFM
QBSUP
…
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IJQFSUSw¾DB

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JODJEFODJB
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FTUg
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DPO
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MB
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EFM
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EF
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8IJUF
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DPNQMJDBDJPOFT
TF
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BDUVBMNFOUF
TPMP
QBSB
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113
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BDUVBM
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Problemas presentes en “Hijo Madre Diabética” y su fisiopatología.

%FOUSP
EF
MPT
GBDUPSFT
EF
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BTPDJBSTF
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DMBTF
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$MBTJ¾DBDJwO
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Según el periodo de análisis:

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114 GUÍAS NACIONALES DE NEONATOLOGÍA

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Exámenes de Laboratorio:

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Manejo:

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116 GUÍAS NACIONALES DE NEONATOLOGÍA

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117
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120 GUÍAS NACIONALES DE NEONATOLOGÍA

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122 GUÍAS NACIONALES DE NEONATOLOGÍA

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126 GUÍAS NACIONALES DE NEONATOLOGÍA
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q
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146 GUÍAS NACIONALES DE NEONATOLOGÍA

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FO
q
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q
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EF
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q
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150 GUÍAS NACIONALES DE NEONATOLOGÍA

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152 GUÍAS NACIONALES DE NEONATOLOGÍA

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154 GUÍAS NACIONALES DE NEONATOLOGÍA
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156 GUÍAS NACIONALES DE NEONATOLOGÍA

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q
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158 GUÍAS NACIONALES DE NEONATOLOGÍA

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160 GUÍAS NACIONALES DE NEONATOLOGÍA

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164 GUÍAS NACIONALES DE NEONATOLOGÍA

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166 GUÍAS NACIONALES DE NEONATOLOGÍA

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182 GUÍAS NACIONALES DE NEONATOLOGÍA

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1. Indicaciones Absolutas de V. Mecánica asistida:

q
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FYJTUFO
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2. Indicaciones Relativas de V. Mecánica asistida:

q
"QOFBT
JOUFSNJUFOUFT
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RVF
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Tipos de Soporte Ventilatorio:


$1"1
q
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V. Mecánico de flujo continuo, ciclado por tiempo y limitado por presión:

No sincronizados: IMV o CMV (Vent. Mec. Convencional)
q
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184 GUÍAS NACIONALES DE NEONATOLOGÍA

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185
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186 GUÍAS NACIONALES DE NEONATOLOGÍA

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188 GUÍAS NACIONALES DE NEONATOLOGÍA

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192 GUÍAS NACIONALES DE NEONATOLOGÍA

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194 GUÍAS NACIONALES DE NEONATOLOGÍA

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195
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196 GUÍAS NACIONALES DE NEONATOLOGÍA

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198 GUÍAS NACIONALES DE NEONATOLOGÍA

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200 GUÍAS NACIONALES DE NEONATOLOGÍA

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204 GUÍAS NACIONALES DE NEONATOLOGÍA

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MONITOREO DEL SHOCK:

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ALGUNOS SISTEMAS INVOLUCRADOS SON:

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q
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q
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206 GUÍAS NACIONALES DE NEONATOLOGÍA

-"
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q
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q
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EF
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q
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OXIGENACION:
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TIPDL
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TF
JOJDJB
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VOB
WrB
BnSFB
QFSNFBCMF
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208 GUÍAS NACIONALES DE NEONATOLOGÍA

 q
%FCF
NBOUFOFSTF
BEFDVBEB
PYJHFOBDJwO
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Z
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FMMP
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EF
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MB
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q
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B
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Z
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FM
DPOTV
NP
FOFSHnUJDP
EBEP
TV
HSBO
DBUBCPMJTNP

REPOSICIÓN DE VOLUMEN:
6UJM
FO
TIPDL
IJQPWPMnNJDP
Z
TnQUJDP
"ENJOJTUSBS
TPMVDJwO
¾TJPMwHJDB
QMBTNB
GSFTDP

DPOHFMBEP
P
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q
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q
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q
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q
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EF
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BM

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EF
VTP
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q
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EF
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q
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IST
q
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EF
QBTP
BM
JOUFSTUJDJP
QVMNPOBS
Z
TVCTFDVFOUFNFOUF
DPOEJDJPOBS
FEFNB

QVMNPOBS
q
4V
NBZPS
VUJMJEBE
FT
FO
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DPO
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FTQBDJP
NVZ
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FTUF

DBTP
TF
VTB
DPO
FM
¾O
EF
QBTBS
MrRVJEP
BM
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CORRECCIÓN DE FACTORES INOTROPICOS NEGATIVOS

$PSSFHJS
IJQPYJB
BDJEPTJT
IJQPHMJDFNJB
IJQPDBMDFNJB
FOUSF
PUSPT
&M
BQPSUF
EF
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CPOBUP
EF
TPEJP
B
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EF

N&RLH
FTUg
JOEJDBEP
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MB
BDJEPTJT
NFUBCwMJDB

DPO
VO
Q)
JOGFSJPS
B
 
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WFOUJMBDJwO
4J
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NFUBCwMJDB

QVFEF
JOJDJBSTF
JOGVTJwO
EF
¿FCPDMJTJT
BMDBMJOJ[BOUF



ESTADO METABOLICO:
$BMDJP

.BOUFOFS
BEFDVBEB
DBMDFNJB
$POTJEFSBS
EJTNJOVDJwO
EFM
DBMDJP
JwOJDP
Z
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FO
BDJ
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FO
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.BHOFTJP

&WBMVBS
NBHOFTFNJB
FO
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EF
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BENJOJTUSBS

 
N&RLHEPTJT
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IPSBT

209
DROGAS VASOACTIVAS:
.FKPSBO
MB
IFNPEJOBNJB
Z
GVODJwO
NJPDgSEJDB
q
%PQBNJOB
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EFQFOEJFOUF
…

NHLN
WBTPEJMBUBEPS
SFOBM
DFSFCSBM
(*
DPSPOBSJP
…

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β
BDUJWB
GVODJwO
NJPDgSEJDB
…

NHLN
α

WBTPDPOUSJDUPS
*OEJDBDJPOFT
4IPDL
TnQUJDP
Z
TIPDL
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q
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β
Z
β
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DPOUSBDUJMJEBE
NJPDgSEJDB
FM
WPMVNFO
FYQVMTJWP

Z
EJTNJOVZF
MB
371

*OEJDBDJPOFT
4IPDL
DBSEJPHnOJDP
Z
TIPDL
TnQUJDP
UBSErP
%PTJT
SFDPNFOEBEB



NDHLHNJO
q
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FM
JOPUSPQJTNP
DSPOPUSPQJTNP
Z
MB
371

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…
  
NDHLHNJO

ββ
…
  
NDHLHNJO

α
Z
β
%PTJT
SFDPNFOEBEB
  
NDHLHNJO
q
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.FKPS
VTP
FO
TIPDL
TnQUJDP
SFGSBDUBSJP

%PTJT

NDHLHNJO

OTRAS DROGAS VASOACTIVAS:

"NSJOPOB
Z
NJMSJOPOB
"VNFOUB
FM
JOPUSPQJTNP
Z
FT
VO
WBTPEJMBUBEPS
QFSJGnSJDP
JO
IJCF
MB
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FM
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Z
FM
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4F
IB
VUJMJ[BEP
FO

TIPDL
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FO
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IBZ
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TV
VTP
FO
OFPOBUPT

¿COMO ADECUAR LA TERAPIA?

*EFBMNFOUF
FWBMVBS
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DPO
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TFSJBEB
QBSB
BEFDVBS

WBTPBDUJWPT
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BQPZP
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DPO
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NDHLHNJO
&WBMVBS
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4r
1".

TJHVF
CBKB
TF
EFCF
SFQFUJS
WPMVNFO
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NBOUFOFS

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DBSEJBDB
CBKP

Y
NJO

Z
BHSFHBS
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NDHLHNJO

$POTJEFSBS
RVF
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EF
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BVNFOUBS
MB
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WBTDV
MBS
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MB
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FT
VO
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Tr
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EF
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4r
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NDHLHNJO
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4J
OP
TF
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1
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P
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NDHLHNJO
Z
DPOTJEFSBS
FM

210 GUÍAS NACIONALES DE NEONATOLOGÍA

VTP
EF
DPSUJDPJEFT
FO
TIPDL
QFSTJTUFOUF
FO
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TF
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FM
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P
BTPDJBDJwO
DPO
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TJ
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NDHLHNJO

CORTICOIDES:
%VSBOUF
FM
FTUBEP
DSrUJDP
EFM
TIPDL
TF
IB
EFTDSJUP
VOB
EFTFOTJCJMJ[BDJwO
HSBEVBM
EF

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EFM
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DBEB
WF[
EPTJT
NgT
BMUB

EF
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FM
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MB
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EF
MPT
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Z
BMHVOPT
DPNQPOFOUFT
EFM
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NB
TFHVOEP
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&TUB
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EF
MB
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EF
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DPO
q
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EF
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B
BHPOJTUB
q
%JTNJOVDJwO
EF
3/"
NFOTBKFSP
q
%JTNJOVDJwO
EF
USBOTDSJQDJwO
q
/FDFTJEBE
EF
OVFWB
TrOUFTJT
QSPUFJDB

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TIPDL
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FO
RVF
TF
QMBOUFB
FM
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EF
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VUJMJ[BS
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NHLHEPTJT
4J
FT
F¾DB[
SFQFUJSMB
DBEB

IPSBT
QPS

B

ErBT
4J
TF
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4VQSBSSFOBM
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NHLHEPTJT
SFQFUJEBT
DBEB

IPSBT

QPS

IST

FORMULAS PARA PREPARAR CUALQUIER VASOACTIVOS:

• Calculo en ml de la droga:

1FTP
LH

Y

NJO

Y

NM
UPUBM
B
QSFQBSBS

Y
O
HBNBLHNJO
B
QBTBS
FO

NMIPSB


NM
EF
ESPHB
QBSB

NM
UPUBMFT

$PODFOUSBDJwO
EFM
WBTPBDUJWP
HBNBNM

&K
3/
EF

LH
TF
SFRVJFSF
RVF
B

NMIPSB
TF
FOUSFHVFO

HBNBLHNJO
%PQBNJOB


NH
NM


NHNM


Y

Y

Y






 
NM
EF
%PQBNJOB

NH
NM

FO
 
NM
EF
4(

HBNBNM

• Calculo en mg de la droga:


Y
QFTP
LH

Y
O
HBNBLHNJO
B
QBTBS
FO

NMIPSB


NH
EF
ESPHB
QBSB

NM
UPUBMFT

211
 &K
3/
EF

LH
TF
SFRVJFSF
RVF
B

NMIPSB
TF
FOUSFHVFO

HBNBLHNJO
%PQBNJOB

NH
NM


NHNM


Y

Y



NH
EF
%PQBNJOB

-VFHP

NH
FTUgO
FO

NM
QPS
UBOUP

NH
FTUgO
FO
 
NM


"EJDJPOBS
 
NM
EF
%PQBNJOB

NH
NM

FO
 
NM
EF
4(

$PNP
FO
HFOFSBM
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216 GUÍAS NACIONALES DE NEONATOLOGÍA

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218 GUÍAS NACIONALES DE NEONATOLOGÍA

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220 GUÍAS NACIONALES DE NEONATOLOGÍA

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222 GUÍAS NACIONALES DE NEONATOLOGÍA

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224 GUÍAS NACIONALES DE NEONATOLOGÍA

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EF
CBTF

DPOTJEFSBS
MB
EFDJTJwO
EF

IPTQJUBMJ[BDJwO
JOEFQFOEJFOUF
Tr
MB
DPOEJDJwO
OFPOBUBM
FT
BQBSFOUFNFOUF
OPSNBM

0CTFSWBS
FO
SnHJNFO

QPS



IST
"MUB
B
QVFSQFSJP
TJ
FWPMVDJwO
FT
OPSNBM

Conducta a seguir en neonatos severamente asfixiados:

"OUF
OFPOBUP
FO
SFBOJNBDJwO
OBDJEP
DPO
"QHBS

BM
QSJNFS
NJOVUP
DPOTJEFSBS
TVT
QFOTJwO
EF
NBOJPCSBT
TJ
QFSTJTUF
B
MPT

NJO
TJO
OJOHVOB
BDUJWJEBE
WJUBM

&M
BOgMJTJT
EF
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SFWFMB
RVF
MB
FWPMVDJwO
EF
MPT
3/
DPO
"QHBS

NBOUFOJEP
IBT
UB
MPT

NJO
FM

GBMMFDF
Z
FM

SFTUBOUF
QSFTFOUB
EBvP
OFVSPMwHJDP
TFWFSP
1PS
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SFTVDJUBDJwO
EF
SFDJnO
OBDJEPT
EFTQVnT
EF

NJO
EF
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FT
NVZ
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RVF

QSPEV[DB
TPCSFWJWFODJB
P
TVQFSWJWFODJB
TJO
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TFWFSB

Medición de gasometría de cordón:

$PO
FM
¾O
EF
DVBOUJ¾DBS
IJQPYJB
JOUSBVUFSJOB
TF
TVHJFSF
SFBMJ[BS
NFEJDJwO
EF
HBTFT
BS
UFSJBMFT
EF
DPSEwO
FO
QSFTFODJB
EF
TVGSJNJFOUP
GFUBM
BHVEP
NPOJUPSJ[BDJwO
FMFDUSwOJDB

GFUBM
BOPSNBM
Z
FO
OFPOBUPT
RVF
OBDFO
EFQSJNJEPT

-B
PCUFODJwO
EF
MB
NVFTUSB
EF
TBOHSF
EF
BSUFSJB
VNCJMJDBM
TF
SFBMJ[B
DPO
EPCMF
QJO[B
EP
EF
DPSEwO
QSPDFEJnOEPTF
B
MMFOBS
MPT
WBTPT
VNCJMJDBMFT
BM
FYQSJNJS
NFEJBOUF
QSFTJwO

DPO
FM
QVMHBS
F
rOEJDF
EFTEF
VOB
[POB
QJO[BEB
IBDJB
MB
TFHVOEB
QJO[B
%FTQVnT
EF
EJT
UFOEFS
DPO
FTUB
NBOJPCSB
MPT
WBTPT
EFM
DPSEwO
TF
WVFMWF
B
QJO[BS
PUSB
WF[
B
MB
NFOPS

EJTUBODJB
QPTJCMF
QBSB
NBOUFOFS
MMFOPT
MPT
WBTPT
DPO
MP
DVBM
FT
GgDJMNFOUF
EJGFSFODJBCMF

MB
WFOB
RVF
FT
|OJDB
UPSUVPTB
Z
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EF
MBT
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RVF
TPO
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QBSFE
¾SNF
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DPSSFO
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%F
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EF
FMMBT
TF
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MB

NVFTUSB
EF
TBOHSF
BSUFSJBM

MANEJO SEGÚN COMPROMISO EN DIFERENTES ÓRGANOS.

I. EFECTO SOBRE CEREBRO.

3FBMJ[BS
NFEJEBT
EF
BQPZP
RVF
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MB
PYJHFOBDJwO
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/JWFMFT
EF
PYJHFOP


%FCF
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EFOUSP
EF
MrNJUFT
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&WJUBS
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P
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/JWFMFT
EF
$0

%FCF
NBOUFOFSTF
EFOUSP
EF
MJNJUFT
OPSNBMFT



NN
)H


236 GUÍAS NACIONALES DE NEONATOLOGÍA


1FSGVTJwO
DFSFCSBM

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QFSEFSTF
MB
BVUPSSFHVMBDJwO
DFSFCSBM
MB
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1S
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1".
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q
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q
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q
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NFOPSFT

HST




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BENJOJTUSBS
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IJQFSPTNPMBSFT
FO
CPMP
SgQJEP


&GFDUVBS
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MFOUB
EF
WPMVNFO

3FEVDJS
BM
NrOJNP
MB
BENJOJTUSBDJwO
EF
BHVB
MJCSF
TJO
FNCBSHP
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MB
EJVSFTJT
FT

CBKB
BTFHVSBSTF
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BEFDVBEP
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EF

SFTUSJOHJS
MrRVJEPT



&M
VTP
KVJDJPTP
EF
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BM
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MB
OFDFTJEBE
EF
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DSJTUBMPJEFT
ZP
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QBSB
NBOUFOFS
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1S
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Z
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5SBOTQPSUF
EF
0YJHFOP
$PSSFHJS
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P
BOFNJB
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IFNBUP
DSJUP
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/JWFMFT
EF
HMVDPTB
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FOUSF



NH



5FNQFSBUVSB
%FCF
NBOUFOFSTF
EFOUSP
EF
MrNJUFT
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SBOHP
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MB
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FO
MB
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EFM
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FM
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EF
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IFNPEJOgNJDB
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MB
1SFTJwO
EF
1FSGVTJwO
$FSFCSBM
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11$

1
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NFEJB
°
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237
 CONVULSIONES:

%FCFO
NBOFKBSTF
QSFDP[NFOUF
TFH|O
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q
%PTJT
EF
DBSHB
EF

NHLH
WrB
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NHLH
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TJ
FT
OFDFTBSJP
QBSB
ZVHVMBS
MBT
DPO
WVMTJPOFT

q
$POUJOVBS
DPO
EPTJT
EF
NBOUFODJwO
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BOUFT
EF

IST
QPS
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NFEJB

QSPMPOHBEB

EF

NHLHErB
GSBDDJPOBEP
DBEB

P

IST
4J
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OFT
OP
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q
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EF
DBSHB

NHLH
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q
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IST
QPS
VO
NgYJNP
EF

ErBT
-B
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TF
BCTPSCF
NBM
FO
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QPS

WrB
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MP
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TPMP
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VTB
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NHLHEPTJT
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FO

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P
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TF
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BEFDVBEP

MEDIDAS GENERALES:
q
1PTJDJwO
TVQJOP
'PXMFS
$BCF[B
FO
MrOFB
NFEJB
&WJUBS
¿FYJwO
P
IJQFSFYUFO
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EF
DVFMMP
q
&TUJNVMP
NrOJNP
&WJUBS
FTUJNVMP
MVNJOPTP
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BOUJGB[
&WJUBS
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BD|T
UJDP
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UBQwO
$"&
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NBOUFOFS
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/P
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MB
JODVCBEPSB
QBSB
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PCTFSWBSMP
q
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DVJEBEPTP

q
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FTUSJDUB
NBOUFOFS
FO
SBOHP
CBKP
EF
UFNQFSBUVSB
q
.POJUPSFP
DPOUJOVP
EF
'SFD
DBSEJBDB
'SFD
SFTQ
1S
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Z
4BU
EF
0
q
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EF
EJVSFTJT

EXÁMENES:
q
&YgNFOFT
JOJDJBMFT
)FNBUPDSJUP
HMJDFNJB

DBMDFNrB

HBTFT
q
&YgNFOFT
EF
FWPMVDJwO
4F
DPOUSPMBSBO
B
MBT

IST
P
BOUFT
TFH|O
FWPMVDJwO

DMrOJDB
&-1
#6/
HMJDFNJB
DBMDFNJB
HBTFT

238 GUÍAS NACIONALES DE NEONATOLOGÍA

 q
4PMP
BOUF
TPTQFDIB
EF
DPNQSPNJTP
NJPDgSEJDP
DPOUSPMBS
$,$1,.#

q
&&(
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q
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EF
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DPO
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EF

MBT

IST
5"$
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TFH|O
OFDFTJEBE
DMrOJDB

II. EFECTO SOBRE EL CORAZÓN

4F
QVFEF
QSPEVDJS
JTRVFNJB
NJPDgSEJDB
USBOTJUPSJB
FYQSFTBEB
QPS
4%3
P
GBMMB

DBSErBDB
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-B
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QVFEF
SFBMJ[BSTF
QPS
q
*OTV¾DJFODJB
USJD|TQJEFB
ZP
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q
&$(

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45
FO
77
…
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q
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UPUBM

q
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HVSHJUBDJwO
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)511

Manejo:
q
"EFDVBEB
WFOUJMBDJwO
.BOUFOFS
PYFNJB
OPSNBM
q
$PSSFHJS
BDJEPTJT
q
.BOUFOFS
HMJDFNJB
Z
DBMDFNJB
OPSNBM
q
$PSSFHJS
EFTCBMBODF
IJESPFMFDUSPMrUJDPT
&WJUBS
TPCSFDBSHB
EF
WPMVNFO

q
"QPZP
JOPUSwQJDP

q
.BOUFOFS
1".
OPSNBM

III. EFECTO SOBRE EL RIÑON.

&M
OFPOBUP
BT¾YJBEP
QSFTFOUB
SJFTHP
EF
TVGSJS
B
OJWFM
SFOBM
EF
OFDSPTJT
UVCVMBS

BHVEB
/5"

Z
EF
TFDSFDJwO
JOBQSPQJBEB
EF
IPSNPOB
BOUJEJVSnUJDB
4*"%)

$POUSPMBS

q
%JVSFTJT
JOJDJBMNFOUF
IPSBSJB

q
1FTRVJTBS
HMPCP
WFTJDBM
q
%FOTJEBE
VSJOBSJB
7/


q
4FEJNFOUP
VSJOBSJP
Z
RVrNJDP
EF
PSJOB

Manejo:
q
&O
PMJHVSJB

 
NMLHIPSB

B
MBT


IST
EF
WJEB
TF
EFCF
EFTDBSUBS
GBMMB

QSFSFOBM

q
"ENJOJTUSBS
CPMP
EF
4PM
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NMLH
FO

NJO
q
*OJDJBS
%PQBNJOB

NDHLHNJO
q
4J
BM
DBCP
EF

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IBZ
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FM
CPMP
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BENJOJTUSBS
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NHLH
WrB
FW
BM
¾OBMJ[BS
MB
JOGVTJwO
239
 q
4J
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FT


NMLHIPSB
MB
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FT
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q
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EF
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RVF
TF
IBZB
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MB
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DPO
GBMMB
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SFGSBDUBSJB
B
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TF
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SFBMJ[BS
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WFTJDBM
Z
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EF
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EF
TPEJP
'F/B


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9




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'BMMB
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&O
DBTP
EF
PMJHVSJB
QFSTJTUFOUF
TF
EFCF
QFOTBS
FO
4*"%)
Z
FO
/5"

Secreción inapropiada de hormona antidiurética. (SIADH):

Diagnóstico:
q
"VNFOUP
EF
QFTP
q
0MJHVSJB
q
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q
0TNPMBSJEBE
VSJOBSJB
BVNFOUBEB
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VSJOBSJB
NgYJNB
FO

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FT
EF

N0TNMU
Z
EF

FO
3/
EF
UnSNJOP

240 GUÍAS NACIONALES DE NEONATOLOGÍA

Manejo:
q
3FTUSJDDJwO
EF
MrRVJEPT
q
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/B
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EF
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Necrosis tubular aguda (NTA).

Diagnóstico:
q
"VNFOUP
EF
QFTP
q
0MJHVSJB
q
4FEJNFOUP
VSJOBSJP
NVZ
BMUFSBEP
QSFTFODJB
EF
DJMJOESPT
FUD

Manejo:
q
3FTUSJDDJwO
EF
MrRVJEPT
q
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EF
IJQFSLBMFNJB
7FS
OPSNB
FTQFDJ¾DB

q
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QFSJUPOFPEJgMJTJT
P
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IV. EFECTO SOBRE EL APARATO GASTROINTESTINAL

1SFWFODJwO
EF
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q
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Z
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TFOUFT
Z
3/
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FTUBCMF

q
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TFH|O
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HgTUSJDB
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SB[wO
EF

NMLHErB
q
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FO
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EF
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q
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V. EFECTO SOBRE EL APARATO RESPIRATORIO



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EF
MB
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FM
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MB
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MB
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EF
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FM
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NP
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Z
FM
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FO
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241
VI. EFECTOS HEMATOLÓGICOS

1VFEF
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EFCJEP
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MFTJPOFT
WBTDVMBSFT
Z
GBMMB
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q
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$*%
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EF
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DJwO
Z
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q
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TFH|O
OFDFTJEBE
QMBTNB
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DPOHFMBEP
Z

P
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VII. EFECTO HEPATICO

1VFEF
QSPEVDJSTF
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q
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EF
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Z
EJSFDUB
GBDUPSFT
EF
DPBHVMBDJwO
Z
BNPOJP

PRONÓSTICO DE LA ASFIXIA PERINATAL

7B
B
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EFM
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EF
4BSOBU
EFM
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EF
WJTUB
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Z
EFM
HSBEP
EF

DPNQSPNJTP
EF
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wSHBOPT

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EF
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OFVSPMwHJDP

q
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TFWFSB
Z
QSPMPOHBEB
"QHBS


B
MPT

NJO
q
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FO
FTUBEJP
***
EF
4BSOBU
q
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EJGrDJMFT
EF
NBOFKBS
q
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EF
FYBNFO
OFVSPMwHJDP
BM
BMUB
IBCJUVBM

TFNBOB
EF
WJEB
QSJODJQBM
NFOUF
BVTFODJB
EF
SF¿FKP
EF
.PSP

q
1FSTJTUFODJB
EF
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FYUFOTBT
FO
MB
FDPHSBGrB
BM
NFT
EF
WJEB
q
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FO
MB
5"$
BM
NFT
EF
WJEB
q
0MJHVSJB
QFSTJTUFOUF
QPS
NgT
EF

IST
q
&&(
BOPSNBM
q
1PUFODJBMFT
FWPDBEPT
WJTVBMFT
BMUFSBEPT

Pronóstico según Apgar en RN de término con EHI Grado II y III.

"QHBS
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242 GUÍAS NACIONALES DE NEONATOLOGÍA

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246 GUÍAS NACIONALES DE NEONATOLOGÍA

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248 GUÍAS NACIONALES DE NEONATOLOGÍA

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258 GUÍAS NACIONALES DE NEONATOLOGÍA

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260 GUÍAS NACIONALES DE NEONATOLOGÍA

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262 GUÍAS NACIONALES DE NEONATOLOGÍA

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VALORES NORMALES DE LOS EXAMENES DE COAGULACION EN RN.

1SFNBUVSP 3/
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EF
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NN



 


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Recién nacidos prematuros entre 30-36 semanas de gestación.

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551,
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° 
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266 GUÍAS NACIONALES DE NEONATOLOGÍA

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DIAGNOSTICO DIFERENCIAL EN RN CON SIND. HEMORRAGIPARO

1MBRVFUBT 51 515 %JBHOwTUJDP
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267
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ENFERMEDAD HEMORRÁGICA DEL RN:

q
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Z
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551
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q
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q
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TF
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MB
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268 GUÍAS NACIONALES DE NEONATOLOGÍA

COAGULACIÓN INTRAVASCULAR DISEMINADA:

q
&M
3/
TF
WF
FOGFSNP
Z
QVFEF
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EF
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q
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q
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SFDVFOUP
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51
Z
551
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q
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q
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,

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q
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PÚRPURA TROMBOCITOPÉNICO INMUNE MATERNO:

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Manejo prenatal:

q
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q
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NN

Manejo neonatal:

q
3/
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NBOUJFOF
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FM
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QPS

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269
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LH

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q
4J
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EF
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P
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PÚRPURA TROMBOCITOPÉNICO NEONATAL ISOINMUNE:

q
&O
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MB
NBESF
OP
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FM
BOUrHFOP
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EF
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BIBLIOGRAFIA

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270 GUÍAS NACIONALES DE NEONATOLOGÍA

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MB
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WBMPSFT
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EF
IFNPHMPCJOB

Cambios en las cifras de hemoglobina durante el primer año de vida.

3/
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3/
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4FNBOB

3/
UnSNJOP

HST

HST

     
      
     
  
   
      
    
   

Valores mínimos de hemoglobina durante el primer año de vida.

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3/
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271
ETIOLOGIA:
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QPS
IFNPSSBHJB
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JOTV¾DJFODJB
EF
MB
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1. Hemorragias:
"
$BVTB
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q
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EF
MB
QMBDFOUB
Z
EFM
DPSEwO

q
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QSFNBUVSP
EF
QMBDFOUB
q
1MBDFOUB
QSFWJB
q
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EFM
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q
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FO
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q
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q
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q
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q
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EFM
3/
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DPSEwO
q
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EF
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2. Hemólisis:
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q
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3I
q
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q
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EF
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q
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q
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272 GUÍAS NACIONALES DE NEONATOLOGÍA

 q
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EF
WJUBNJOB
&
q
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3. Defectos en la producción de glóbulos rojos:

q
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q
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q
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q
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LABORATORIO:

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TRATAMIENTO:
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273
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284 GUÍAS NACIONALES DE NEONATOLOGÍA

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286 GUÍAS NACIONALES DE NEONATOLOGÍA

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288 GUÍAS NACIONALES DE NEONATOLOGÍA

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290 GUÍAS NACIONALES DE NEONATOLOGÍA

Causas estructurales de hiperbilirrubinemia conjugada:

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TPSEFSB

%BvP
JO¿BNBUPSJP
DSwOJDP
BUSP¾B
DFSFCSBM
NJDSPDFGBMJB
DBMDJ¾DBDJPOFT

QFSJWFOUSJDVMBSFT
BMUFSBDJwO
EFM
FTNBMUF
EFOUBM
v
1FSJOBUBM
/FVNPOrB
EFM
MBDUBOUF
NFOPS

Herpes simple:
v
$POHnOJUB
IJESPBOFODFGBMJB
DBMDJ¾DBDJPOFT
DFSFCSBMFT
DPSJPSSFOUJOJUJT
DJDBUSJDFT
EF

QJFM
v
1FSJOBUBM
*OGFDDJwO
EJTFNJOBEB
FODFGBMJUJT
JOGFDDJwO
MPDBMJ[BEB
EF
MB
QJFM
PKPT
P
NVDPTB

PSBM

Varicela:
v
$POHnOJUB
&YUFOTBT
DJDBUSJDFT
EF
QJFM
FYUSFNJEBEFT
IJQPQMgTJDBT
DPSJPSSFUJOJUJT

NJDSPGUBMNrB
BUSP¾B
DFSFCSBM
v
1FSJOBUBM
*OGFDDJwO
EJTFNJOBEB

Parvovirus B19:
v
)JESPQT
GFUBMJT
OP
JONVOF

Hepatitis B:
v
)FQBUJUJT
QPSUBEPS
DSwOJDP
EF
)#T"H

HIV:
v
3FUBSEP
EFM
DSFDJNJFOUP
Z
EFTBSSPMMP
JOGFDDJPOFT
SFDVSSFOUFT
N|MUJQMFT
JOGFDDJPOFT

PQPSUVOJTUBT
FODFGBMJUJT
EJBSSFB
DSwOJDB
IFQBUPFTQMFOPNFHBMJB
OFVNPOrB
MJOGPDrUJDB

Enterovirus:
1FSJOBUBM
NFOJOHJUJT
BTnQUJDB
NJPDBSEJUJT
JOGFDDJwO
HFOFSBMJ[BEB

311
BIBLIOGRAFIA:

/FXUPO
&3
%JBHOPTJT
PG
QFSJOBUBM
503$)
JOGFDUJPOT
$MJO
0CTUFU
(ZOFDPM

.BS

 


3FWJFX

3FE
#PPL

3FQPSU
PG
UIF
$PNNJUUFF
PO
*OGFDUJPVT
%JTFBTF
UI
&EJUJPO

4FNJOBST
JO
1FEJBUSJDT
*OGFDUJPOT
%JTFBTF
7PM

O

KVMJP


.BOVBM
EF
DVJEBEPT
OFPOBUBMFT
$MPIFSUZ
4UBSL

&EJDJwO
&E
.BTTPO

(SFFOPVHI
"
5IF
503$)
TDSFFO
BOE
JOUSBVUFSJOF
JOGFDUJPOT
"SDI
%JT
$IJME
'FUBM

/FPOBUBM
&E

.BZ 
'
3FWJFX

312 GUÍAS NACIONALES DE NEONATOLOGÍA

 ).&%##)/.%3
./3/#/-)!,%3

-B
TFQTJT
OPTPDPNJBMFT
TJHVF
TJFOEP
DBVTB
JNQPSUBOUF
EF
NPSUBMJEBE
Z
NPSCJMJEBE

FO
MBT
VOJEBEFT
OFPOBUBMFT
B
QFTBS
EF
MPT
BWBODFT
FO
UFSBQJB
BOUJNJDSPCJBOB
EF
MBT
NF
EJEBT
EF
TPQPSUF
Z
EFM
DPOPDJNJFOUP
EF
MPT
GBDUPSFT
EF
SJFTHP
JOGFDDJPTP
"GFDUB
B
VO

B


EF
UPEPT
MPT
SFDJnO
OBDJEPT
IPTQJUBMJ[BEPT
Z
IBTUB
VO

EF
MPT
3/
JOHSFTBEPT
FO

MB
65*
QPS
NgT
EF

IPSBT
-PT
QSFNBUVSPT
TPO
MPT
NgT
BGFDUBEPT
EFTBSSPMMBOEP
TFQTJT

OPTPDPNJBM
VO

EF
MPT
NFOPSFT
EF

TFNBOBT
Z
VO

B

EF
MPT
NFOPSFT
EF


TFNBOBT

DEFINICIÓN:
*OGFDDJwO
OPTPDPNJBM
P
JOUSBIPTQJUBMBSJB
TF
EF¾OF
DPNP
BRVFMMB
JOGFDDJwO
BERVJSJEB

EFTQVnT
EF
MBT

IPSBT
EF
WJEB
QPS
QBUwHFOPT
EFM
BNCJFOUF
IPTQJUBMBSJP
OP
EFSJWBEPT
EF

MB
NBESF
)BCJUVBMNFOUF
PDVSSF
EFTQVnT
EF
MPT

ErBT
EF
WJEB
MP
RVF
TF
IB
MMBNBEP
MBUF
POTFU
TFQTJT
P
TFQTJT
EF
JOJDJP
UBSErP
QBSB
EJGFSFODJBSMB
EF
MBT
JOGFDDJPOFT
QFSJOBUBMFT

MICROBIOLOGÍA:
-PT
QBUwHFOPT
SFTQPOTBCMFT
EF
MBT
**)
IBO
WBSJBEP
ESgTUJDBNFOUF
FO
MPT
|MUJNPT


BvPT
"DUVBMNFOUF
NgT
EFM

EF
MBT
JOGFDDJPOFT
OPTPDPNJBMFT
TPO
QSPWPDBEBT
QPS
FT
UB¾MPDPDPT
DPBHVMBTB
OFHBUJWPT
VO

QPS
FTUB¾MPDPDP
BVSFVT
NFUJDJMJOPSFTJTUFOUFT


VO

TPO
HSBN
OFHBUJWPT
,MFCTJFMMB
1TFVEPNPOB
&
DPMJ
,
&OUFSPCBDUFS
Z
PUSPT

PUSP


TPO
IPOHPT
FTQFDJBMNFOUF
$gOEJEB
BMCJDBOT

Z
NFOPT
EFM

QPS
FOUFSPDPDPT

FACTORES DE RIESGO:
Extrínsecos:
q
6TP
EF
DBUnUFSFT
JOUSBWFOPTPT
UVCPT
FOEPUSBRVFBMFT
ErBT
EF
WFOUJMBDJwO
NFDg
OJDB
TPOEB
QMFVSBM
TPOEB
WFTJDBM

313
 q
"MJNFOUBDJwO
QBSFOUFSBM
QSPMPOHBEB
6TP
MrQJEPT
"MJNFOUBDJwO
FOUFSBM
DPO
MFDIF

NBUFSOB
EJTNJOVZF
SJFTHP
q
6TP
JOEJTDSJNJOBEP
Z
QSPMPOHBEP
EF
BOUJCJwUJDPT
EF
BNQMJP
FTQFDUSP
q
6TP
EF
DPSUJDPJEFT
Z
CMPRVFBEPSFT
TFDSFDJwO
gDJEB
HgTUSJDB
q
1VODJPOFT
N|MUJQMFT
QPS
WrB
QFSJGnSJDB
q
$JSVHrBT
q
%VSBDJwO
EF
MB
IPTQJUBMJ[BDJwO
"ERVJTJDJwO
Z
DPMPOJ[BDJwO
EF
¿PSB
CBDUFSJBOB
JO
USBIPTQJUBMBSJB
q
$FSDBOrB
EF
VO
QBDJFOUF
B
PUSP
Z
QFSTPOBM
RVF
BUJFOEF
BM
3/
JOTV¾DJFOUF
-BWBEP

JOBEFDVBEP
EF
NBOPT

Intrínsecos:
q
5PEB
MB
*H(
EFM
GFUP
Z
3/
TPO
EF
MB
NBESF
Z
MPT
OJWFMFT
DBFO
SgQJEBNFOUF
QPTUF
SJPS
BM
OBDJNJFOUP
q
*H"
TFDSFUPSB
NVZ
EJTNJOVJEB
UBOUP
FO
MPT
QVMNPOFT
DPNP
FO
FM
TJTUFNB
HBTUSP
JOUFTUJOBM
q
%JTNJOVDJwO
WrB
BMUFSOB
EFM
DPNQMFNFOUP
$

'BMUB
PQTPOJ[BDJwO
DgQTVMB
QPMJ
TBDgSJEB
q
3gQJEP
BHPUBNJFOUP
EF
MPT
EFQwTJUPT
EF
OFVUSw¾MPT
NBEVSPT
NFEVMBSFT
DVBOEP

IBZ
FYQPTJDJwO
B
VOB
JOGFDDJwO
q
&TUPT
OFVUSw¾MPT
UJFOFO
NFOPS
DBQBDJEBE
EF
BEIFSFODJB
Z
GBHPDJUPTJT
Z
NFOPS

DBQBDJEBE
CBDUFSJDJEB
q
#BSSFSBT
OBUVSBMFT
JONBEVSBT
&TQFDJBMNFOUF
QJFM
F
JOUFTUJOP
q
*ONVOJEBE
NFEJBEB
QPS
MJOGPDJUP
5
IFMQFS
Z
/,
/BUVSBM
LJMMFS

BMUFSBEBT
.FNPSJB

JONVOPMwHJDB
EF¾DJFOUF
q
"
NBZPS
QSFNBUVSJEBE
NgT
JONBEVSF[
JONVOPMwHJDB
Z
NBZPS
GSFDVFODJB
EF
JOGFD
DJPOFT

DIAGNÓSTICO CLÍNICO:
-PT
TrOUPNBT
TPO
JOFTQFDr¾DPT
q
3FTQJSBUPSJPT
"QOFB
EJ¾DVMUBE
SFTQJSBUPSJB
BVNFOUP
EF
MPT
SFRVFSJNJFOUPT
EF

PYrHFOP
q
*OFTUBCJMJEBE
UnSNJDB
¾FCSF
P
EJ¾DVMUBE
QBSB
UFSNPSSFHVMBS
q
*OUPMFSBODJB
BMJNFOUBSJB
SFTJEVPT
HgTUSJDPT
BVNFOUBEPT
EJTUFOTJwO
BCEPNJOBM

rMFP
GVODJPOBM
q
(FOFSBMFT
DPNQSPNJTP
EFM
FTUBEP
HFOFSBM
MFUBSHJB
IJQPUPOrB
q
)FNBUPMwHJDBT
QFUFRVJBT
Q|SQVSB
q
"DJEPTJT
NFUBCwMJDB
IJQFSHMJDFNJB
q
)JQPUFOTJwO
NBMB
QFSGVTJwO
QFSJGnSJDB
TIPDL

314 GUÍAS NACIONALES DE NEONATOLOGÍA

LABORATORIO SUGERENTE:

Hemocultivos.
q
$PO¾SNBO
FM
EJBHOwTUJDP
EF
CBDUFSFNJB
TJO
FNCBSHP
MB
TFOTJCJMJEBE
EFM
IFNP
DVMUJWP
FT
CBKB

B



q
4F
SFDPNJFOEB
UPNBS
TJFNQSF
EPT
IFNPDVMUJWPT
USFT
OP
BVNFOUBO
FM
SFOEJNJFOUP


q
-B
DBOUJEBE
NrOJNB
EF
TBOHSF
B
FYUSBFS
FT

NM
FTUVEJPT
DPO
NJDSPNnUPEPT
EF

 
NM
UJFOFO
NFOPS
BJTMBNJFOUP
CBDUFSJBOP


q
4F
EFCF
UPNBS
MBT
NVFTUSBT
EF
QVODJwO
EF
TJUJPT
QFSJGnSJDPT
EJGFSFOUFT
DBEB
VOB

EF
VO
NM

q
-BT
UPNBT
QVFEF
TFS
TJNVMUgOFBT
OP
FT
SFRVJTJUP
EFKBS
QBTBS
VO
UJFNQP
QSFEFUFS
NJOBEP
FOUSF
NVFTUSB
Z
NVFTUSB

q
1BSB
EJBHOwTUJDP
EF
TFQTJT
QPS
DBUnUFS
UPNBS
VOB
NVFTUSB
QPS
BSSBTUSF
EF
FTF

DBUnUFS
Z
VOB
QFSJGnSJDB
Z
SFBMJ[BS
SFDVFOUPT
EF
DPMPOJBT
DVBOUJUBUJWPT
DPO
UnDOJDB

EF
.BLJ
SFDVFOUPT
EJGFSFODJBMFT
NBZPSFT
B

WFDFT
FT
EJBHOwTUJDB


q
/P
UJFOF
VUJMJEBE
DMrOJDB
UPNBS
DVMUJWPT
EF
QVOUB
EF
DBUnUFS

q
7BMPS
QSFEJDUJWP
OFHBUJWP
EF
MPT
IFNPDVMUJWPT
FT
DFSDBOP
BM

DPO

IPSBT


DPO

IPSBT

DPO

IPSBT
Z
 
DPO

IPSBT
EF
IFNPDVMUJWPT
OF
HBUJWPT
1PS
MP
UBOUP
FT
TFHVSP
TVTQFOEFS
BOUJCJwUJDPT
DPO

IPSBT
EF
USBUBNJFO
UP
FNQrSJDP

Hemograma:
q
-BT
BMUFSBDJPOFT
EFM
IFNPHSBNB
FO
MB
TFQTJT
DPOOBUBM
QSFDP[
FTUgO
CBTUBOUF

CJFO
EFTDSJUBT
QFSP
FO
MB
TFQTJT
UBSErB
FM
IFNPHSBNB
OP
UJFOF
CVFOBT
SFGFSFODJBT

EF
DPNQBSBDJwO

q
4J
FM
IFNPHSBNB
UJFOF
rOEJDFT
EF
*ONBEVSPT
5PUBMFT
NBZPS
EF
 
P
*ONBEVSPT

.BEVSPT
NBZPS
EF
 
MB
QSPCBCJMJEBE
EF
TFQTJT
FT
NBZPS
EFM


q
/JWFMFT
EF
MFVDPDJUPT
NBZPSFT
B

P
NFOPSFT
EF

DPO
OFVUSP¾MPT
NF
OPSFT
B

P
SFDVFOUP
EF
QMBRVFUBT
NFOPS
B

TPO
TVHFSFOUFT

q
/FVUSP¾MJBT
NBZPSFT
B

Z
SFDVFOUPT
EF
CBDJMJGPSNFT
NBZPSFT
BM

B


EFT
QVnT
EF
MB
QSJNFSB
TFNBOB
EF
WJEB
TPO
TPTQFDIPTPT

q
3FDPSEBS
RVF
OPSNBMNFOUF
IBZ
VO
QSFEPNJOJP
MJOGPNPOPOVDMFBS
FO
FM
QSFUnSNJ
OP
NBZPS
EF

ErBT
RVF
JODMVTP
B
MBT

B

TFNBOBT
TF
QSFTFOUB
DPO
VOB
MFWF

OFVUSPQFOJB
SFMBUJWB
q
&O
MBT
TFQTJT
QPS
FTUB¾MPDPDP
DPBHVMBTB
OFHBUJWP
MBT
BMUFSBDJPOFT
EFM
IFNPHSB
NB
QVFEFO
TFS
NrOJNBT
QVEJFOEP
IBCFS
TwMP
OFVUSP¾MJB

q
-B
TVTQFOTJwO
EFM
USBUBNJFOUP
EFCF
SFBMJ[BSTF
DPO
IFNPHSBNB
OPSNBM

315
Proteína C reactiva.
q
&T
VO
FMFNFOUP
RVF
BQPZB
B
MB
TPTQFDIB
DMrOJDB
ZP
IFNPHSBNB
BOPSNBM

q
&T
VO
CVFO
FYBNFO
QBSB
FWBMVBS
SFTQVFTUB
BOUJCJwUJDP

q
1PS
PUSB
QBSUF

WBMPSFT
EF
1$3
CBKPT
UJFOFO
VO
WBMPS
QSFEJDUJWP
OFHBUJWP
EF
TFQ
TJT
EF
VO

Z

1$3
CBKBT
VO
 

q
0USBT
NFEJDJPOFT
EF
QSPUFrOBT
EF
GBTF
BHVEB
UBNCJnO
QVFEFO
VUJMJ[BSTF

Punción Lumbar.
q
&O
FTUVEJPT
SFUSPTQFDUJWPT
FO
OFPOBUPT
DPO
TFQTJT
OPTPDPNJBM
TF
EFUFDUw
NFOJO
HJUJT
TwMP
FO

B

EF
MPT
QBDJFOUFT

q
4JO
FNCBSHP
TF
EFCJFSB
SFBMJ[BS
QVODJwO
MVNCBS
B
UPEP
OFPOBUP
TJOUPNgUJDP
P

DPO
FYgNFOFT
JOGFDDJPTPT
BMUFSBEPT
EBEP
RVF
FM

EF
MPT
DBTPT
EF
NFOJOHJUJT

PDVSSJFSPO
DPO
IFNPDVMUJWPT
OFHBUJWPT

Otros cultivos.
q
"OUF
MB
TPTQFDIB
EJBHOwTUJDB
TF
EFCF
SFBMJ[BS
DVMUJWP
EF
QJFM
DFMVMJUJT
BCTDFTPT


PSJOB
BOUFDFEFOUF
VTP
EF
TPOEB
WFTJDBM

MrRVJEP
QMFVSBM
EFSSBNF
QMFVSBM

FOEPUSBRVFBM

QPS
FM
UVCP
TPTQFDIB
OFVNPOrB
QPS
WFOUJMBDJwO
NFDgOJDB

BTDJUJT
BSUJDVMBS
TFH|O
DP
SSFTQPOEB

TRATAMIENTO:

q
4F
SFDPNJFOEB
DVCSJS
FTQFDJBMNFOUF
&TUB¾MPDPDP
FQJEFSNJEJT
Z
&TUB¾MPDPDP
BV
SFVT
NgT
VO
BOUJCJwUJDP
DPO
FTQFDUSP
BEFDVBEP
QBSB
HSBN
OFHBUJWPT
JOJDJBS
USB
UBNJFOUP
DPO
$MPYBDJMJOB
Z
VO
BNJOPHMJDwTJEP
P
$FGPUBYJNB
QSJODJQBMNFOUF
FO

DBTP
EF
NFOJOHJUJT


q
&O
VOJEBEFT
DPO
GSBODP
QSFEPNJOJP
EF
&TUB¾MPDPDP
BVSFVT
NVMUJSFTJTUFOUFT
TF

EFCF
JOJDJBS
USBUBNJFOUP
DPO
7BODPNJDJOB
-B
JOGFDDJwO
QPS
&TUB¾MPDPDP
FQJEFS
NJEJT
DPBHVMBTB
OFHBUJWP

EB
UJFNQP
QBSB
NPEJ¾DBS
FM
FTRVFNB
BOUJCJwUJDP

q
-P
NgT
JNQPSUBOUF
FT
DVCSJS
EFTEF
VO
DPNJFO[P
MPT
(SBN
OFHBUJWPT
TFH|O
TFOTJCJ
MJEBE
MPDBM
ZB
RVF
FTUPT
HnSNFOFT
DVSTBO
DPO
SgQJEP
DPNQSPNJTP
NVMUJTJTUnNJDP

q
/P
VTBS
$FGUSJBYPOB
FO
OFPOBUPT
DPO
IJQFSCJMJSSVCJOFNJB
ZB
RVF
EFTQMB[B
MB
CJMJ
SSVCJOB
OP
DPOKVHBEB
EF
MB
BMC|NJOB
BM
DPNQFUJS
DPO
nTUB
q
4F
EFCFO
SFUJSBS
DBUnUFSFT
TJ
IFNPDVMUJWPT
TPO
QPTJUJWPT
B
IPOHPT
Z
FO
DBTP
EF

DPMPOJ[BDJwO
EF
DBUnUFS
QPS
(SBN
OFHBUJWPT

q
&O
3/
DPO
IFNPDVMUJWPT
QPTJUJWPT
B
&TUB¾MPDPDP
DPBHVMBTB
OFHBUJWP
QVFEF
NBO
UFOFSTF
FM
DBUnUFS
JO
TJUV
BENJOJTUSBOEP
MPT
BOUJCJwUJDPT
B
USBWnT
EF
nM
Z
SFFWBMVBS
BM

QBDJFOUF
FO
IPSBT
DPO
TFHVJNJFOUP
DMrOJDP
FTUSJDUP
Z
IFNPHSBNB1$3IFNP

316 GUÍAS NACIONALES DE NEONATOLOGÍA

 DVMUJWPT
4J
QFSTJTUF
TJOUPNgUJDP
P
DPO
FYgNFOFT
BMUFSBEPT
P
IFNPDVMUJWPT
B|O

QPTJUJWPT
TF
EFCF
SFUJSBS
DBUnUFS
&O
DBTP
EF
&#4"
SFUJSBS
DBUnUFS
q
&O
DBTP
EF
TFQTJT
QPS
HnSNFOFT
HSBN
OFHBUJWPT
NVMUJSSFTJTUFOUFT
TF
SFDPNJFOEB

VTP
EF
.FSPQFOFN
TwMP
DPNP
UFSDFSB
MrOFB
BOUJCJwUJDB

q
3FTQFDUP
B
MB
EVSBDJwO
EFM
USBUBNJFOUP
BOUJCJwUJDP
TF
SFDPNJFOEB
USBUBS

ErBT
FO

JOGFDDJPOFT
FWJEFOUFT
TJO
HFSNFO
EFNPTUSBEP
/P
IBZ
FTUVEJPT
RVF
EFNVFTUSFO

RVF
BMBSHBS
FM
USBUBNJFOUP
TFB
NgT
CFOF¾DJPTP
FO
MB
FSSBEJDBDJwO
CBDUFSJBOB

q
&O
DBTP
EF
TFQTJT
DPO
CBDUFSFNJB
EFNPTUSBEB
IFNPDVMUJWPT
QPTJUJWPT

TF
USB
UBSg
DPO
NPOPUFSBQJB
BOUJCJwUJDB
FTQFDr¾DB
QPS

B

ErBT
Z

B

ErBT
TJ
FM

HFSNFO
TF
BrTMB
EF
-$3

q
3FDPSEBS
RVF
OP
IBZ
RVF
USBUBS
DPO
BNJOPHMJDwTJEPT
QPS
NgT
EF

ErBT
QPSRVF

TF
FMFWB
OPUBCMFNFOUF
MB
PUPUPYJDJEBE

ESTRATEGIAS DE PREVENCIÓN:

q
-BWBEP
EF
NBOPT
FTUSJDUP

B

TFHVOEPT
BOUFT
Z
EFTQVnT
EF
BUFOEFS
P
FYB
NJOBS
BM
QBDJFOUF
DPO
UnDOJDB
BEFDVBEB
/P
VTBS
BOJMMPT
KPZBT
SFMPKFT
P
QVMTF
SBT
.BOUFOFS
VvBT
DPSUBT
TJO
FTNBMUF
q
"JTMBNJFOUP
EF
DPOUBDUP
EFM
DBTP
rOEJDF
EVSBOUF
MBT
QSJNFSBT

IPSBT
q
1FSTPOBM
TV¾DJFOUF
QBSB
BUFOEFS
B
MPT
QBDJFOUFT
DBQBDJUBEP
Z
DPODJFOUF
EF
TV

SPM
QSFWFOUJWP

q
"TFHVSBS
DPOEJDJPOFT
EF
BTFQTJB
wQUJNBT
QBSB
MB
QSFQBSBDJwO
EF
NFEJDBNFO
UPT
GwSNVMBT
JOGBOUJMFT
Z
BMJNFOUBDJwO
QBSFOUFSBM
q
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340 GUÍAS NACIONALES DE NEONATOLOGÍA

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341
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342 GUÍAS NACIONALES DE NEONATOLOGÍA

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Tabla 1:
Valores normales de creatinina sérica en RNT Y RNPreT (media ± p95)

&EBE
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TFNBOBT 
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Manejo:
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364 GUÍAS NACIONALES DE NEONATOLOGÍA

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365
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366 GUÍAS NACIONALES DE NEONATOLOGÍA
 q
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q
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Manejo diagnóstico antenatal de hidronefrosis

1BSB
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q
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q
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Criterios para diagnóstico antenatal de hidronefrosis.

q
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367
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EF
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FM
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Conducta frente a diagnóstico antenatal de hidronefrosis

q
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MB
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368 GUÍAS NACIONALES DE NEONATOLOGÍA

Presentación clínica:

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MBT
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q
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q
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370 GUÍAS NACIONALES DE NEONATOLOGÍA

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q
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q
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q
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EF
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q
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q
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372 GUÍAS NACIONALES DE NEONATOLOGÍA

Conducta quirúrgica
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374 GUÍAS NACIONALES DE NEONATOLOGÍA

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377
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Presentación clínica de hiperplasia suprarrenal congénita

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MANIFESTACIONES CLINICAS

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378 GUÍAS NACIONALES DE NEONATOLOGÍA
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380 GUÍAS NACIONALES DE NEONATOLOGÍA

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397
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MANEJO Y TRATAMIENTO:
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TRATAMIENTO QUIRÚRGICO:

Atresia esofágica con FTE distal:

q
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398 GUÍAS NACIONALES DE NEONATOLOGÍA
 q
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Atresia esofágica sin fístula:

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Atresia Esofágica con FTE proximal:

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Atresia esofágica con FTE proximal y distal:

q
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FT
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Fístula Traqueo esofágica en H:

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TRATAMIENTO POSTOPERATORIO:
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399
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400 GUÍAS NACIONALES DE NEONATOLOGÍA

 02/",%-!
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401
402 GUÍAS NACIONALES DE NEONATOLOGÍA
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Patogénesis:
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Incidencia:
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Factores de riesgo asociados:

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MB
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EF
301
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MPT
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q
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q
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Clasificación:
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Localización:
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Severidad:
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q
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404 GUÍAS NACIONALES DE NEONATOLOGÍA

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Curso clínico:
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406 GUÍAS NACIONALES DE NEONATOLOGÍA

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408 GUÍAS NACIONALES DE NEONATOLOGÍA

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410 GUÍAS NACIONALES DE NEONATOLOGÍA
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412 GUÍAS NACIONALES DE NEONATOLOGÍA

AMOMALIAS MAYORES:
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EVALUACIÓN DE LOS HALLAZGOS EN RECIÉN NACIDO:

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414 GUÍAS NACIONALES DE NEONATOLOGÍA

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DVUgOFBT

Z

DPOWJFOF
DPOUSPMBS
QSVFCBT
EF
DPBHVMBDJwO
FO
MPT
DBTPT
TFWFSPT

Fractura de Cráneo:

-B
NBZPSrB
TF
DPOTJEFSBO
IPZ
EF
PSJHFO
QSFOBUBM
Z
TPO
HFOFSBMNFOUF
TFDVOEBSJBT

B
QBSUPT
QSPMPOHBEPT
P
EJGrDJMFT
P
BM
VTP
EF
GwSDFQT
(FOFSBMNFOUF
TPO
MJOFBMFT

Z
BDPNQBvBO
B
VO
DFGBMPIFNBUPNB
/P
EBO
TrOUPNBT
OP
SFRVJFSFO
USBUBNJFOUP

4F
EJBHOPTUJDBO
QPS
3Y
EF
DSgOFP

-BT
GSBDUVSBT
EFQSJNJEBT
IBCJUVBMNFOUF
TFDVOEBSJBT
B
JOTUSVNFOUBDJwO
TPO
MB

NBZPSrB
BTJOUPNgUJDBT
OP
SFRVJFSFO
USBUBNJFOUP
QFSP
TJ
EBO
TrOUPNBT
P
TPO
NB
ZPSFT
EF
EPT
DFOUrNFUSPT
EFCFO
TFS
FWBMVBEBT
QPS
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-BT
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EF
MB
CBTF
EFM
DSgOFP
SBSrTJNBT
TF
BDPNQBvBO
DBTJ
TJFNQSF
EF

IFNPSSBHJB
TFWFSB
QPS
EFTHBSSP
EF
TFOPT
WFOPTPT
TVCZBDFOUFT
TPO
HSBWFT
Z
EF
CFO
TFS
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QPS
OFVSPDJSVKBOP
UJFOFO
NBM
QSPOwTUJDP
Z
MPT
TPCSFWJWJFOUFT

UJFOFO
FMFWBEB
JODJEFODJB
EF
TFDVFMBT

416 GUÍAS NACIONALES DE NEONATOLOGÍA

Hemorragia Subdural:

1SgDUJDBNFOUF
JOFYJTUFOUF
FO
MB
BDUVBMJEBE
-B
UPNPHSBGrB
BYJBM
FT
EF
HSBO
BZVEB

EJBHOwTUJDB
&M
QSPOwTUJDP
FT
TPNCSrP
QBSB
MBT
NPEFSBEBT
P
HSBWFT
B|O
EFTQVnT

EF
TFS
FWBDVBEBT

Hemorragia Subaracnoidea:

%B
QPDB
P
OJOHVOB
TJOUPNBUPMPHrB
4PMP
FO
MPT
DBTPT
HSBWFT
FYJTUF
SJFTHP
EF
IJ
ESPDFGBMJB
4F
EFCFO
VTBS
BOUJDPOWVMTJWBOUFT
TJ
nTUBT
TF
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QFSP
nM
QSP
OwTUJDP
FT
GBWPSBCMF
FO
MB
NBZPSrB
EF
MPT
DBTPT

Hematoma del Esternocleidomastoideo:

-B
MFTJwO
TF
PSJHJOB
QPS
FTUJSBNJFOUP
EFM
N|TDVMP
FO
QPTJDJPOFT
EJTUwDJDBT
)BZ

VOB
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EFM
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FO
TV
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DPOEVDJSg
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NBTB
QBMQBCMF
GVTJGPSNF
JOEPMPSB
Z
MVFHP

TFDVOEBSJP
B
MB
DPOUSBDUVSB
TF
QPOF
EF
NBOJ¾FTUP
QPS
MB
QPTJDJwO
JODMJOBEB
EF
MB

DBCF[B
TPCSF
FM
N|TDVMP
DPOUSBDUVSBEP
1VFEF
QSPEVDJS
BTJNFUSrB
EF
MB
DBSB

4VFMF
SFHSFTBS
FO
GPSNB
FTQPOUgOFB
FO

B

TFNBOBT
QFSP
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TFS
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SJP
USBUBNJFOUP
DPO
¾TJPUFSBQFVUB
Z
MB
UPSUrDPMJT
SFTPMWFSTF
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MPT

NFTFT
EF

FEBE

Parálisis Facial:

&YJTUFO
EPT
WBSJFEBEFT

$FOUSBM
/P
IBZ
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EF
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EF
MB
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FTQgTUJDB

EF
MB
NJUBE
JOGFSJPS
EF
MB
DBSB
FM
MBEP
QBSBMJ[BEP
TF
BQSFDJB
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HVF
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DPNJTVSB
MBCJBM
DBrEB
"M
MMBOUP
MB
CPDB
TF
EFTWrB
IBDJB

FM
MBEP
TBOP
/P
IBZ
DPNQSPNJTP
EF
GSFOUF
OJ
EF
QgSQBEPT
4F
EFCF
EFTDBSUBS

PUSBT
BMUFSBDJPOFT
EF
PSJHFO
DFOUSBM

TrOESPNF
EF
.PFCJVT
FUD

1FSJGnSJDB
1VFEF
FYJTUJS
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EF
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¿gDJEB

DPNQSPNFUF
UPEB
MB
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&O
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FM
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TrOUPNB
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TFS
FM
PKP
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TJTUFOUFNFOUF
BCJFSUP
FO
FM
MBEP
BGFDUBEP
4F
DPNQSPNFUF
MB
GSFOUF
MJTB
FO
MBEP

BGFDUBEP

Z
QgSQBEPT
4F
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PKP
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DPO
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DPMJSJPT
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VO
HFOUPT
PGUgMNJDPT
4VFMF
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QFSP
TJ
OP
MP
IBDF
FO
TJFUF
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EJF[
ErBT
EFCF
TFS
FWBMVBEP
QPS
VO
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Lesión de la médula espinal:

.VZ
SBSBT
FO
MB
BDUVBMJEBE
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TF
QSPEVDFO
QPS
MB
USBDDJwO
Z
MBUFSP
¿FYJwO
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FO
MB

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EF
DBCF[B
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FO
FM
QBSUP
EF
OBMHBT
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SFUFODJwO
EF
IPNCSPT
FO
QSFTFO
UBDJwO
DFGgMJDB

-FTJwO
DFSWJDBM
BMUB
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EF
USPODP
FODFGgMJDP
NPSUJOBUPT
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TJO
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B
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TJHOPT
OFVSPMwHJDPT
417

-FTJwO
DFSWJDBM
NFEJB
BM
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BQBSJFODJB
OPSNBM
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DBFO
FO

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DPNP
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EF
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NVTDVMBS
Z
EFGPSNJ
EBEFT
wTFBT

Parálisis braquial:

4F
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QPS
QBSgMJTJT
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QBSFTJB
EF
MPT
N|TDVMPT
EF
MBT
FYUSFNJEBEFT
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TFDVOEBSJB
B
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NFDgOJDP
EF
MBT
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FTQJOBMFT
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MB
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MB
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4F
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CSBRVJBM
TVQFSJPS
P
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%VDIFOOF
°
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&M
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EF
MB
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DFSWJDBMFT
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FM
CSB[P
TF
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FO

BEVDDJwO
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JOUFSOB
DPEP
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BOUFCSB[P
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EF
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QFSP
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1BSgMJTJT
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JOGFSJPS
P
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,MVNQLF

)BZ
MFTJwO
EF
MBT
SBrDFT
TnQUJNB

Z
PDUBWB
DFSWJDBMFT
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UPSgDJDB
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NVZ
SBSB
/P
IBZ
QSFIFOTJwO
QBMNBS

IBZ
VOB
NBOP
QBSBMrUJDB
FO
HBSSB
TJO
NPWJNJFOUPT
FTQPOUgOFPT
EF
MB
NVvFDB
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Tr

EFM
SFTUP
EFM
CSB[P

1BSgMJTJT
CSBRVJBM
UPUBM
$PNQSPNFUF
UPEP
FM
QMFYP
CSBRVJBM
Z
FT
MB
TFHVOEB
FO

GSFDVFODJB
-B
FYUSFNJEBE
FTUg
FOUFSB
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DPO
UPEPT
MPT
SF¿FKPT
BCPMJEPT
Z
BM
UFSBDJwO
EF
MB
TFOTJCJMJEBE

&M
USBUBNJFOUP
DPOTJTUF
FO
QPTJDJwO
OFVUSB
EFM
BOUFCSB[P
NVvFDB
DPO
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FO
FM
QVvP
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IBZ
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CBKP

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NPWJNJFOUPT
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WF[
RVF
TF
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FM
FEFNB
EFM
OFSWJP

B

ErBT

-B
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TFNBOBT

Z
FM
QSPOwTUJDP
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FT
CVFOP
4PMP
Tr
QFSTJTUFO
MPT
TrOUPNBT
NBT
EF

NFTFT
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QSPOwTUJDP
FT
NBMP
-B
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&O
MB
QBSgMJTJT
UPUBM
TF
EFCFO
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FTUVEJPT
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EF

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EF
MBT
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OFSWJPTBT

IBZ
RVF
DPOTJEFSBS
MB
NJDSPDJSVHrB
SFQBSBEPSB

TÓRAX

Fractura Clavícula:

&T
MB
NgT
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EF
MBT
GSBDUVSBT
wTFBT
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FM
QBSUP
&O
TV
NBZPSrB
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4V
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FT
MB
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EFM
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FO

418 GUÍAS NACIONALES DE NEONATOLOGÍA

 MB
QSFTFOUBDJwO
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MB
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FO
MB
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4F

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EF
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EF

B

ErBT
1SPOwTUJDP
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TJO
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Lesión del nervio frénico:

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Z
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SFTQJSBUPSJB

3BSB
WF[
FT
VOB
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FO
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FO
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MFTJwO
CJMBUFSBM
1SPOwTUJDP
MB
NBZPSrB
NFKPSB
FTQPOUgOFBNFOUF
FO
BMHVOBT
TFNBOBT

ABDOMEN:
&M
USBVNBUJTNP
EF
MPT
wSHBOPT
JOUSBBCEPNJOBMFT
EFCF
TPTQFDIBSTF
FO
QBSUPT
FO
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TF
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EF
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FO
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EF
NBESF
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GFUBM
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UBRVJDBSEJB
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TVDDJwO
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Traumatismo hepático:

"QBSFDF
NBTB
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FO
IJQPDPOESJP
EFSFDIP
1VFEF
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EF
MB
DgQ
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BOFNJB
ZP
TIPDL
EF
BQBSJDJwO
NgT
P
NFOPT
CSVTDB

Hemorragia renal y/o suprarrenal:

4F
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TPTQFDIBS
BOUF
MB
QSFTFODJB
EF
NBTBT
BCEPNJOBMFT
QBMQBCMFT
NgT
FM
BO
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EF
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TVQSBSSFOBM
BHVEB

419
FRACTURA DE HUESOS LARGOS

Fractura de húmero:

4F
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QPS
FKFSDFS
VOB
QSFTJwO
TPCSF
FM
UFSDJP
NFEJP
EFM
CSB[P
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FO
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-PT
TJHOPT
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Z
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FT
MB
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Fractura de fémur:

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BM
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4V
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TFNBOBT

TRAUMATISMOS DE LA PIEL
1VFEFO
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Necrosis adiposa subcutánea:

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-B
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DVCSF
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4F
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4F
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FO

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TF
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DPO
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BIBLIOGRAFIA

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420 GUÍAS NACIONALES DE NEONATOLOGÍA

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Evaluación del recién nacido

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SFEVDF
FM
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EF
MFDIF
QSPEVDJEP NgT
EF


DJHBSSJMMPT
EJBSJPT


q
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FO
MB
UBTB
EF
QSFNBUVSJEBE
Z
QnSEJEB
GFUBM

q
4J
EFKB
EF
GVNBS
FO
FM
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USJNFTUSF
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QFTP
EFM
3/
FT
DPNQBSBCMF
DPO
FM
QFTP

EFM
3/
IJKP
EF
OP
GVNBEPSB

Alcohol:
1SFTFODJB
EF
TrOESPNF
BMDPIwMJDP
GFUBM

q
SFUBSEP
EF
DSFDJNJFOUP
JOUSBVUFSJOP
q
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EF
4/$
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q
EJTNPS¾BT
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OBTBM

CBKP
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TVQFSJPS
EFMHBEP
¾TVSB
QBMBUJOB
q
IJESPOFGSPTJT
NBMGPSNBDJPOFT
FTRVFMnUJDBT

&M
FYDFTP
EF
BMDPIPM
FO
FNCBSB[P
FTUg
BTPDJBEP
DPO
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FO
FM
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USF
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QSFNBUVSP
3$*6
Z
DPOTUJUVZF
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EF
MBT
DBVTBT
NgT
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EF
SFUBSEP

NFOUBM

&M
OFPOBUP
QVFEF
QSFTFOUBS
TrOESPNF
EF
BCTUJOFODJB
UFNCMPS
CPTUF[PT
CBKB
BDUJWJ
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SFTQVFTUB
B
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BVEJUJWPT

&M
BMDPIPM
QBTB
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B
MFDIF
NBUFSOB
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MP
UBOUP
OP
EFCF
TFS
DPOTVNJEP
QPS

MB
OPESJ[B

Cocaína y derivados:

$SV[B
MB
QMBDFOUB
QPS
EJGVTJwO
GBDJMJUBEB
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TPMVCJMJEBE
MrQJEJDB
-B
DPDBrOB
BDU|B
OP
DJWBNFOUF
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NFDBOJTNPT
q
1PS
WBTPDPOUSJDDJwO
Z
UBRVJDBSEJB
NBUFSOB
Z
GFUBM
RVF
MMFWB
B

)JQPYJB
GFUBM
BVNFOUP
EF
MB
DPOUSBDUJMJEBE
VUFSJOB
EJTNJOVDJwO
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¿VKP
|UFSP
QMB
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JTRVFNJB
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EF
QMBDFOUB
3$*6
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BSSJUNJBT
Z
NBMGPSNBDJPOFT
DBSEJBDBT
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JOUFTUJOBM
JOGBSUP

DFSFCSBM
FO
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EF
BSUFSJB
DFSFCSBM
NFEJB
DPO
MFTJPOFT
RVrTUJDBT
&$/
EF

JOJDJP
QSFDP[
EJTHFOFTJB
SFUJOBM
Z
DPMPCPNB
SFUJOBM
q
1PS
CMPRVFP
EF
MB
SFDBQUBDJwO
EF
DBUFDPMBNJOBT
QSPEVDF
JSSJUBCJMJEBE
EFM
4/$

UPYJDJEBE
EFM
4/$
GFUBM
BOPSNBMJEBEFT
DPOEVDUVBMFT

-B
$PDBrOB
Z
EFSJWBEPT
QBTBO
MB
CBSSFSB
IFNBUPFODFGgMJDB
Z
FKFSDF
FGFDUPT
UwYJDPT

428 GUÍAS NACIONALES DE NEONATOLOGÍA

 FO
DFSFCSP
GFUBM
NBMGPSNBDJwO
DPOHnOJUB
Z
BTPDJBDJwO
DPO
IJQFSUFOTJwO
QVMNPOBS

1VFEF
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JOGBSUPT
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NJDSPJOGBSUPT
NJDSPDFGBMJB

%JTNPS¾B
GBDJBM
GPOUBOFMB
BNQMJB
FEFNB
QFSJPSCJUBSJP
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OBTBM
CBKP
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DPSUB

MBCJP
TVQFSJPS
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¾MUSVN
BNQMJP
¾TVSB
QBMBUJOB
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PSUFKPT
QFRVFvB

.FUBBOgMJTJT
EFNVFTUSBO
MB
BTPDJBDJwO
DPO
TrOESPNF
EF
NVFSUF
T|CJUB
RVF
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NgT
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FO
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DPDBrOB

B

WFDFT
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BVORVF
FTUB

BTPDJBDJwO
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NBZPS
FO
IJKPT
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VTVBSJBT
EF
QPMJESPHBT


-B
DPDBrOB
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B
MB
MFDIF
NBUFSOB
FTUg
DPOUSBJOEJDBEB
BCTPMVUBNFOUF
FO
MB
MBDUBODJB

Marihuana:

4F
IB
BTPDJBEP
DPO
NFOPS
QFTP
UBMMB
BM
OBDFS
Z
BOPSNBMJEBEFT
TVUJMFT
FO
FM
OFVSP
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UFUSBIJESPDBOBCJOPM
BUSBWJFTB
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QMBDFOUB
Z
FT
DBQB[
EF
BVNFOUBS
MPT

OJWFMFT
EF
DBSCPYJIFNPHMPCJOB

WFDFT
NgT
RVF
FM
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IJQPYJB
GFUBM

EJTNJOVZFOEP
FM
¿VKP
VUFSJOP

1BTB
B
MFDIF
NBUFSOB

Opiáceos:

*ODSFNFOUP
EF
MBT
NBMGPSNBDJPOFT
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4F
QSFTFOUBO
DPOWVMTJPOFT
FO
 
EF
IJKPT
EF
NBESFT
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NFUBEPOB
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EF
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4rOESPNF
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EF
MPT
3/

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FO

EF
NFUBEPOB

-PT
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JOJDJBO
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IPSBT
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FO
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IFSPrOB
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ErBT
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#
Z
$

Diagnósticos de farmacodependencia:

"OBNOFTJT
'BDUPSFT
EF
SJFTHP
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NBZPS
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EF
BOBM
HnTJDPT
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5FTU
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MB
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q
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FO
PSJOB
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EF

q
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NFDPOJP
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EF

q
&TUVEJP
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q
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q
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EF
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429
 
%JBHOwTUJDP
EF
EFQSJWBDJwO

q
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EF
BCTUJOFODJB
FT
UBCVMBEP
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4DPSF
4"/

PUNTAJE PARA EVALUAR SINDROME DE ABSTINENCIA

NEONATAL
16/5"+&
4*(/04
   
5SFNPSFT /PSNBM -FWF
BVNFOUP
DPO
.PEFSBEP
P
.BSDBEP
BVNFOUP
P

)BNCSF
P
NBSDBEP
BVNFOUP
BM
USFNPSFT
DPOUJOVPT

NBOJQVMBDJwO
UPDBSMP B|O
TJO
UPDBSMP

4F
DBMNB
DPO
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P
BM
QBSFDFS
DPOWVMTJPOFT
BDVOBSMP
*SSJUBCJMJEBE /PSNBM -FWF
BVNFOUP .PEFSBEB
B
TFWFSB
.BSDBEB
B|O
TJO

MMBOUP
FYDFTJWP
DVBOEP
TF
MF
UPDB
P
UPDBSMP
DPO
IBNCSF

3F¿FKPT /PSNBMFT "VNFOUBEPT .VZ
BVNFOUBEPT
%FQPTJDJPOFT /PSNBMFT &YQMPTJWBT
QFSP
&YQMPTJWBT
NgT
EF

GSFDVFODJB
OPSNBM ErB
5POP
.VTDVMBS /PSNBM "VNFOUBEP 3rHJEP
&SPTJPOFT
FO
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Z
DPEPT
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EF
MB

DPO
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'SFDVFODJB
  
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/P 4J
SFQFUJEPT
#PTUF[PT
/P 4J
SFQFUJEPT
7wNJUP /P 4J
'JFCSF /P 4J
Tomado de Lipsitz, PJ. Clin Pediatr. 1975;14:592-594.

*OUFSQSFUBDJwO

q
/FPOBUPT
DPO

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NFEJEPT
DBEB

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TFS

USBUBEPT

q
-B
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4"/
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3/
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Síntomas de deprivación de opiáceos.

4/$
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MMBOUP
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BM
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¿PKB
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430 GUÍAS NACIONALES DE NEONATOLOGÍA

Intervenciones:

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q
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q
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EF
FNCBSB[BEB
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EF
ESPHBT

…
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BEJDUB
B
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MB
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EF
PQJg
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FT
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GFUP
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MB
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EF
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…
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VTP
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ESPHB
…
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EF
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EF
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FM
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EF
ESPHBT
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…
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BEPMFTDFOUF


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q
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3/
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TV
NBESF
VTBS
UnDOJDBT
EF
SFMBKBDJwO
FOWPMWFS

FO
NBOUJMMB
NBTBKF
CBvP

Manejo de deprivación según puntaje NAS:

q
4r
QVOUBKF
FT

WFDFT
NBZPS
EF

w
JHVBM
P
NBZPS
EF

QPS

WFDFT
IPTQJUBMJ[BS
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DPO
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EF

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q
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Régimen de Morfina
1VOUBKF
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P
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NH
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DBEB

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&M
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VTVBM
EF
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DPO
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FT
EF

NFTFT

Manejo del RN con deprivación y vómitos:

q
"TFHVSBS
RVF
OJvP
OP
FTUn
TPCSFBMJNFOUBEP
VTBS
UnDOJDB
EF
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BEF
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q
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Tr
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Tr

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EF

NJOVUPT
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BMFKBEP
EF
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431
Deprivación por depresores no opiáceos del SNC
q
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Régimen de Fenobarbital
'/#

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FW
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FO

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EF

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EPTJT
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'/# '/#

NHLHErB
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'/#

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q
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q
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NBESF
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DPO
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ALTA:

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BTJTUFOUF
TPDJBM
Z
QTJRVJBUSB
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432 GUÍAS NACIONALES DE NEONATOLOGÍA

 ./2-!$%3%$!#)œ.
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ANALGESIA:
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q
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q
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q
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433
 …
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EN PERINATOLOGÍA.

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466 GUÍAS NACIONALES DE NEONATOLOGÍA


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