HSP-GU-260-004 Meningitis Neonatal y Tecnica de Puncion Lumbar

download HSP-GU-260-004 Meningitis Neonatal y Tecnica de Puncion Lumbar

of 13

Transcript of HSP-GU-260-004 Meningitis Neonatal y Tecnica de Puncion Lumbar

  • 8/2/2019 HSP-GU-260-004 Meningitis Neonatal y Tecnica de Puncion Lumbar

    1/13

    Wd|xfek: >0DKFKIFPFX KDEKAPAC V

    PDHKFHA @D ^TKHFEK CTOLA\Bex~fpac

    Xfoek Lecfwa|

    BEX^FPACFZAHFEKTKcEA@ @D \DHFDK KAHF@EX

    PALCA @D HEKPDKF@E

    1+ JTXPFGFHAHFEK

  • 8/2/2019 HSP-GU-260-004 Meningitis Neonatal y Tecnica de Puncion Lumbar

    2/13

    ODKFKIFPFX KDEKAPAC VPDHKFHA @D ^TKHFEK CTOLA\

    H7`fie: BX^/IT//>>0

    F

    BEX^FPACFZAHFEK Wd|xf7k: $# ca htac ke ba`fxofktf`e dk ge|oa xfikfgfhapfwa dk cex tcpf|kex 1> a|fdx+

    Odkfkifpfx lahpd|faka ait`a: dx ca fkgcaoahf7k `d cax odol|akax qt{ |e`dakdc hd|dl|a v od`tca dx~fkac# fkhctvdk`e ca `t|aoa`|d# a|ahkef`dx v ~faoa |d#xdhtk`a|fa ca ~|dxdkhfa `d lahpd|fax dk dc cfqtf e hdgace||aqtf`de+ Xd ~td`da`qtf|f| fk tpd|e# dk heotkf`a` > fkp|a bex~fpaca|fa+

    Odkfkifpfx ~a|hfacodkpd p|apa`a: xex~dhba `d odkfkifpfx lahpd|faka hekhtcpfwex dxpd|fcdx# ~|dxtoflcdodkpd heoe |dxtcpa`e `dc p|apaofdkpe hekakpflf7pfhex akpdx `d elpdkd| ca otdxp|a `d Fgqtf`e hdgace||aqtf`de+ "dxpafkhctvd cex akpflf7pfhex xtofkfxp|a`ex a ca oa`|d ~e| xex~dhba `d fkgdhhf7k >

    he|feaokfekfpfx&+ Odkfkifpfx axd~pfha: Hta`|e hpfkfhe `d odkfkifpfx dk atxdkhfa `d dwf`dkhfa `d

    tk ~ap7idke ofh|alfake `dpdhpalcd dk dccfqtf`e hdgace||aqtf`de ~e| od`fe `dcax pdhkfhax `d cale|ape|fe+

    Hekpahpe fkp|a `eofhfcfa|fe Dx tk fk`fwf`te qtd |dxf`d hek dc haxe fk`fhd > tkke hekwfwfdkpd qtd dxptwe htap|e > oax be|ax dk hekpahpe hek dc haxe fk`fhdac odkex `t|akpd hfkhe `d cex xfdpd `fax qtd ~|dhd`fd|ek ac oeodkpa `d cabex~fpacfzahf7k+

    ^atfka < `d 18

    8+ ELJDPFWE V ^ELCAHFEK ELJDPE

    Ca fkgdhhf7k `dc xfxpdoa kd|wfexe hdkp|ac dx tka `d cax ~apeceifax ~epdkhfacodkpdhapaxp|7gfhax# qtd |dqtfd|dk xex~dhba hcfkfha v `dpdhhf7k v p|apaofdkpe pdo~|akex~a|a `fxofktf| > dwfpa| cax i|awdx xdhtdcax kdt|ac7ifhax qtd ~td`d idkd|a|+

    D~f`dofeceifa Ca fkhf`dkhfa dk dc ~d|fe`e kdekapac dx `d a 1>> haxex ~e|1>>+>>> kahf`ex wfwex# v dk oave|dx `d tk odx dx `d 4 ~e| 1>>+>>>balfpakpdx#`d~dk`fdk`e `dc a|da qdeq|agfha+

  • 8/2/2019 HSP-GU-260-004 Meningitis Neonatal y Tecnica de Puncion Lumbar

    3/13

    ACHACF&}A OAVE\edLEIEPAE++h++

    +3X;)F+T+++@

    {+Y={%!p&a *==,#}f ,f{=gv,

    FH7`fie: BX^/IT//>>0DKFKIFPFX KDEKAPAC V

    PDHKFHA @D ^TKHFEK CTOLA\Bex~fpac

    Xfoek Lecfwa| FFWd|xf7k: $ xditf`ax ~e|: f||fpalfcf`a` v a~kdaxdk e|`dk `dh|dhfdkpd+ Odkex g|dhtdkpd dx dc aleolaofdkpe `d ca gekpakdca v dccFakpe `d pekd ait`e# xfdk`e |a|a ca |fif`dz `d ktha+ Odkex g|dhtdkpdodkpd gfdl|d#`dxe|`dkdx |dx~f|ape|fex# dodxfx# heo~|eofxe bdoe`fka|kfhe+ Acitkex kdekapex~|dxdkpak xfikex heoe ca oaca ~d|gtxfek `fxpac# hfakexfx# fhpd|fhfa# bd~apeodiacfa#

    ^aecka 0 `d 18

  • 8/2/2019 HSP-GU-260-004 Meningitis Neonatal y Tecnica de Puncion Lumbar

    5/13

    ODKFKIFPFX KDEKAPAC VPDHKFHA @D ^TKHFEK CTOLA\

    Wd|xf7k: >0

    Bex~fpa!Xfoek Lecfwa|

    BEX^FPACFZAHFEKTKF@A@ @D \DHFDK KAHF@EX

    dx~cdkeodiacfa# ~dpdqtfax# qtdjf`e# `fa||da# bf~epekga v xfk` |eod `d `fgfhtcpa`|dx~f|ape|fa+

    @FAIKEXPFHE @FGD\DKHFAC: Xcgfcfx hekqdkfpa# Pere~caxoexfx# xd~xfx ~e|Hak`f`a aclfhakx# ckgdhhfek ~e| Bd|~dx xfo~cdr v ep|ax odkfkiedkhdgacfpfx wf|acdxheoe |tldeca# dc hfpeodiacewf|tx# dc herxahmfd v cex dhewf|tx

    PdHKFHA @D CA ^TKHFEK CTOLA\:AKPDX @D BAHD\ CA ^TKHFEK XD @DLD PDKD\ TKA HFG\A @DICTHEODP\FA ^A\A BAHD\ CA A@DHTA@A FKPD\^\DPAHFEK @D CA

    ICTHEXA DK CH\+ Axd~xfa v akpfxd~xfa dxp|fhpa+ Xd ~td`d |dacfza| fkgfcp|ahf7k cehac `d ca ~fdc v pdjf`e xtlhtpakde hek cf`ehafka

    ac 1$= xfk d~fkdg|fka+ "\dhe|kdk`ahfek I|a`e A&+ Ca aitja f`dac ~a|a tka ~tkhfek ctola| dk cex kfkdx `dld xd| he|pa# `d

    `fa|kdp|e ~dqtd|fe " `dx~tdx `dc~|ehd`fofdkpe htak`e dc htdcce dxpa gcdrfeka`e# ~e| 1> qtd xd |dheofdk`abahd| ca ~tkhfek hek dc htdcce drpdk`f`e > hek dc kfke xdkpa`e= a`doax# ca~exfhfek xdkpa`a ~d|ofpd qtd dc xahe `d ca `t|a xd a|k~cfd ~e| dgdhpebf`|expapfhe `dc CH\ hek 1> qtd xd `fxofktvd ca ~|elalfcf`a` `d tka ~tkhfekp|atoapfha= dc tkfhe fkhekwdkfdkpd `d ca ~exfhfek xdkpa`a dx qtd ke ~d|ofpd caod`fhfek `d ca ~|dxfek `d a~d|pt|a+

    Dk cex ldldx hek heo~|eofxe bdoe`fka|kfhe > |dx~f|ape|fe# xd `dld|dacfza| pe`e dc ~|ehd`fofdkpe laje tka dxp|fhpa oekfpe|fzahf7k+ Cexdx~ahfex oax tpfcfza ex ~a|a |dacfza| ca ~tkhf7k ctola| xek C 8/0 v C 0/4= xd ~td`d |d~dpf| dc fkpdkpe tk dx~ahfe fkpd|wd|pdl|ac oax a||fla dkhaxe `d ~tkhf7k p|atoapfha+

    Dk ktdxp|e bex~fpac xd |dqtfd|d a~|erfoa`aodkpd 1 a 1/4 ho `d ccqtf`e ~a|a xtakacfxfx pepac+ "8>iepax `d tka aitja Ke+

  • 8/2/2019 HSP-GU-260-004 Meningitis Neonatal y Tecnica de Puncion Lumbar

    6/13

    ODKFKIFPFX KDEKAPAC V H7`fie: BX^/IT/PDHKFHA @D ^TKHFEK CTOLA\ 1/>>0

    Ac/HAF++f:c0A OAWE\@D LEIEPA e+h+ex~fpac

    Xfoek Lecfwa|

    BEX^FPACFZAHFEKTKcEA@ @D \DHFDK KAHF@EX

    Wd|xf7k: bdoe`fkaofhe+ Dk dxpax xfptahfekdx xd

    ~td`d fkpdkpa| dxpalfcfza| ac ~ahfdkpd v ctdie |dacfza| ca ~tkhfek= pa|klfdk xd~td`d |dacfza| hek dc ~ahfdkpd fkptla`e v laje oekfpe|de bdoe`fka|kfhe

    |fdxie fkofkdkpd`d bd|kfahfek hd|dl|ac: akfxehe|fa > of`|faxfx ke |dahpfwa# `dpd|fe|e |a~f`e `dcdxpa`e `d hekhfdkhfa# ~a~fcd`doa# p|ga`a `d Htxbfki "l|a`fha|`fa#bf~d|pdkxfek# |dx~f|ahfek f||ditca| ~expt|a `d `dxhd|dl|ahfek >`dhe|pfhahfek+ " ke g|dhtdkpd dk kdekapex&

    8+ ckgdhhfek `d ca zeka ~e| ca htac `dld ~axa| ca aitja ~a|a ca elpdkhfek `dcCH\# bfxpe|fa > xfikex `d tk xfk`|eod bd|ke||aqfhe: Dk cex ~ahfdkpdxbdoegfcfhex dc |fdxie dx |dcapfwe v 4d ~td`d he||dif| hek ca a`|kfkfxp|ahfek `dcgahpe| he||dx~ek`fdkpd+ Dk haxex `d p|eolehfpe~dkfa# xd `dldk xe~dxa| cex|fdxiex va qtd dk ehaxfekdx ca odkfkifpfx ~td`d ht|xa| hek ~dpdqtfax= xf cax~caqtdpax dxpak odke|dx `d 4>>>> > xf bav xaki|a`e ahpfwe xd `dld bahd|p|akxgtxfek hek ~caqtdpax+

    Heo~cfhahfekdx :

    DF |fdxie `d heo~cfhahfekdx oave|dx ~e| tka ~tkhfek ctola| ba xf`e dxpfoa`edkp|d >#16$ a >#08$ hek tka fkhf`dkhfa `d heo~cfhahfekdx odke|dx qtd wa `d>#

  • 8/2/2019 HSP-GU-260-004 Meningitis Neonatal y Tecnica de Puncion Lumbar

    7/13

    ACHACF:ccAOAWE\@DLEIEPA@{

    *{:+UT!&

    +,?,))):3)1{=)3k7, p,#egc"K

    ODKFKIFPFX KDEKAPAC V H7`fie: BX^/IT/PDHKFHA @D ^TKHFEK CTOLA\ 1/>>0

    Bex~fpacXfoek Lecfwa|

    BEX^FPACFZAHFEKTKcEA@ @D \DHFDK KAHF@EX

    FWd|xf7k: qtd xd hekhdkp|ak cex dcdodkpex hdctca|dx ~a|a|dacfza| dc |dhtdkpe `fgd|dkhfac ~e| pfkhf7k `d Y|fibp `d ~e| 1> odkex oo BIcthexa ; 1%8 `d ca laxac^|epdf kax: `d 10< baxpa 19> " dk ~|doapt|ex xd ~td`dk ahd~pa| wace|ax baxpa &IF7ltfex lcakhex `d > baxpa 8$Oekekthcda|dx 8>/9/1>>>%oc

    FKPD\^\DPAHFEK @DC CH\ DK HAXE @D ^TKHFEK CTOLA\ P\ATOAPFHA

    Xd `dgfkd heoe ~tkhf7k ctola| p|atoapfha dc CH\ hek d|fp|ehfpex ; a 1>>>%oc Xdelxd|wa pt|lfe htak`e bav dkp|d 4>> v 1+>>> d|fp|ehfpex%oc v g|akhaodkpd bdoapfhehtak`e bav dkp|d 4+>>> v 1>+>>>= dxpa xfptahf7k xd ~|dxdkpa baxpa dk tk $+Drfxpdk hachtcex qtd ~td`dk avt`a| a dxpalcdhd| xf dc CH\ pdkfa ~cdehfpexfx akpdx`d ca~tkhf7k:

    1+ ^|fod|e xd `fwf`dk cex cdthehfpex%d|fp|ehfpex dk CH\ v cex cdthehfpex%d|fp|ehfpex dk xaki|d ~d|fgd|fha v ctdie xd |dacfza ca `fwfxf7k dkp|d dc |dxtcpa`e`dc CH\ v dc |dxtcpa`e `d ca xaki|d ~d|fgd|fha+ Xf dc |dxtcpa`e dx ; 1idkd|acodkpd ca ~cdehfpexfx `dc CH\ ~|dhd`f7 a ca ~tkhf7k ctola| p|at|kapfha+Htak`e ca ~tkhf7k ctola| dx p|at|kapfha ke xd elxd|wa rakpeh|eoca v a qtdcex d|fp|ehfpex xd `doe|ak oax `d 0 be|ax ~a|a ffxa|xd

    >> d|fp|ehfpex%oo8 ~|dxdkpdx dk dcCH\+

    8+ Ep|ex atpe|dx odkhfekak qtd ~e| ha`a 1>>> d|fp|ehfpex%oo 8 xd elxd|wak 1 a>0 F

    {//////FBEX^FPACFZAHFEK FWd|xf7k: < F

    TKcEA@ @D \DHFDK KAHF@EX F

    ACHAC@fA OAVE \@pDLEIEPA@H+

    cdthehfpex%oo 8+Kfkitka `d dxpax ge|otcax dx 1>xtgfhfdkpdodkpd xdkxflcd v dx~dhfgfha v ke `dldxd| dc tkfhe dcdodkpe `d pdkd| dk htdkpa ~a|a dc `faqkexpfhe `d odkfkifpfxlahpd|faka ait`a dk haxe `d ~tkhf7k p|atoapfha: dk dxpa hf|htkxpakhfa dc I|ao~td`d xd| `d othba tpfcf`a`# axc heoe ca ~|tdla `d aqctpfkahfek `d ~a|pfhtcax `dcapdr+ "\dheodk`ahcek I|a`e H&+

    FKPD\^\DPAHFEK @DC CfQTF@E HDGACE\\AQTfEDE DK ^AHFDKPDX QTDBAK \DHFLF@E AKPFLFEPFHEX : Atkqtd ke dx g|dhtdkpd dk |dhfdk kahf`ex# dkp|dtk v tk 44$ `d cex kfkdx hek odkfkifpfx lahpd|faka bak |dhflf`e akpflfepfhex"idkd|acodkpd e|acdx& akpdx `d ca |dacfzahf7k `d ca ~tkhfek ctola|+ DF ~|fkhf~ac~|elcdoa xd `a dk ca fkpd|~|dpahfek `d !ex htcpfwex# va qtd ~td`d eht||f|kdqapfwfzahfek dx~dhfacodkpd dk haxex `d odkfkiehehe# hek odkex g|dhtdkhfa hekbdoegfctx v kdtoehehe= xfk dola|ie# htak`e cex akpflfepfhex bak xf`ea`ofkfxp|a`ex ~e| wfa e|ac# cax acpd|ahfekdx `dc CH\ ~d|xfxpdk+ Dk dxpax xfptahfekdx~td`d xd| `d tpfcf`a` dc txe `d acitka `d cax ~|tdlax |a~f`ax ~a|a f`dkpfgfhahfek~|dxtkpfwapc+apdr&+ "\dheodk`ahf7k I|a`e A&+

    Haxex `t`exex: baxpa tk 8$ `d cex kfkdx hek odkfkifpfx lahpd|faka ait`a ~td`dkpdkd| tk CH\ `d ha|ahpd|fxpfhax ke|oacdx dx~dhfac|kdkpd dk acitkex haxex `dodkfkifpfx ~e| odkfkiehehe `d dwecthf7k otv ait`a= dk dxpa xfptahfek# cadwactahf7k hcpkfha dx `d wfpac fo~e|pakhfa= ax! ofxoe dk haxex `t`exex# xd|dheofdk`a |d~dpf| ca~tkhf7k ctola| dk 7 a 2 be|ax# pfdo~e hachtca`e `d ~excpfwfzahfek `d cex baccaziex`dc CH\+ @t|akpd dc p|apaofdkpe# drfxpdk acitkax hf|htkxpakhfax qtd aod|fpak ca|d~dpfhfek `d dxpd ~|ehd fofdkpe+^a|a |d~dpf| ca ~tkhfek ctola| "02 b& ~apec7ifha:

    1+ Odkfkifpfx hatxa`a ~e| X+ ~kdtoekfad |dxfxpdkpd

  • 8/2/2019 HSP-GU-260-004 Meningitis Neonatal y Tecnica de Puncion Lumbar

    9/13

    Wd|xf7k: >0

    ACHAC+J:ccA OA+VE\@DLEIEPAe++h+ex~fpac

    Xfoek Lecfwa|

    BEX^FPACFZAHFEKTKcEA@ @D \DHFDK KAHF@EX

    ~exfpfwdx+ Ca oave| tpfcf`a` `d dxpax ~|tdlax dx dk haxex `d odkfkifpfx

    ~a|hfacodkpd p|apa`ax# ~tkhfekdx ctola|dx p|at|kapfhax v kdekapex hek|fdxie `d xd~xfx+ Xfk dola|ie# tk |dxtcpa`e kdiapfwe ke `dxha|pa tkaodkfkifpfx lahpd|faka ait`a v |a|aodkpd xd ~td`dk `a| gacxex ~exfpfwdx: ~e|1> pakpe# ca `dhfxfek xel|d p|apaofdkpe akpflfepfhe ke xd `dld laxa|tkfha|kdkpd dk dxpax ~|tdlax+ "\dheodk`ahfek I|a`e H&+

    |dxekakhfa oaqkdpfha a pe`e ~ahfdkpdhek xex~dhba `d odkfkifpfx= tkfhaodkpd dxpak fk`fha`ex htak`e drfxpakbaccaziex hcfkfhex `d bf~d|pdkxfek fkp|ah|akdaka# ~exflfcf`a` `faqkexpfha `dep|a ~apeceifa fkp|ah|akdaka `fgd|dkpd a odkfkifpfx lahpd|faka ait`a#xex~dhba `d odkfkifpfx PLH+ Dk haxe `d e|`dka|xd dxpd pf~e `d dra|kdkdx#xd `dldk peoa| bdoehtcpfwex d fkfhfa| akpflfepfhex akpdx `dc ~|ehd`fofdkpe"\dheodk`ahfek i|a`e A& +Drfxpdk hf|htkxpakhfax qtd aod|fpak dc txe `d peoei|agga heo~tpa|fza`a >|dxekakhfa oaqkdpfha `t|akpd ca gaxd `d p|apaofdkpe: 1+ Pe`e kdekapd hekfkgdhhfek ~e| Hfp|elahpd| `fwd|xtx# ^|epdtx v Xacoekdcca+ |dhag`ax 2+ Dhei|agfa p|akxgekpakdca| `t`exa > xex~dhbexa

    ^TKHFEK CTOLA\ DK XD^XFX KDEKAPAC PDO^\AKA:Dk ca ahptacf`a` bav `fxhtxfek xel|d htacdx kdekapex xek hak`f`apex ~a|a ca|dacfzahfek `d tka ~tkhfek ctola|= laxa`ex dk cex kfwdcdx `d dwf`dkhfa ~e`doexdxpalcdhd|:1+ Kdekape hek xex~dhba `d xd~xfx: Xd `dld |dacfza| ca ~tkhfek ctola| heoe ~a|pd`dc dxpt`fe ~a|a xd~xfx ]\dhe|kdk`ahfek I|a`e A&+aod|fpak `dlf eac ofkfoa |fdxie `d odkfkifpfx qtd xd elxd|wa dk dxpex ~ahfdkpdx "\dheodk`ahfekI|a`e A&+8+ ^|doapt|e hek xex~dhba `d xd~xfx: \dacfza| ~tkhfek ctola| heoe ~a|pd `dcdxpt`fe ~a|a xd~xfx "\dhe|kdk`ahfek I|a`e A&

    ^aQfka 6 `d 18

  • 8/2/2019 HSP-GU-260-004 Meningitis Neonatal y Tecnica de Puncion Lumbar

    10/13

    ODKFKIFPfX KDEKA+PAC VPDHKFHA @D ^TKHFEK CTOLA\

    + -/ F ACHAC@fAOAVQ\//1 >pD LEIe,pA e#h+

    F

    He`fqe: BX^/IT//>>0

    F Xf:)={j):={C:fwa|f / / / / /:1 ! BEX^FPATZAHFEKFcUU F TKF@A@ @D \DHfDK KAHF@EXl+ ??????????????{?????????????? #{????????????{?????

    F

    ! Wd|xfek: a )8 odxdx: Dk pe`e kfke odke| `d 8odxdx hek gfdl|d xfk gehe xd `dld |dacfza| ~tkhfek ctola| heoe ~a|pd `dc dxpt`fe~a|a xd~xfx "\dheodk`ahf7k I|a e A&+4+ Haxex `d hdct|fpfx gahfac > ~d|f e|lfpa|fa htak`e ke bav tk gehe ~|elalcd `ddkp|a`a ~a|a ca fkgdhhfek+ "\dheodk`ahf k I|a e L&+

    7+ P\APAOFDKPE

    / @dld fkq|dxa| a htf`a`e fkpdkxfwd ~e| 1> odkex

  • 8/2/2019 HSP-GU-260-004 Meningitis Neonatal y Tecnica de Puncion Lumbar

    11/13

    FH7`fie: BX^/IT//>>0DKFKIFPFX KDEKAPAC V

    PDHKFHA @D ^TKHFEK CTOLA\Ap++HAp++>0A O,VE\@D LEIEPA e+h+ex~fpa!

    Xfoek Lecfwa|

    BEX^FPACFZAHFEKTKF@A@ @D \DHFDK KAHF@EX

    Wd|xf7k: a 10 `fax `d p|apaofdkpe xek a`dhta`ex ~a|ahaxex `d Dxp|d~pehehe `dc i|t~e L v C+ oekehvpeidkdx+ ^a|a ca odkfkifpfx hatxa`a~e| lahfcex dkpd|fhex xd |dheofdk`a tk ogkfoe `d 8 xdoakax > < xdoakax `dx~tdx`d ca dxpd|fcfzahf7k `dc CH\# dc pfdo~e qtd |dxtcpd xd| oax ca|ie+/Cex ~|doapt|ex v |dhfdk kahf`ex dk THF pfdkdk |fdxie `d `dxa||ecca| fkgdhhfekdx ~e|~ap7idkex kexeheofacdx+ Ca heolfkahf7k `d erahfcfka oax aofkeicfh7xf`e >hdgacex~e|fka `d pd|hd|a idkd|ahf7k eg|dhdk ao~cfe dx~dhp|e ~a|a htl|f| DxpagfceheheAt|dtx > lahfcex I|aokdiapfwex |dxfxpdkpdx+ Xf xd xex~dhba fkgdhhf7k ~e|Dxpagfcehehe At|dtx |dxfxpdkpd a erahfcfka > Dxpagfcehehe heaitcaxa kdqapfwe# xd

    `dld tpfcfza| wakheofhfka baxpa pdkd| |dxtcpa`ex `d akpflfei|aoa+ oax hdgacex~e|fka`d pd|hd|a idkd|ahf7k "\dheodk`ahf7k I|a`e A&

    DXPD\EF@DX: xt txe dx hekp|ewd|pf`e dk ca odkfkifpfx kdekapac+ Ke bav dxpt`fexqtd a~evdk xt txe# ~tdx dc kt|kd|e `d ~ahfdkpdx dx cfofpa`e ~a|a cFdwa| a halep|alajex hcfkfhex hekp|eca`ex+ Xfk dola|ie# cex dwdkpex gfxfe~apec7ifhex `t|akpd cafkgdhhf7k `dldk xd| heo~a|alcdx a cex `d cex kfkdx oave|dx v ~e| 1 >pakpe xd ~e`|gapde|fza| fitacodkpd dk tk dgdhpe ldkdgfhd dk dxpd i|t~e `d d`a` ~d|e ke xd ~td`dkbahd| oave|dx |dheodk`ahfekdx ac ~|dxdkpd+ Ha`a ~ahfdkpd `dld xd|htf`a`exaodkpd dxpt`fa`e ~e| dc i|t~e ~a|a peoa| ca `dhfxf7k+

    XDHTDCAX: Cax oax g|dhtdkpdodkpd dkhekp|a`ax xek xe|`d|a kdt|e xdkxe|fac"Fa oaxg|dhtdkpdaparfa# ~|ehdxex fxqtdofhex# bf`|ehdgacfa# `dxe|`dkdx `dcheo~e|paofdkpe v heo~|eofxe fkpdcdhptac+ Ca oe|pacf`a` v ca fkhf`dkhfa `d xdhtdcaxdx oave| dk ca odkfkifpfx ~e| kdtoehehe v ~e| i|ao kdiapfwex dk kdekapex+ DFkdtoehehe hatxa xe|`d|a dk tk 8>$ `d cex ~ahfdkpdx# heo~a|a`e hek 4/1>$ dk~ahfdkpdx hek odkfkifpfx ~e| B+ fkgctdkzad > odkfkiehehe+ Dx oax g|dhtdkpd caxe|`d|a dk ~ahfdkpdx htva icthe||aqtfa dx `d 3 oi%`c+

    HEO^CFHAHFEKDX AIT@AX:Hekwtcxfekdx pdo~|akax akpdx `d 9

  • 8/2/2019 HSP-GU-260-004 Meningitis Neonatal y Tecnica de Puncion Lumbar

    12/13

    ODKFKIFPFX KDEKAPAC V H7`fie: BX^/IT/PDHKFHA @D ^TKHFEK CTOLA\ 1/>>0

    Xfoek Lecfwa|

    BEX^FPACFZAHFEK FWd|xf7k: hek xex~dhba `d

    fkgdhhf7k pa|`fa

    CH\ Ke|oac

    1Hekpfkta oakdje od fheWfifcakhfa hcgkfha ]LAHPD\FAKA 1

    P|apaofdkpe akpflf7pfhea `exfx odkfkidaxPfdo~e xditk id|odk

    Hekp|ec CH\ a cax 9< be|ax +UUUF

    KeOdjd|fa Odje|fa

    a

    FKDX^DhFGFHA

    Hekp|ec CH\ 1

  • 8/2/2019 HSP-GU-260-004 Meningitis Neonatal y Tecnica de Puncion Lumbar

    13/13

    AD+HA!++@cA O{VE\EDLEIEPA e+h+

    {{U{fp):c##{+#+#"#fp:++J !,##{1f/cc {+;fw ;)

    H7`fie: BX^/IT//>>0DKFKIFPFX KDEKAPAC V

    PDHKFHA @D ^TKHFEK CTOLA\Bex~fpac

    Xfoek Lecfwa| F

    BEX^FPACFZAHFEK FWd|xfek: