ELEMENTOS DE PROTECCIÓN PERSONAL PARA REDUCIR EL RIESGO DE INFECCIÓN POR VIRUS SARS-COV-2 EN TRABAJADORES DE LA SALUD INVOLUCRADOS EN CIRUGÍA POR NEUROTRAUMA EN PAÍSES DE BAJOS Y MEDIANOS INGRESOS: REVISIÓN PANORÁMICA
DOI:
https://doi.org/10.51437/nj.v27i3.210Keywords:
COVID-19; neurocirugía; neurotrauma; EPP; prevención en cirugía.Abstract
ResumenIntroducción: En países de medianos y bajos ingresos es común encontrar instalaciones para el cuidado de la salud dotadas con recursos insuficientes. La pandemia de COVID-19 representa una amenaza que puede aumentar aún más la brecha entre los recursos necesarios y los disponibles en los servicios quirúrgicos, a menos que se tomen medidas para optimizar su utilización y proteger a los trabajadores de la salud.
Objetivo:Sintetizar la evidencia actual en relación al uso de los elementos de protección personal, como estrategia para reducir el riesgo de infección por SARS-CoV-2 en los trabajadores de la salud encargados de la atención a los pacientes sometidos a cirugía por neurotrauma.
Materiales y métodos: Realizamos una búsqueda en la plataforma LOVE (Living Overview of Evidence) de COVID-19, este sistema realiza búsquedas automatizadas en PubMed, Embase, el Registro Central de Ensayos Controlados Cochrane (CENTRAL) y más de treinta fuentes diferentes. Los resultados de la búsqueda se presentaron de acuerdo con el diagrama de flujo de elementos para revisiones sistemáticas (PRISMA). Se llevó a cabo una evaluación crítica de los estudios elegibles mediante AMSTAR 2 y AGREE II, e incluyeron revisiones sistemáticas de estudios experimentales y cuasiexperimentales, estudios individuales con dichos diseños, guías de manejo y recomendaciones, que evaluaran el efecto de diferentes EPP, sobre el riesgo de infección por Sars-Cov2 en trabajadores de la salud involucrados en cirugía por neurotrauma. Se extrajeron los datos más relevantes como base para la redacción de la revisión.
Resultados:Se obtuvieron 258 registros de los cuales 18 cumplieron los criterios de selección y fueron incluidos para su síntesis. No identificamos ningún ensayo clínico aleatorizado llevado a cabo durante la pandemia de COVID-19 o estudios adicionales.
Conclusiones: El uso de EPP es una medida eficaz para reducir el riesgo de contagio de COVID-19 en comparación con el no uso de tapabocas en trabajadores de la salud en ambientes hospitalarios. Las máscaras/respiradores N95 o equivalentes proveen una mayor protección, pues reducen a la mitad el riesgo de contagio de COVID-19 en ambientes de riesgo moderado y alto al compararse con la mascarilla quirúrgica. La protección ocular también ofrece protección adicional y está asociada a una menor incidencia de contagio. Estos efectos aplican para el cuidado de pacientes de neurotrauma. La descontaminación y el reúso de los EPP parecen ser medidas factibles que pueden ayudar a sobreponerse a su escasez.
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