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2019, Número 4

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Cardiovasc Metab Sci 2019; 30 (4)


Modulación de tono autonómico y trabajo en turno de noche: un estudio prospectivo en residentes médicos en Medellín, Colombia

López‑Patiño HG, Niño‑Pulido CD, Vásquez‑Trespalacios EM, Aristizábal‑Aristizábal JM, Duque‑Ramírez M

Idioma: Inglés [English version]
Referencias bibliográficas: 35
Paginas: 126-135
Archivo PDF: 247.96 Kb.


RESUMEN

Objetivo: Evaluar en residentes médicos que hacen turnos nocturnos la presencia de alteraciones en la variabilidad de la frecuencia cardiaca (HRV), repolarización y ritmo, a través de monitoreo Holter como medida no invasiva del tono autonómico en Medellín, Colombia. Material y métodos: Se realizó un estudio observacional, descriptivo, que evalúa y compara los parámetros del Holter antes, durante y después de la realización de los turnos nocturnos, en residentes de Medellín. Se dividieron las 48 horas en cuatro periodos: periodo 1 (noche anterior al turno o 24 horas antes del turno hasta 12 horas antes del turno); periodo 2 (día del turno o 12 horas antes del turno hasta iniciar el turno); periodo 3 (durante el turno o guardia o 12 horas del turno) y periodo 4 (12 horas post-turno). Se incluyeron 52 residentes con edad promedio de 28 años y 45 horas de registro. El 59.6% eran mujeres, 77% eran de universidad pública y se incluyeron áreas clínicas y quirúrgicas. La variabilidad de la frecuencia cardiaca se redujo significativamente (p ‹ 0.0001) en el periodo 2, con una reducción adicional (menos pronunciada) al iniciar el turno (periodo 3). Conclusiones: Los residentes que realizan turnos nocturnos presentan reducción de la variabilidad de la frecuencia cardiaca durante los periodos 2 y 3, siendo más evidente en el periodo 2 (fenómeno de anticipación), este cambio en la variabilidad se debe a disminución de la actividad parasimpática, pero oscila dentro del rango de la normalidad. Se requieren más estudios para definir el impacto de estos hallazgos a largo plazo.


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