MANEJO CLÍNICO DE LA SEPSIS NEONATAL Y RESULTADOS ASOCIADOS EN UNIDADES DE CUIDADOS INTENSIVOS
DOI:
https://doi.org/10.56519/3ce6k867Palabras clave:
sepsis neonatal, cuidados intensivos neonatales, terapia antimicrobiana, manejo clínico, mortalidad neonatal, resistencia a los antimicrobianos, neonatal sepsis, neonatal intensive care, antimicrobial therapy, clinical management, neonatal mortality, antimicrobial resistanceResumen
La sepsis neonatal sigue siendo una de las principales causas de morbimortalidad en los recién nacidos a nivel mundial, sobre todo en los países en vías de desarrollo, donde las carencias en el diagnóstico precoz y en la aplicación de protocolos terapéuticos constituyen un reto en los resultados clínicos. La cuestión de investigación está relacionada con la variabilidad del manejo clínico de la sepsis neonatal y en conocer cuáles son las intervenciones que se han asociado a la evolución del paciente ingresado en unidades de cuidados intensivos neonatales. La finalidad del presente trabajo fue analizar el manejo clínico en la sepsis neonatal y sus resultados en unidades de cuidados intensivos neonatales, identificando las intervenciones terapéuticas en mayor uso y su efecto en el curso clínico. Se realizó una investigación de enfoque cuantitativo, tipo documental, mediante una revisión sistemática de la literatura científica siguiendo las directrices PRISMA 2020. La búsqueda de la bibliografía se realizó en las bases de datos PubMed, Scopus, Web of Science, SciELO y Google Scholar, y se seleccionaron un total de 30 artículos científicos publicados desde 2020 hasta 2025 y que cumplían los criterios de inclusión. Los resultados mostraron que la antibioticoterapia precoz fue la intervención más comúnmente documentada (100%), seguido del continuo monitoreo de signos vitales (93,3%), el soporte respiratorio (83,3%) y el soporte hemodinámico (76,7%). También se observó una mejor supervivencia global (90%), disminución de la mortalidad (86,7%), y el menor número de complicaciones clínicas (80%) y estancia hospitalaria (73,3%) cuando se aplican los protocolos clínicos estandarizados. Se llega a la conclusión de que la terapia antibiótica precoz, el monitoreo continuo y el soporte integral siguiendo un protocolo estandarizado se asocian significativamente con los mejores resultados clínicos y disminuyen la mortalidad asociada a la sepsis neonatal; no obstante, la resistencia antimicrobiana es un gran reto en la atención neonatal.
ABSTRACT:
Neonatal sepsis remains one of the leading causes of morbidity and mortality in newborns worldwide, particularly in developing countries, where shortcomings in early diagnosis and the implementation of treatment protocols pose a challenge to clinical outcomes. The research question relates to the variability in the clinical management of neonatal sepsis and to identifying which interventions have been associated with the clinical course of patients admitted to neonatal intensive care units. The purpose of this study was to analyze the clinical management of neonatal sepsis and its outcomes in neonatal intensive care units, identifying the most commonly used therapeutic interventions and their effect on the clinical course. A quantitative, documentary-style study was conducted through a systematic review of the scientific literature following the PRISMA 2020 guidelines. The literature search was conducted in the PubMed, Scopus, Web of Science, SciELO, and Google Scholar databases, and a total of 30 scientific articles published between 2020 and 2025 that met the inclusion criteria were selected. The results showed that early antibiotic therapy was the most commonly documented intervention (100%), followed by continuous monitoring of vital signs (93.3%), respiratory support (83.3%), and hemodynamic support (76.7%). Improved overall survival (90%), reduced mortality (86.7%), and fewer clinical complications (80%) and shorter hospital stays (73.3%) were also observed when standardized clinical protocols were applied. It is concluded that early antibiotic therapy, continuous monitoring, and comprehensive support following a standardized protocol are significantly associated with better clinical outcomes and reduce mortality associated with neonatal sepsis; however, antimicrobial resistance remains a major challenge in neonatal care.
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