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Capítulo Dos

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Capítulo Tres

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Capítulo Cuatro

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Capítulo Cinco

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Capítulo Seis

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Capítulo Siete

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Capítulo Ocho

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Capítulo Nueve

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Capítulo Diez

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Capítulo Once

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Capítulo Doce

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Capítulo Trece

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Nombre Genérico	Dextrosa	Na	Cl	K	Ca	Lactato	Mg	Acetato	Kcal x litro
DEXTROSA
D-5% en agua	5%								200
D-10% en agua	10%								400
D-50% en agua	50%								2000
MIXTOS
D-5% ClNa 0.45% D-5% ClNa 0.33% D-5% ClNa 0.9%	5% 5% 5%	77 56.5 154	77 56.5 154						200 200 200
SALINOS
ClNa 0.9% en agua		154	154
ClNa 0.45% en agua		77	77
RINGER
Ringer Lactato*		130	11	5.4	2.7	27
Ringer Lactato en D-5%*	5%	130	11	5.4	2.7	27			200
Solución Electrólitica	XILITOL 2.5%	100	9	18	4		6	38	100

PUNTOS	TIPO DE QUEMADURA	TIPO DE SECUELA
0 a 40	Leve	Ligera secuela estética
41 a 70	Moderada	Secuela estética con leve alteración funcional
71 a 100	Grave	Alteraciones funcionales severas
101 a 150	Crítica	Pérdida de parte anatómica
> 151	Mortal

Edad/ años	Puntos
0 - 20	1
21-40	2
41 - 60	3
61 - 80	4
81 - 100	5

Lesión Inhalatoria	1 punto
Quemaduras de Espesor Total (3° grado)	1 punto

% SCQ	Puntos
1 - 10	1
11 - 20	2
21 - 30	3
31 - 40	4
41 - 50	5
51 - 60	6
61 - 70	7
71 - 80	8
81 - 90	9
91 - 100	10

Puntaje	Amenaza de Muerte	% de Sobrevivencia	% Riesgo de Mortalidad
2 -3	Baja	> 99%	< 1%
4 - 5	Mediana	98%	2%
6 - 7	Mediana Seria	80 - 90%	10 - 20%
8 - 9	Severa	50 - 70%	30 - 50%
10 - 11	Grave	20 - 40%	60 - 80%
12 - 13	Muy Grave	< 10	> 90%

Nutrientes	Requerimientos diarios para adultos sanos*	Efectos por deficiencia	Comentarios
Proteínas	0.8g x kg	trastorna todos los aspectos de la curación y defensas del huésped	1.5 a 2g x kg. Necesarios para la curación
Calorías	Reposo-1,500 Sedentario - 2,000 Muy activo- 3,500	Pérdida de masa muscular	Puede necesitar cinco veces esta cantidad para obtener balance nitrogenado positivo
Vitamina C	60mg	Inestabilidad del colágeno: Fuerza ténsil	No se almacena; puede ocurrir deficiencia rápidamente
Vitamina A	1,000mg	Epitelización, síntesis de colágeno, resistencia a la infección vía producción de macrófagos	Suplementación revierte los efectos de glucocorticoides
Vitamina B6	2mg	Síntesis Proteica	Colágeno/ fuerza tensil en animales de laboratorio
Vitamina B12	2mg	Síntesis Proteica	Colágeno/ fuerza ténsil en animales de laboratorio
Folato	200mg	Síntesis Proteica	Absorción en envejecientes
Zinc	15mg	Inmunidad, síntesis de colágeno	Curación luego de suplementación en deficiencia verdadera

Fase Inflamatoria	Clínicamente- se manifiesta por edema, eritema, calor y dolor Celular/Molecular- actividad (vía plaquetas y macrófagos) incluye vasoconstricción y vasodilatación, liberación de quimiotáxicos y factores que promueven el crecimiento y emigración de neutrófilos, seguidos por macrófagos Duración -3 días, típico
Fase Proliferativa	Clínicamente- manifiesta como tejido rojo de granulación, circunscrito por una fina capa epitelial que resulta en contractura de la herida Celular/Molecular-incluye actividad de macrófagos. síntesis de colágeno, angiogénesis, contractura y epitelización. Duración- Traspasa la fase inflamatoria y continua hasta la curación completa de la herida
Fase de Maduración	Clínicamente- se manifiesta como contractura de la cicatriz y palidez Celular/Molecuar- actividad de remodelación de colágeno y regresión de los capilares Duración- Inicia luego de producida la herida y puede continuar por varios años