{"id":1983,"date":"2026-04-16T10:03:52","date_gmt":"2026-04-16T13:03:52","guid":{"rendered":"https:\/\/hospitalsanroque.gob.ar\/?p=1983"},"modified":"2026-04-16T10:03:52","modified_gmt":"2026-04-16T13:03:52","slug":"guia-preoperatoria-para-pacientes-pediatricos-asa1-y-asa-2-del-hmisr","status":"publish","type":"post","link":"https:\/\/hospitalsanroque.gob.ar\/index.php\/2026\/04\/16\/guia-preoperatoria-para-pacientes-pediatricos-asa1-y-asa-2-del-hmisr\/","title":{"rendered":"Gu\u00eda Preoperatoria para Pacientes Pedi\u00e1tricos ASA1 y ASA 2 del HMISR"},"content":{"rendered":"\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><em>Esta gu\u00eda presenta&nbsp;<\/em><strong><em>3 dimensiones claves del proceso preoperatorio pedi\u00e1trico.&nbsp;<\/em><\/strong><\/p>\n\n\n\n<p><em>El objetivo es<\/em><strong><em>&nbsp;promover<\/em><\/strong>&nbsp;<em>un&nbsp;<\/em><strong><em>uso correcto de las herramientas diagn\u00f3sticas<\/em><\/strong><em>&nbsp;apuntadas a la&nbsp;<\/em><strong><em>seguridad de las intervenciones quir\u00fargicas y el \u00f3ptimo tr\u00e1nsito preoperatorio de nuestros pacientes<\/em><\/strong><em>.<\/em><\/p>\n\n\n\n<p><em>La eficiencia en el uso de los recursos&nbsp;<\/em><em>hospitalarios y de los pacientes y sus familias<\/em><em>&nbsp;hace a la<\/em><strong><em>&nbsp;calidad de los servicios de salud<\/em><\/strong><em>.&nbsp;<\/em><\/p>\n\n\n\n<p><em>Esta versi\u00f3n fue aprobada y emitida por la Direcci\u00f3n del Hospital durante el mes de mayo de 2025.<\/em><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/docs.google.com\/document\/d\/1NQWIQWqtQ05yuhX653Hw-eDf4J3Gj2M8\/edit#heading=h.skwijq8lxqwh\"><strong>Uso oportuno y eficiente de herramientas diagn\u00f3sticas:<\/strong><\/a><br><a href=\"https:\/\/docs.google.com\/document\/d\/1NQWIQWqtQ05yuhX653Hw-eDf4J3Gj2M8\/edit#heading=h.lalt1qriq1fn\">&#8211; Cardiovascular\u00a0<\/a><br><a href=\"https:\/\/docs.google.com\/document\/d\/1NQWIQWqtQ05yuhX653Hw-eDf4J3Gj2M8\/edit#heading=h.77ed1du0rwp7\">&#8211; Laboratorio<\/a><br>&#8211;\u00a0<a href=\"https:\/\/docs.google.com\/document\/d\/1NQWIQWqtQ05yuhX653Hw-eDf4J3Gj2M8\/edit#heading=h.53rdpe2bapm1\">Rx de T\u00f3rax\u00a0<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/docs.google.com\/document\/d\/1NQWIQWqtQ05yuhX653Hw-eDf4J3Gj2M8\/edit#heading=h.4n914j983eiq\"><strong>Ayuno Preoperatorio Pedi\u00e1trico<\/strong><\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/docs.google.com\/document\/d\/1NQWIQWqtQ05yuhX653Hw-eDf4J3Gj2M8\/edit#heading=h.2s7jfn2b9mrh\"><strong>Clasificaci\u00f3n de ASA<\/strong>\u00a0<\/a><\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Uso oportuno y eficiente de herramientas diagn\u00f3sticas:<\/strong><\/h3>\n\n\n\n<p>Electrocardiogramas, hemograma, coagulograma y Rx de t\u00f3rax no se deben solicitar como \u201cde rutina\u201d. S\u00f3lo proceden en los casos que se explican a continuaci\u00f3n:<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Cardiovascular<\/strong><\/h4>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Pacientes menores de 1 a\u00f1o = ECG<\/li>\n\n\n\n<li>Pacientes con hallazgos en el examen f\u00edsico y\/o soplos card\u00edacos = ECG evaluaci\u00f3n cardiovascular<\/li>\n\n\n\n<li>Pacientes mayores de 1 a\u00f1o, sin antecedentes cardiovasculares, examen f\u00edsico normal, sin soplos= No solicitar ECG.<\/li>\n<\/ol>\n\n\n\n<p><em>&nbsp;&nbsp;El ECG no tiene vencimiento: es v\u00e1lido para toda la vida si no hubo cambios en su condici\u00f3n cl\u00ednica desde su realizaci\u00f3n&nbsp; .<\/em><\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Laboratorio<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Hemograma<\/strong><\/li>\n<\/ul>\n\n\n\n<p><strong><em>S\u00f3lamente:<\/em><\/strong><\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Para cirug\u00eda potencialmente sangrante y\/o cirug\u00eda de alto riesgo.<\/li>\n\n\n\n<li>En ni\u00f1os con enfermedad cr\u00f3nica asociada con anemia\u00a0 (c\u00e1ncer, enfermedad inflamatoria intestinal)<\/li>\n\n\n\n<li>En ni\u00f1os que est\u00e9n tomando f\u00e1rmacos que puedan afectar la producci\u00f3n de hemat\u00edes (anticonvulsivantes, quimioter\u00e1picos, antiretrrovirales).<\/li>\n<\/ol>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Coagulograma<\/strong><\/li>\n<\/ul>\n\n\n\n<p>S\u00f3lamente en&nbsp;<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>pacientes con antecedentes de sangrado o anamnesis y ex\u00e1men f\u00edsico sugerente de problemas de coagulaci\u00f3n.<\/li>\n\n\n\n<li>Si durante la entrevista se pesquisan problemas de sangrado (debe interrogarse sobre este punto)<\/li>\n<\/ol>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Rx de T\u00f3rax<\/strong><\/h4>\n\n\n\n<p><strong>S\u00f3lo si<\/strong>&nbsp;modifica la conducta o t\u00e9cnica anest\u00e9sica&nbsp;<strong>ante casos de<\/strong>:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>sospecha de masa mediastinal,<\/li>\n\n\n\n<li>displasia broncopulmonar,<\/li>\n\n\n\n<li>asma severa,<\/li>\n\n\n\n<li>enfermedad neuromuscular y<\/li>\n\n\n\n<li>fibrosis\u00a0qu\u00edstica.<\/li>\n<\/ol>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Ayuno Preoperatorio Pedi\u00e1trico<\/strong><\/h3>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>&nbsp;<\/td><td>&nbsp;<\/td><td><em><strong>S\u00f3lamente:<\/strong><\/em><\/td><\/tr><tr><td rowspan=\"5\">hasta<\/td><td>1 hora antes<\/td><td><strong>L\u00edquidos:<\/strong><strong>? Permitidos:<\/strong>Agua, infusiones (mate, t\u00e9, caf\u00e9 sin leche) bebidas deportivas sin gas, bebidas saborizadas sin gas.<strong>?No permitidos:<\/strong>Jugos con pulpa, gaseosas y bebidas alcoh\u00f3licas)<\/td><\/tr><tr><td>3 horas antes<\/td><td>Leche materna<\/td><\/tr><tr><td>4 horas antes<\/td><td>Leche de f\u00f3rmula y de vaca<\/td><\/tr><tr><td>6 horas antes<\/td><td>Comidas livianas<\/td><\/tr><tr><td>8 horas antes<\/td><td>Comidas ricas en grasas<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>Adem\u00e1s, la siguiente infograf\u00eda estar\u00e1 disponible (en formato papel) en los servicios quir\u00fargicos y las salas de cuidados intermedios para mejor orientaci\u00f3n de los acompa\u00f1antes y cuidadores de los pacientes:<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/historico.hospitalsanroque.gob.ar\/descarga\/imagenes\/articulos\/424\/1641.png\" alt=\"\"\/><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Clasificaci\u00f3n de ASA<\/strong><\/h3>\n\n\n\n<p><strong><em>Gu\u00eda dise\u00f1ada para pacientes ASA I y II, con cuadro de referencia.<\/em><\/strong><\/p>\n\n\n\n<p><strong>IMPORTANTE:<\/strong>&nbsp;Las condiciones mencionadas en el apartado anterior son claves por encima del tipo de ASA.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>ASA<\/strong><\/td><td><strong>Definici\u00f3n<\/strong><\/td><td><strong>Ejemplos<\/strong><\/td><\/tr><tr><td><strong>I<\/strong><\/td><td>Paciente sano, sin patolog\u00edas<\/td><td>Saludable (sin patolog\u00eda aguda o cr\u00f3nica). IMC en percentilo normal para la edad<\/td><\/tr><tr><td><strong>II<\/strong><\/td><td>Paciente con enfermedad sist\u00e9mica leve<\/td><td>Cardiopat\u00eda cong\u00e9nita asintom\u00e1ticaArritmias bien controladasAsma sin exacerbaci\u00f3nEpilepsia bien controladaDiabetes mellitus no insulino-dependiente&nbsp;IMC anormal para la edadSAOS leve\/moderadaPaciente oncol\u00f3gico en remisi\u00f3nAutismo con limitaciones moderadas<\/td><\/tr><tr><td><strong>III<\/strong><\/td><td>Paciente con enfermedad sist\u00e9mica severa<\/td><td>Cardiopat\u00eda cong\u00e9nita estable no corregidaAsma con exacerbacionesEpilepsia mal controladaDiabetes mellitus insulino-dependienteObesidad m\u00f3rbidaDesnutrici\u00f3nSAOS severoPaciente oncol\u00f3gico en tratamiento (no en remisi\u00f3n)Insuficiencia renalDistrofia muscularFibrosis qu\u00edsticaPaciente trasplantadoMalformaciones cerebrales o en m\u00e9dula espinalHidrocefalia sintom\u00e1ticaPrematuro &lt; 60 semanas de edad posconcepci\u00f3nAutismo con limitaciones severasEnfermedades metab\u00f3licasV\u00eda a\u00e9rea dificultosaAlimentaci\u00f3n parenteral prolongadaReci\u00e9n nacidos de t\u00e9rmino &lt; 6 semanas de edad<\/td><\/tr><tr><td><strong>IV<\/strong><\/td><td>Paciente con enfermedad sist\u00e9mica severa con riesgo permanente a su vida<\/td><td>Cardiopat\u00eda cong\u00e9nita sintom\u00e1ticaInsuficiencia cardiaca congestivaPrematuro con secuelas activasEncefalopat\u00eda isqu\u00e9mica agudaShock, Sepsis, CIDPaciente portador de CDIPaciente dependiente de ventilaci\u00f3n mec\u00e1nicaTrauma severoDistress respiratorioEstado oncol\u00f3gico avanzado<\/td><\/tr><tr><td><strong>V<\/strong><\/td><td>Paciente moribundo que no se espera que sobreviva sin la cirug\u00eda<\/td><td>Trauma masivoHemorragia intracerebral con efecto de masaPaciente que requiere ECMOFalla respiratoria o paro respiratorioInsuficiencia cardiaca congestiva descompensadaEncefalopat\u00eda hep\u00e1ticaIsquemia mesent\u00e9ricaDisfunci\u00f3n de m\u00faltiples \u00f3rganos o sistemas<\/td><\/tr><tr><td><strong>VI<\/strong><\/td><td>Paciente con muerte cerebral, donante de \u00f3rganos<\/td><td>&nbsp;<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Esta gu\u00eda presenta&nbsp;3 dimensiones claves del proceso preoperatorio pedi\u00e1trico.&nbsp; El objetivo es&nbsp;promover&nbsp;un&nbsp;uso correcto de las herramientas diagn\u00f3sticas&nbsp;apuntadas a la&nbsp;seguridad de [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[15],"tags":[],"class_list":["post-1983","post","type-post","status-publish","format-standard","hentry","category-repositorio-digital"],"_links":{"self":[{"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/posts\/1983","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/comments?post=1983"}],"version-history":[{"count":1,"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/posts\/1983\/revisions"}],"predecessor-version":[{"id":1984,"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/posts\/1983\/revisions\/1984"}],"wp:attachment":[{"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/media?parent=1983"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/categories?post=1983"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/tags?post=1983"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}