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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABM= AAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJRE= FUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICj= UKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5i= miZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGE= YKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3v= D8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgz= kSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz= +H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A= 8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiY= QRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFK= kcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhb= n4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZn= JZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD= 2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRB= w8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kgh= aDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5Q= yMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR= 5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFT= kSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; pos= ition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSU= hEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOG= wAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6MjuY= GYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhhPi= 5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQKN= DpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61Wo= 9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKhSL= RQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJkcf= eARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9VqlX= A4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398JB= AK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+CwL= YwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kEsG= KRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEwtT= Y81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+65976= cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEolw= dHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80Gg= 0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width=3D= "19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute" /= ><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAASCAY= AAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI1VlM= 1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPyMrAy= ofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycxDAMh= xI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpyeOjo4= olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKtMz0w= TUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9Ho9D= g4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI6PX1= lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA4HGZ= 1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26RO9bp= d/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQTab5= f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm8dTv= 02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3xmWm= axvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cjAYcH= x8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2B+FN= k2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3QN7c= 7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" width= =3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " />Revista Anatom=C3=ADa Digital<s= pan class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt"> &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3= =ADn Ambate=C3=B1o) </span= >Tels. = (00593) 511262 y 0984058533 = Tel. 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(00593) 511262 y 0984058533 &#= xa0; Tel. 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(00593) 511262 y 0984058533 &= #xa0; Tel. 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(00593) 511262 y 0984058533 &= #xa0; Tel. 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(00593) 511262 y 0984058533 &= #xa0; Tel. 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(00593) 511262 y 0984058533 = 0; Tel. 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q5duwgEAowaNYq+vj5qa2tJTU0lMzOTL7/88sawSImorq6WWVlZ37tZIQSKomAwGEKNrMfjwe/3= f28OGCwWi4WFCxei0+k4d+4cJ06cwOv1snjxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQ= ghODw4cM0Nzff1E5WVhbTp0/n4sWLNDcHC2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/= +XNz1YBhOK/67+/0b36rX/FXvXmzN47GY2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVOR= K5CYII=3D" width=3D"77" height=3D"28" alt=3D"" style=3D"margin-left:441.05p= t; position:absolute" />Buenas pr=C3=A1cticas de enfermer=C3=ADa en la preven= ci=C3=B3n de neumon=C3=ADas asociadas a la ventilaci=C3=B3n mec=C3=A1nica e= n hospitales de tercer nivel de Am=C3=A9rica LatinaGood nursing prac= tices in the prevention of pneumonia associated with mechanical ventilation= at third level hospitals in Latin America1Indira Anabel S=C3=A1nchez Estrada</= span>https://orcid.= org/0009-0003-1551-1890Universidad Estatal de Bol=C3=ADvar (UEB), Guaranda, Ecuador.</s= pan>Maestr=C3=ADa e= n Salud P=C3=BAbicaanabel.sanchez<a href=3D"mailto:molalla@ueb.ed= u.ec" style=3D"text-decoration:none"></a><a href=3D"mailto:molalla@= ueb.edu.ec" style=3D"text-decoration:none">@ueb.edu.ec</span= ></a>2Mar= =C3=ADa Humbelina Olalla Garc=C3=ADa https://orcid.org/0000-0002-8358-9273<p= class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt; font-size:10pt= ">Universidad Estatal de Bo= l=C3=ADvar (UEB), Guaranda, Ecuador.<a href=3D"mailto:molalla@ueb.edu.ec" st= yle=3D"text-decoration:none">molalla@ueb.edu.ec</a></= p>Art= =C3=ADculo de Investigaci=C3=B3n Cient=C3=ADfica y Tecnol=C3=B3gica<= /p>Enviado: 17/12/2024<= /span>Revisado: 15/= 01/2025Acept= ado: 27/02/2025Publicado:03/04/2025DOI: <a href=3D"https://doi.org/10.33262/anatomiadigital= .v8i2.3373" style=3D"text-decoration:none"></a><a href=3D"https://d= oi.org/10.33262/anatomiadigital.v8i2.3373" style=3D"text-decoration:none"><= span class=3D"awspan" style=3D"font-size:10pt; font-weight:bold; text-decor= ation:underline; color:#0563c1">https://doi.org/10.33262/anatomiadigital.v8= i2.3373</a> C=C3=ADtese: S=C3=A1nchez Estrada, I. A., &= Olalla<spa= n class=3D"awspan" style=3D"font-size:10pt; letter-spacing:2.7pt"> <= span class=3D"awspan" style=3D"font-size:10pt">Garc=C3=ADa , M. H. (2025= ). Buenas<s= pan class=3D"awspan" style=3D"font-size:10pt; letter-spacing:2.7pt"> </span= >pr=C3=A1cticas<span= class=3D"awspan" style=3D"font-size:10pt; letter-spacing:2.7pt"> <s= pan class=3D"awspan" style=3D"font-size:10pt">de enfermer=C3=ADa<spa= n class=3D"awspan" style=3D"font-size:10pt; letter-spacing:1.05pt"> = en la prevenci=C3=B3n de neumon=C3=ADas asociadas a</= span> la <span= class=3D"awspan" style=3D"font-size:10pt">ventilaci=C3=B3n <span= class=3D"awspan" style=3D"font-size:10pt">mec=C3=A1nica en hospitales de tercer nivel = de Am=C3=A9rica</s= pan> = Latina. <sp= an class=3D"awspan" style=3D"font-size:10pt">Anatom=C3=ADa Digital, 8(2), 6-25. <a href=3D"https://doi.org/10.33262/anatom= iadigital.v8i2.3373" style=3D"text-decoration:none"></a><a href=3D"= https://doi.org/10.33262/anatomiadigital.v8i2.3373" style=3D"text-decoratio= n:none">https://doi.org/10.33262/anatomiadigital.v8i2.3373</= span></a>ANATOM=C3=8D= A DIGITAL,<s= pan class=3D"awspan" style=3D"font-size:8pt; letter-spacing:0.45pt"> </span= >es una Revista Electr=C3=B3nica, Trimestral, = que se <sp= an class=3D"awspan" style=3D"font-size:8pt">publicar=C3=A1 en soporte electr=C3=B3nico tiene como misi=C3=B3n co= ntribuir a<s= pan class=3D"awspan" style=3D"font-size:8pt; letter-spacing:-0.5pt"> </span= >la formaci=C3=B3n de profesionales co= mpetentes con</span= > </s= pan>visi=C3=B3n <sp= an class=3D"awspan" style=3D"font-size:8pt">human=C3=ADstica <span= class=3D"awspan" style=3D"font-size:8pt">y cr=C3=ADtica que sean capaces de= exponer sus= </sp= an>resultados <span= class=3D"awspan" style=3D"font-size:8pt">investigativos y cient=C3=ADficos en la misma</spa= n> </= span>medida que se promueva mediante su intervenci=C3=B3n cambios = positivos en la sociedad. <a href=3D"https://anatomiadigital.org" st= yle=3D"text-decoration:none"></a><a href=3D"https://anatomiadigital.= org" style=3D"text-decoration:none">https://anatomiadigital.o= rg</a> La revista es editada<= /span>= por la Editorial Ciencia = Digital (Editorial</= span> = de prestigio registrada en la C=C3=A1mara E= cuatoriana de Libro con No de Afiliaci=C3=B3n 663) <a href=3D"http:/= /www.celibro.org.ec" style=3D"text-decoration:none"></a><a href=3D"h= ttp://www.celibro.org.ec" style=3D"text-decoration:none">www.= celibro.org.ec</a>Esta revista</= span> est=C3=A1<sp= an class=3D"awspan" style=3D"font-size:8pt; letter-spacing:-0.05pt"> </span= >protegida bajo una licencia Creative Commo= ns Atribuci=C3=B3n= -NoComercial-CompartirIgual 4.0 International. 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(00593) 511262 y 0984= 058533 Tel. Directo (0059= 3) 0998-235-485 <a h= ref=3D"http://www.anatomiadigital.org" style=3D"text-decoration:none"></a><= /p><a href=3D"http://www.anatomiadigital.org" style=3D"text-decoration:= none">www.anatomiadigital.org</a= > &#x= a0; <a href=3D"http://www.cienciadigit= aleditorial.com" style=3D"text-decoration:none"></a><a href=3D"http= ://www.cienciadigitaleditorial.com" style=3D"text-decoration:none">www.cienciadigitaleditorial.com</a><= p class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt; font-size:9pt= ">= <img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByU= DbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cY= xn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICjUKglBgndWq0/lj= bCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCK= FfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGEYKgDP89jf32dpa= YmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzL= wh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkq= J7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t= 7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr= 2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8H= ZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8= /vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeX= nYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxv= c7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/= 1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5b= LvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2Cc= MQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7Xabc= rnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqV= KBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; 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position:absolute" /><sp= an class=3D"awspan" style=3D"font-family:Calibri; font-size:9pt; font-weigh= t:bold; color:#4472c4">Revista Anatom=C3=ADa Digital = ; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3= =B1o) Tels. (00593) 5112= 62 y 0984058533 <spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Tel. Direct= o (00593) 0998-235-485 </sp= an><a href=3D"http://www.anatomiadigital.org" style=3D"text-decoration:none= "></a><a href=3D"http://www.anatomiadigital.org" style=3D"text-deco= ration:none">www.anatomiadigital.org</s= pan></a><= span class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt"> &#= xa0; <a href=3D"http://www.cienc= iadigitaleditorial.com" style=3D"text-decoration:none"></a><a href= =3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:none">= www.cienciadigitaleditorial.com<= /a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATC= AYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJREFUOI1t= lM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICjUKglBg= ndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5imiZSSj= 4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGEYKgDP8= 9jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3vD8+XMq= lQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgzkSemZm= H5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz+H6AEJ= K9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A8j1Qqx= bWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiYQRrYZB= ZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFKkcV1tf= XeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhbn4l8MB= hEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZnJZEin0= wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD2qIFD0= el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRBw8ekkq= l0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kghaDQdPt= Y+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5QyMrqKC= qUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR5KKeLx= OLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFTkSuQmC= C" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:= absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAA= ABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAyx= JREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6MjuYGYVHl3= TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhhPi5DP/3F= 601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQKNDpdBBC= MBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61Wo9Vq4Tg= OuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKhSLRQaDAb= Zts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJkcfeARPVz= WaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9VqlXA4zPLy= MouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398JBAK4rst= gMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+CwLYwxSSo= LBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kEsGKRCKsr= Kz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEwtTY81Wpc= XV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+65976cdojfI= UAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEolwdHQ0Ac= G3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80Gg0+Pj4Q= GtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width=3D"19" h= eight=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute" /></spa= n>= <img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAASCAYAAABWz= o5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI1VlM1PIkkY= xn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPyMrAyofY2tB= de2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycxDAMhxI9DBP= geUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpyeOjo4olUo0m= 01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKtMz0wTUALe3= t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJq= aGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI6PX1lbOzM1= +DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA4HGZ1dRVN0= 4hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26RO9bpd/W00K= +3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQTab5f7+/n/= /CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm8dTv02630T= SNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3xmWmaxvT09= AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cjAYcHx8zPb2= Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1= NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3QN7c7Xa5vr= 6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" width=3D"18= " height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:absolute" /></= span>Revista Anatom=C3=ADa Digital &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Amb= ate=C3=B1o) Tels. (00593) = 511262 y 0984058533 = Tel. 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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= MAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJR= EFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReIC= jUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5= imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoG= EYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3= vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPg= zkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7N= z+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/= A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomi= YQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMF= KkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUh= bn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZ= nJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsU= D2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iR= Bw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kg= haDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5= QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvhe= R5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElF= TkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; po= sition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAAN= SUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSs= OGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mj= uYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhh= Pi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQ= KNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61= Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKh= SLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJk= cfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vq= lXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398= JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+C= wLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kE= sGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEw= tTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+659= 76cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEo= lwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80= Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAAS= CAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI1= VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPyM= rAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycxD= AMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpyeO= jo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKtM= z0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9H= o9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI6= PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA4= HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26RO= 9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQT= ab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm8= dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3x= mWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cjA= YcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2B= +FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3Q= N7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" wi= dth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:absol= ute" />Revista Anatom=C3=ADa Digital</span= > = Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. (00593) 511262 y 0984058533 &#x= a0; Tel. Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-= decoration:none"></a><a href=3D"http://www.anatomiadigital.org" sty= le=3D"text-decoration:none">www.anatomi= adigital.org</a> <a href=3D"h= ttp://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= /p><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-dec= oration:none">www.cienciadigitaleditori= al.com</a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSU= hEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOG= wAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAq= FAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgB= DQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHic= ViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEg= QqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDab= rKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwx= Dcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4O= HMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1y= eVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185Oemy= uLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpB= MJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJ= SSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5= nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2i= x3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3Pj= mBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPH= nyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW= 1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidn= AAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0K= GgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAA= ADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQ= jiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UE= ikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59Fs= Nrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQG= OFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4= IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZ= DJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3F= cZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dn= BdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u= 7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xL= It4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28T= DocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgG= M1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNW= qS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlq= NfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC= " width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:a= bsolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAA= ABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAzt= JREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhF= mVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkU= ikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13Wl= lJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dE= NQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/= 2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo= 8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1W= i2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/= U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1= KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo= 6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvy= zrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5= UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7+= +/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMx= l8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSu= QmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; positi= on:absolute" />Revista Anatom=C3=ADa</span= > Digital<= /span>&= #xa0; Ambato =E2=80=93 Ecuador (J= ard=C3=ADn Ambate=C3=B1o) = = Tels. (00593) 511262 y 0984058533 = Tel. 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/88sawSImorq6WWVlZ37tZIQSKomAwGEKNrMfjwe/3f28OGCwWi4WFCxei0+k4d+4cJ06cwOv1s= njxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1E5WVhbTp0/n4sWLNDcH= C2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+/0b36rX/FXvXmzN47GY= 2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" width=3D"77" height=3D= "28" alt=3D"" style=3D"margin-left:441.05pt; position:absolute" /><s= pan class=3D"awspan" style=3D"font-weight:bold">Palabras claves: </p= >buenas pr=C3=A1cticas, infecci=C3=B3n, paciente, respiraci=C3= =B3n artificial.ResumenIntroducci=C3= =B3n: <sp= an class=3D"awspan">Las Neumon=C3=ADas = Asociadas </s= pan>a la Ventilaci= =C3=B3n Mec=C3=A1nica (NAVM), son<= span class=3D"awspan" style=3D"letter-spacing:4.15pt"> las infecciones nosocomiales</= span> de mayor prevalencia en</= span> las Unidades de<sp= an class=3D"awspan" style=3D"letter-spacing:2.25pt"> Cuidados Intensivos (UCI).<= span class=3D"awspan" style=3D"letter-spacing:0.2pt"> Para = su prevenci=C3=B3n,<sp= an class=3D"awspan" style=3D"letter-spacing:0.2pt"> las </= span>buenas pr=C3=A1cticas<s= pan class=3D"awspan" style=3D"letter-spacing:0.35pt"> de <= /span>enfermer=C3=ADa resultan</spa= n> indispensables. Obje= tivo: <spa= n class=3D"awspan" style=3D"letter-spacing:0.1pt">realizar una revisi=C3=B3n<spa= n class=3D"awspan" style=3D"letter-spacing:0.1pt"> sistem=C3=A1tica<= span class=3D"awspan" style=3D"letter-spacing:5.4pt"> sobre buenas= pr=C3=A1cticas de enfermer=C3= =ADa <= span class=3D"awspan">en la prevenci=C3= =B3n <= span class=3D"awspan">de infecciones nosocom= iales <sp= an class=3D"awspan">asociadas a la<sp= an class=3D"awspan" style=3D"letter-spacing:0.2pt"> ventilaci=C3=B3n mec=C3=A1nica, y</= span> evaluar la efectividad</s= pan> de su implementaci=C3=B3n, en <s= pan class=3D"awspan">hospitales de tercer= <span= class=3D"awspan">nivel en Am=C3=A9rica L= atina. = Metodolog=C3=ADa<s= pan class=3D"awspan" style=3D"font-weight:bold; color:#767171">:<spa= n class=3D"awspan" style=3D"letter-spacing:1.8pt"> se </sp= an>realiz=C3=B3 una revisi=C3=B3n sistem=C3=A1tica de estudio= s <span= class=3D"awspan">publicados entre los</spa= n> a=C3=B1os 2019 y 2024. </span= >El proceso de b=C3= =BAsqueda </s= pan>se realiz=C3=B3 en <= span class=3D"awspan">las bases de= datos Scielo, LILACS<s= pan class=3D"awspan" style=3D"letter-spacing:1.25pt"> y Redalyc y permiti=C3=B3= seleccionar 10 art=C3=ADculos= , <spa= n class=3D"awspan">de 6 pa=C3=ADses</span= > de Latinoam=C3=A9rica, cuyas<= /span> muestras fueron paciente= s <spa= n class=3D"awspan">pedi=C3=A1tricos, adultos y<span= class=3D"awspan" style=3D"letter-spacing:4.25pt"> adultos= mayores. Resultados: en los pacientes pedi=C3=A1tr= icos <= span class=3D"awspan">se aplica un= paquete de intervenciones</s= pan> que pone =C3=A9nfasis en</s= pan> el mantenimiento de<sp= an class=3D"awspan" style=3D"letter-spacing:0.1pt"> la </sp= an>higiene bucal y <spa= n class=3D"awspan">la elevaci=C3=B3n del</= span> cabecero de las<spa= n class=3D"awspan" style=3D"letter-spacing:1.5pt"> camas. = Estas intervenciones<s= pan class=3D"awspan" style=3D"letter-spacing:1.4pt"> se </s= pan>conciben tambi=C3=A9n en<= span class=3D"awspan" style=3D"letter-spacing:4.2pt"> pacientes adultos y adultos </sp= an>mayores. En los</= span> estudios en poblaci=C3=B3n adulta, aunque = no se logra una adhesi=C3=B3n total a las</span= > intervenciones implementadas, = se <spa= n class=3D"awspan">observa una reducci=C3= =B3n <s= pan class=3D"awspan">del riesgo de<s= pan class=3D"awspan" style=3D"letter-spacing:1.4pt"> neumon=C3=ADas y de los <s= pan class=3D"awspan">d=C3=ADas de estancia= <span= class=3D"awspan">hospitalaria. Conclusiones: <= /span>los paquetes de <s= pan class=3D"awspan">intervenci=C3=B3n de enfermer=C3=AD= a, <spa= n class=3D"awspan">que se aplican<sp= an class=3D"awspan" style=3D"letter-spacing:0.9pt"> en </sp= an>las UCI de= Am=C3=A9rica Latina, en atenci= =C3=B3n </span= >de pacientes con</= span> NAVM, coinciden en<= span class=3D"awspan" style=3D"letter-spacing:0.65pt"> incluir como principales</spa= n> acciones de cuidados</spa= n> de enfermer=C3=ADa,<= span class=3D"awspan" style=3D"letter-spacing:-0.45pt"> las medidas de higiene</spa= n> bucal, la elevaci=C3=B3n</s= pan> del cabecero y<span= class=3D"awspan" style=3D"letter-spacing:-0.5pt"> la </sp= an>observancia de = los protocolos para la = aspiraci=C3=B3n endotraqueal. =C3=81rea de estudio general: medicina.= =C3=81rea de estudio espec=C3=ADfica: unidad de cuidados intensivos. Tipo de estudio: Revisi=C3=B3n Bibliogr=C3=A1fica Keywords: Good practice= s, infection, patient, artificial respirationAbstractIntroduction: Ventilator-A= ssociated </sp= an>Pneumonia (VAP) i= s <span= class=3D"awspan">the most prevalent nosoco= mial <s= pan class=3D"awspan">infection in Intensive= Care Units (ICU). Good</s= pan> nursing practices are</spa= n> essential for its<spa= n class=3D"awspan" style=3D"letter-spacing:0.45pt"> prevention. Objective: </sp= an>to conduct a</s= pan> systematic review of</span= > good nursing practices in</sp= an> the prevention of<sp= an class=3D"awspan" style=3D"letter-spacing:-0.1pt"> nosocomial infections associated = with <= span class=3D"awspan">mechanical ventilation, and </sp= an>to evaluate the= <span= class=3D"awspan">effectiveness of its implementation in third-level<s= pan class=3D"awspan" style=3D"letter-spacing:-0.15pt"> hospitals in Latin<s= pan class=3D"awspan" style=3D"letter-spacing:-0.15pt"> America. <img src=3D"data:image/jpeg;base64,/9j/4= AAQSkZJRgABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8SEhEPERET= FhwXExQaFRERGCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4eHh4eHh4= eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAxoDASIAAh= EBAxEB/8QAHAABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGCQMEAgMAA= AECAwQFEQYSByExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0haCsRg4Q2IkwWNz= 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position:absolute" />Revista Anatom=C3=ADa Digital &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) = = Tels. (00593) 511262 y 098= 4058533 Tel. 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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= MAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJR= EFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReIC= jUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5= imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoG= EYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3= vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPg= zkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7N= z+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/= A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomi= YQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMF= KkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUh= bn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZ= nJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsU= D2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iR= Bw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kg= haDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5= QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvhe= R5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElF= TkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; po= sition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAAN= SUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSs= OGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mj= uYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhh= Pi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQ= KNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61= Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKh= SLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJk= cfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vq= lXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398= JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+C= wLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kE= sGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEw= tTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+659= 76cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEo= lwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80= Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital</spa= n> = ; Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. (00593) 511262 y 0984058533 &#x= a0; Tel. Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-= decoration:none"></a><a href=3D"http://www.anatomiadigital.org" sty= le=3D"text-decoration:none">www.anatomi= adigital.org</a> <a href=3D"h= ttp://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= /p><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-dec= oration:none">www.cienciadigitaleditori= al.com</a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSU= hEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOG= wAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAq= FAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgB= DQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHic= ViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEg= QqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDab= rKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwx= Dcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4O= HMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1y= eVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185Oemy= uLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpB= MJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJ= SSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5= nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2i= x3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3Pj= mBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPH= nyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW= 1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidn= AAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0K= GgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAA= ADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQ= jiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UE= ikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59Fs= Nrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQG= OFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4= IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZ= DJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3F= cZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dn= BdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u= 7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xL= It4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28T= DocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgG= M1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNW= qS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlq= NfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC= " width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:a= bsolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAA= ABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAzt= JREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhF= mVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkU= ikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13Wl= lJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dE= NQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/= 2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo= 8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1W= i2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/= U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1= KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo= 6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvy= zrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5= UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7+= +/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMx= l8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSu= QmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; positi= on:absolute" />Revista Anatom=C3=ADa</span= > Digital<= /span>&= #xa0; Ambato =E2=80=93 Ecuador (J= ard=C3=ADn Ambate=C3=B1o) = = Tels. (00593) 511262 y 0984058533 = Tel. 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/88sawSImorq6WWVlZ37tZIQSKomAwGEKNrMfjwe/3f28OGCwWi4WFCxei0+k4d+4cJ06cwOv1s= njxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1E5WVhbTp0/n4sWLNDcH= C2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+/0b36rX/FXvXmzN47GY= 2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" width=3D"77" height=3D= "28" alt=3D"" style=3D"margin-left:441.05pt; position:absolute" /><s= pan class=3D"awspan" style=3D"font-weight:bold">Methodology: a systematic review </spa= n>of studies publish= ed between </= span>2019 and 2024= <span= class=3D"awspan">was conducted. The</spa= n> search process was conducted= <span= class=3D"awspan">in the Scielo,<s= pan class=3D"awspan" style=3D"letter-spacing:0.85pt"> LILACS and Redalyc databases and allowed the<span= class=3D"awspan" style=3D"letter-spacing:-0.1pt"> selection of 10 = articles </sp= an>from 6 Latin</s= pan> American countries, whose s= amples = were pediatric patie= nts, <s= pan class=3D"awspan">adults, and older adu= lts. <= span class=3D"awspan" style=3D"font-weight:bold">Results: a package of <= span class=3D"awspan">interventions is = applied </spa= n>in pediatric patients<spa= n class=3D"awspan" style=3D"letter-spacing:-0.65pt"> that= emphasizes maintaining</sp= an> oral hygiene and raising= <span= class=3D"awspan">the head of<span= class=3D"awspan" style=3D"letter-spacing:3.65pt"> the </s= pan>bed. These int= erventions </= span>are also conceived<span= class=3D"awspan" style=3D"letter-spacing:1pt"> for <s= pan class=3D"awspan">adult and older<spa= n class=3D"awspan" style=3D"letter-spacing:1pt"> adult </span= >patients. In studies</s= pan> in <= /span>the adult population,<s= pan class=3D"awspan" style=3D"letter-spacing:1pt"> although <= /span>full adherence to<= /span> the implemented interventions = is <sp= an class=3D"awspan">not achieved, a</span= > reduction in the risk </s= pan>of pneumonia and in= the length of hos= pital <sp= an class=3D"awspan">stay is observed. <s= pan class=3D"awspan" style=3D"font-weight:bold">Conclusions: t= he <spa= n class=3D"awspan">nursing intervention p= ackages, </spa= n>which are applied in <s= pan class=3D"awspan">the ICUs of<s= pan class=3D"awspan" style=3D"letter-spacing:1.05pt"> Latin America, in the </span= >care of patients = with <s= pan class=3D"awspan">VAP, coincide in</span= > including as main nursing </s= pan>care actions, oral hygiene <= /span>measures, elevation<= span class=3D"awspan" style=3D"letter-spacing:1.55pt"> of the head = of <sp= an class=3D"awspan">the bed and observanc= e <span= class=3D"awspan">of protocols for<s= pan class=3D"awspan" style=3D"letter-spacing:1.1pt"> endotracheal aspiration. General Area of</= span> Study:<= span class=3D"awspan" style=3D"font-weight:bold; letter-spacing:1.25pt"> </= span>Medicine. Specific area of</s= pan> study<sp= an class=3D"awspan" style=3D"font-weight:bold; color:#767171">:<span= class=3D"awspan" style=3D"letter-spacing:1.25pt"> Intensive care unit. Type of study: = Bibliography Review.1.Introducci=C3=B3nLa Neumo= n=C3=ADa </sp= an>Asociada a la</= span> Ventilaci=C3=B3n Mec=C3=A1nica<span= class=3D"awspan" style=3D"letter-spacing:2.95pt"> (NAVM) = constituye una de </span= >las infecciones nosocomiales</spa= n> de mayor incidencia= en UCIS a = nivel = mundial (<a href=3D"#ref1" s= tyle=3D"text-decoration:none"></a><a href=3D"#ref1" style=3D"text-decoration:none">= 1</a>= ).</s= pan> Clasifica dentro de las</spa= n> Infecciones Asociadas a<= span class=3D"awspan" style=3D"letter-spacing:0.1pt"> la </= span>Atenci=C3=B3n en Salud </span= >(IAAS) dado que</sp= an> el paciente no la presenta <= /span>al momento d= e <span= class=3D"awspan">su entrada al<span= class=3D"awspan" style=3D"letter-spacing:2.2pt"> hospital,= ni se encuen= tra <sp= an class=3D"awspan">en proceso de incubaci= =C3=B3n.La NAVM es<= /span> una infecci=C3=B3n del</= span> tracto respiratorio infer= ior <s= pan class=3D"awspan">que evoluciona al</s= pan> menos 48 horas despu=C3=A9= s <spa= n class=3D"awspan">de la intubaci=C3=B3n<= /span> endotraqueal o en= las primeras 48 horas </s= pan>de la extubaci= =C3=B3n (<a href=3D"#ref2" style=3D"text-decoration:none"></a><p= class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt"><a href=3D"#re= f2" style=3D"text-decoration:none">2</a>). Al ser</= span> la ventilaci=C3=B3n mec= =C3=A1nica </= span>un tratamiento de <= span class=3D"awspan">soporte vital de</s= pan> uso habitual en<spa= n class=3D"awspan" style=3D"letter-spacing:0.25pt"> las ucis, las neumon=C3=ADas asociadas a este tratamiento invasivo s= on bastante frecuentes. Las NAVM</sp= an> pueden ser originadas</span= > por factores internos<= span class=3D"awspan" style=3D"letter-spacing:1.35pt"> y= externos. Entre<span= class=3D"awspan" style=3D"letter-spacing:1.35pt"> los </s= pan>factores externos constan= el= manejo inadecuado<spa= n class=3D"awspan" style=3D"letter-spacing:0.6pt"> de </spa= n>equipos y material= es <spa= n class=3D"awspan">y el incumplimiento</sp= an> de las normas de bioseguridad por los p= rofesionales <= /span>de la salud</s= pan> (<a href=3D"#ref3" style=3D"text-decoration:none"></a>= <a href= =3D"#ref3" style=3D"text-decoration:none">3</a>). Es <sp= an class=3D"awspan">comprensible, entonces, que<span= class=3D"awspan" style=3D"letter-spacing:0.2pt"> la </span= >NAVM represente u= n <span= class=3D"awspan">desaf=C3=ADo cl=C3=ADnico que <s= pan class=3D"awspan">pondera, entre otras</= span> acciones, <img src=3D"data:image/jpeg;base64,/= 9j/4AAQSkZJRgABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8SEhEP= ERETFhwXExQaFRERGCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4eHh4= eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAxoDAS= IAAhEBAxEB/8QAHAABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGCQMEA= gMAAAECAwQFEQYSByExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0haCsRg4Q2Ik= wWNzg//EABsBAQEBAQEBAQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgIABAIJAwQDAAAAAAE= CEQMSBFEFITFBE4EUIjI0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPwDqXfGR5+77cnfGR5= +77cuIf0nUfi91yzkX/P3fblO+L/n7vty4w1F3XJORf8/d9uU74yPP3fblhKGobrk74v8An7vty= d8ZHn7vty4w1Flrk74v+fu+3KTkZHn7vtywSV1F3WffOR5+77cnfOR5+77cuMXUZ3XJ3zkefu+3= 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Ecuador (Jard=C3=ADn Amb= ate=C3=B1o) Tels. (00593) = 511262 y 0984058533 = Tel. Di= recto (00593) 0998-235-485 = <a href=3D"http://www.anatomiadigital.org" style=3D"text-decoration:= none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"text-= decoration:none">www.anatomiadigital.org</a></p= > = <a href=3D"http://www.cienciadigitale= ditorial.com" style=3D"text-decoration:none"></a><a href=3D"http://= www.cienciadigitaleditorial.com" style=3D"text-decoration:none">www.cienciadigitaleditorial.com</a><img src=3D"data:= image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICA= gIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpE= pNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZ= afT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dl= hdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAy= AMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1= Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL= 16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQ= kSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0z= QZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtu= xGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJyc= AKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++= TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraR= AwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6= fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h= 4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx= 2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFL= quUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl= 0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFTkSuQmCC" width=3D"19" height=3D= "19" alt=3D"" style=3D"margin-left:3.84pt; position:absolute" /><spa= n style=3D"height:0pt; display:block; position:absolute; z-index:194"><img = src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAA= AABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zO= n9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbn= N8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XR= QSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwN= bWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFB= DQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev= 1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlR= K0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQM= dxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp= 354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaW= pz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3A= kQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38= cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+I= QTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FR= Rh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj= 0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" = style=3D"margin-left:3.84pt; position:absolute" /><img src=3D"data:im= age/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgI= fAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozs= BD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE= 89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6u= sKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKR= YH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl= 8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SC= gUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIR= CI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jP= Fo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVI= ihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJ= TEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KM= wyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUc= x6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10= XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2L= bN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkM= qTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" width=3D"18" height=3D"18" alt= =3D"" style=3D"margin-left:5.66pt; position:absolute" />Revista Anatom=C3=ADa Digital &= #xa0; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) </sp= an> = 0; Tels. (00593) 511262 y 0984058= 533 Tel. 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position:absolute" />Revista Anatom=C3=ADa Digital &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) = = Tels. (00593) 511262 y 098= 4058533 Tel. 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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= MAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJR= EFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReIC= jUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5= imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoG= EYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3= vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPg= zkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7N= z+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/= A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomi= YQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMF= KkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUh= bn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZ= nJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsU= D2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iR= Bw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kg= haDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5= QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvhe= R5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElF= TkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; po= sition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAAN= SUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSs= OGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mj= uYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhh= Pi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQ= KNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61= Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKh= SLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJk= cfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vq= lXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398= JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+C= wLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kE= sGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEw= tTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+659= 76cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEo= lwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80= Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital</spa= n> = ; Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. (00593) 511262 y 0984058533 &#x= a0; Tel. Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-= decoration:none"></a><a href=3D"http://www.anatomiadigital.org" sty= le=3D"text-decoration:none">www.anatomi= adigital.org</a> <a href=3D"h= ttp://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= /p><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-dec= oration:none">www.cienciadigitaleditori= al.com</a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSU= hEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOG= wAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAq= FAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgB= DQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHic= ViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEg= QqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDab= rKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwx= Dcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4O= HMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1y= eVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185Oemy= uLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpB= MJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJ= SSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5= nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2i= x3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3Pj= mBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPH= nyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW= 1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidn= AAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0K= GgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAA= ADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQ= jiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UE= ikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59Fs= Nrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQG= OFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4= IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZ= DJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3F= cZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dn= BdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u= 7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xL= It4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28T= DocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgG= M1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNW= qS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlq= NfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC= " width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:a= bsolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAA= ABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAzt= JREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhF= mVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkU= ikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13Wl= lJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dE= NQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/= 2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo= 8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1W= i2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/= U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1= KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo= 6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvy= zrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5= UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7+= +/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMx= l8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSu= QmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; positi= on:absolute" />Revista Anatom=C3=ADa</span= > Digital<= /span>&= #xa0; Ambato =E2=80=93 Ecuador (J= ard=C3=ADn Ambate=C3=B1o) = = Tels. (00593) 511262 y 0984058533 = Tel. 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/88sawSImorq6WWVlZ37tZIQSKomAwGEKNrMfjwe/3f28OGCwWi4WFCxei0+k4d+4cJ06cwOv1s= njxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1E5WVhbTp0/n4sWLNDcH= C2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+/0b36rX/FXvXmzN47GY= 2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" width=3D"77" height=3D= "28" alt=3D"" style=3D"margin-left:441.05pt; position:absolute" /><s= pan class=3D"awspan">la necesidad de</spa= n> mantener la vigilancia</span= > epidemiol=C3=B3gica, cumplimiento de </spa= n>los protocolos de prevenci=C3=B3n= de infecciones y la capacitaci=C3=B3n continua del personal de salud (</sp= an><a href=3D"#ref4" style=3D"text-decoration:none"></a><a href=3D"#ref4" style=3D"= text-decoration:none">4</a>). Es una<spa= n class=3D"awspan" style=3D"letter-spacing:2.1pt"> patolog=C3=ADa compleja pero<s= pan class=3D"awspan" style=3D"letter-spacing:2.1pt"> prevenible desde el quehacer </sp= an>del personal sani= tario, especialmente, del personal= de enfermer=C3=ADa. A<= span class=3D"awspan" style=3D"letter-spacing:1.65pt"> decir de (<a href=3D"#= ref5" style=3D"text-decoration:none"></a><a href=3D"#ref5" style=3D"text-decoration= :none">5<= /a>) <s= pan class=3D"awspan">el papel de<s= pan class=3D"awspan" style=3D"letter-spacing:1.65pt"> los = enfermeros resulta decisivo<= /span> en la prevenci=C3=B3n</= span> de NMVA por ser </spa= n>estos los profes= ionales </spa= n>que prestan la a= tenci=C3=B3n = directa a = los <s= pan class=3D"awspan">pacientes y los</spa= n> que manipulan los<spa= n class=3D"awspan" style=3D"letter-spacing:-0.5pt"> sistemas de ventilaci=C3=B3n</span= > mec=C3=A1nica. En consec= uencia </span= >es crucial que</s= pan> las enfermeras y<sp= an class=3D"awspan" style=3D"letter-spacing:0.05pt"> enfermeros realicen un<spa= n class=3D"awspan" style=3D"letter-spacing:0.05pt"> manejo= correcto de la<span= class=3D"awspan" style=3D"letter-spacing:-0.15pt"> ventilaci=C3=B3n mec=C3=A1nica, que = eleven el conoci= miento </spa= n>relacionado con la = prevenci=C3=B3n de infecciones,<= /span> dominen las t=C3=A9cnica= s <spa= n class=3D"awspan">de aspiraci=C3=B3n de<= /span> secreciones, usen barrer= as <sp= an class=3D"awspan">de protecci=C3=B3n y hagan </= span>uso adecuado del </span= >lavado de mano<= /span> <span= class=3D"awspan">y la bioseguridad,</s= pan> de manera general (</sp= an><a href=3D"#ref6" style=3D"text-decoration:none"></a><a href=3D"#ref6" style=3D"= text-decoration:none">6</a>). En otros estudios <= /span>(<a href=3D"#ref3" style=3D"text-decora= tion:none"></a><a href=3D"#ref3" style=3D"text-decoration:none">3</a><a href=3D"#ref7" style= =3D"text-decoration:none"></a><a href=3D"#ref7" style=3D"text-decoration:none"><spa= n class=3D"awspan" style=3D"text-decoration:underline">, </sp= an>7</a><= a href=3D"#ref8" style=3D"text-decoration:none"></a><a href=3D"#ref8" style=3D"text= -decoration:none">, 8</a><spa= n class=3D"awspan">), como buenas<sp= an class=3D"awspan" style=3D"letter-spacing:0.7pt"> pr=C3=A1cticas del personal<s= pan class=3D"awspan" style=3D"letter-spacing:0.7pt"> de </s= pan>enfermer=C3=ADa en la prevenci=C3=B3n de NAVM, se = pondera la elevaci= =C3=B3n </span= >del cabecero de</sp= an> las camas, la higiene bucal, la evaluaci=C3=B3n de la sedaci=C3=B3n diaria y la realizac= i=C3=B3n de terapia respiratoria. Otros autores </s= pan>(<a href=3D"#ref9" style=3D"text-decorati= on:none"></a><a href=3D"#ref9" style=3D"text-decoration:none">9</a>, <a href=3D"#ref10" style=3D"tex= t-decoration:none"></a><a href=3D"#ref10" style=3D"text-decoration:none">10</a>),<spa= n class=3D"awspan" style=3D"letter-spacing:0.6pt"> previo <= /span>desarrollo de programas </s= pan>de intervenci=C3=B3n,<spa= n class=3D"awspan" style=3D"letter-spacing:0.6pt"> han </sp= an>comprobado la efectividad= de= la aplicaci=C3=B3n<sp= an class=3D"awspan" style=3D"letter-spacing:0.3pt"> de </sp= an>paquetes de medid= as <spa= n class=3D"awspan">en la prevenci=C3=B3n</s= pan> de neumon=C3=ADa en pacientes= con ventilaci=C3=B3n mec=C3=A1nica. A pesar </span= >de ello, son= escasos los informes<sp= an class=3D"awspan" style=3D"letter-spacing:0.5pt"> que </s= pan>dan cuenta de</s= pan> la totalidad de pr=C3=A1cticas de enfermer=C3=ADa que</= span> es posible aplicar= en la prevenci=C3=B3n<= span class=3D"awspan" style=3D"letter-spacing:5.55pt"> de NAVM. Los estudios, generalmente, se dirigen</span= > a= la caracterizaci=C3=B3n</sp= an> del diagn=C3=B3stico cl=C3= =ADnico </spa= n>y a las<s= pan class=3D"awspan" style=3D"letter-spacing:-0.7pt"> condicionantes de las infeccione= s <spa= n class=3D"awspan">nosocomiales asociadas a <sp= an class=3D"awspan">ventilaci=C3=B3n mec=C3=A1nica,= sin evaluar el quehacer preventivo de los profesionales de enfermer=C3=ADa.<= p class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt">Ante tal vac=C3=ADo<span= class=3D"awspan" style=3D"letter-spacing:2.9pt"> en </span= >la literatura cient= =C3=ADfica, </= span>resulta relevante conocer </s= pan>=C2=BFCu=C3=A1les son<spa= n class=3D"awspan" style=3D"letter-spacing:2.9pt"> las pr=C3=A1cticas de enfermer=C3=ADa= que contribuyen a<s= pan class=3D"awspan" style=3D"letter-spacing:1.6pt"> la </s= pan>prevenci=C3=B3n de infecciones= nosocomiales asociadas a la ventilaci=C3=B3n= mec=C3=A1nica, en hospitales de tercer nivel en Am=C3=A9rica Latina?</span= >La prevenci=C3=B3n de</= span> esta infecci=C3=B3n no= <spa= n class=3D"awspan">es posible mediante<= /span> <span= class=3D"awspan">la pr=C3=A1ctica de</= span> una medida aislada o</= span> un n=C3=BAmero reducido</spa= n> de= ellas. El p= resente </span= >estudio permitir=C3=A1 identificar las buenas pr=C3=A1cticas</= span> de enfermer=C3=ADa que</s= pan> se emplean en ucis </s= pan>de Am=C3=A9rica Latina </sp= an>para prevenir = la NAVM </spa= n>y, en consecuenc= ia, <s= pan class=3D"awspan">permitir=C3=A1 realizar una </spa= n>valoraci=C3=B3n cr=C3=ADtica</spa= n> del uso las mismas, en cada UCI de la regi=C3=B3n. La<spa= n class=3D"awspan" style=3D"letter-spacing:1.45pt"> NAVM <= /span>est=C3=A1 presentes<= span class=3D"awspan" style=3D"letter-spacing:1.45pt"> en pa=C3=ADses de<span= class=3D"awspan" style=3D"letter-spacing:1.45pt"> todos <= /span>los continentes, llegando= a alcanzar a <sp= an class=3D"awspan">la cuarta parte de<s= pan class=3D"awspan" style=3D"letter-spacing:1pt"> los </span= >pacientes que ingresan<= /span> en= cuidados intensivos<sp= an class=3D"awspan" style=3D"letter-spacing:1pt"> (<a href=3D"#ref11" style=3D"text-decoration:none"></a><a href=3D"#ref1= 1" style=3D"text-decoration:none">11</a>). </span= >A decir de (<a href=3D"#ref4" style=3D"text-decoration:none"></a><a href=3D"#ref4" st= yle=3D"text-decoration:none">4</a>) infecci=C3=B3n afecta entre el 20 y el 50 % de lo= s pacientes sometidos a ventilaci=C3=B3n mec=C3=A1nica, provocando<s= pan class=3D"awspan" style=3D"letter-spacing:0.45pt"> un <= /span>aumento significativo<= span class=3D"awspan" style=3D"letter-spacing:0.45pt"> en la morbimortalidad<= span class=3D"awspan" style=3D"letter-spacing:0.45pt"> y= en los cos= tos <s= pan class=3D"awspan">de atenci=C3=B3n m=C3=A9dica.<= span class=3D"awspan" style=3D"letter-spacing:0.55pt"> Basados en estad=C3=ADsticas= <span= class=3D"awspan">recientes (<a href=3D"#ref12" sty= le=3D"text-decoration:none"></a><a href=3D"#ref12" style=3D"text-decoration:none"><= span class=3D"awspan" style=3D"text-decoration:underline">12</a>= ) reportan que<span= class=3D"awspan" style=3D"letter-spacing:0.55pt"> en </sp= an>Latinoam=C3=A9rica la<spa= n class=3D"awspan" style=3D"letter-spacing:0.55pt"> tasa <= /span>de neumon=C3=ADa asociada</s= pan> a ventilaci=C3=B3n mec= =C3=A1nica <= /span>es 10 vece= s <sp= an class=3D"awspan">mayor que en= pa=C3=ADses desarrollados, alcanzando 11.47 p= or cada 1,000 d=C3=ADas de ventilaci=C3=B3n.<img src=3D"data:= image/jpeg;base64,/9j/4AAQSkZJRgABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIB= 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position:absolute" /><= span class=3D"awspan" style=3D"font-family:Calibri; font-size:9pt; font-wei= ght:bold; color:#4472c4">Revista Anatom=C3=ADa Digital &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3= =B1o) Tels. 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(00593) 511262 y 0984058533 &#x= a0; Tel. 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Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" st= yle=3D"text-decoration:none"></a><a href=3D"http://www.anatomiadigi= tal.org" style=3D"text-decoration:none">www.anatomiadigital.org</a> = <a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration= :none"></a><a href=3D"http://www.cienciadigitaleditorial.com" style= =3D"text-decoration:none">www.cienciadi= gitaleditorial.com</a><img src=3D"data:image/png;base64,iVBORw= 0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOx= AAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM= 3xfCue0huWAqFAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qe= npzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKR= aLFItFRkdHicViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk= 0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE= 43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbp= dEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n8= 3NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVA= LLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovP= Fvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSk= ECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/j= tse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIB= KZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJ= r1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd= 9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O1= 8z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcw= S6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqK= T0/sycXcKidnAAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"= margin-left:-1pt; position:absolute" /><img src=3D"data:image/png;bas= e64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAl= wSFlzAAAOxAAADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QT= d9hT5iVCBdFQjiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+= fmJMQa/34+UEikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBK= OQUVY2We59FsNrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8s= MBgMsy0JrPQGOFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM= 7OziiVSnieN4IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EE= KyurgKQz+fJZDJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFa= rUa328V6fX3FcZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/d= kMhmur6/Z2dnBdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8G= vIr8Avmi9N7u7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G= +vrzAQCaK2xLIt4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoR= CoWwpJRsb28TDocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT08= 5Pz9HKTVphgGM1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZp= QtITDagIAvNWqS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNpp= JT/2vNzOCqlqNfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAA= AElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt= ; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoA= AAANSUhEUgAAABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQ= BlSsOGwAAAztJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpC= shMtFl1sSPhFmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6= HQ6CCGIx+OkUikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzM= DIZheOkI13WllJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05= OTigUCrTb7dENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7= MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8= V/HWJaFlJJGo8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32G= wyF3d3cAKK1Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41= t2xweHqLrOv/U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIx= qNsrGxQa/Xo1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQ= OPj4yQSCT/Zo6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HG= xmL8/OEDruvyzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq= 1cIaO3yq5XG5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0= Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg= 3Q6zdraGplMxl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukF= AAAAAElFTkSuQmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" />Revista Anatom= =C3=ADa Digital <spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Ambato =E2= =80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) &#= xa0; Tels. 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(00593) 511262 y 0984058533 = 0; Tel. 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ei0+k4d+4cJ06cwOv1snjxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1= E5WVhbTp0/n4sWLNDcHC2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+= /0b36rX/FXvXmzN47GY2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" wid= th=3D"77" height=3D"28" alt=3D"" style=3D"margin-left:441.05pt; position:ab= solute" />Varios estudios</s= pan> (<a href=3D"#ref13" style=3D"text-decoration:none"></= a><a hre= f=3D"#ref13" style=3D"text-decoration:none">13</a>, <a href=3D"#ref14" style=3D"text-decora= tion:none"></a><a href=3D"#ref14" style=3D"text-decoration:none">14,</a> <a href=3D"#ref15" style=3D"text-decoration:none"><= /a><a hr= ef=3D"#ref15" style=3D"text-decoration:none">15</a>) dan<sp= an class=3D"awspan" style=3D"letter-spacing:0.65pt"> cuenta de la sig= nificativa </= span>incidencia de las </span= >infecciones nosocomiales, relaciona= das <sp= an class=3D"awspan">con la ventilaci=C3=B3n= mec=C3=A1nica, en hospital= es <spa= n class=3D"awspan">de tercer nivel<s= pan class=3D"awspan" style=3D"letter-spacing:0.3pt"> de Am=C3=A9rica Latina. Seg=C3=BAn<= /span> describe (<a href=3D"#ref11" style= =3D"text-decoration:none"></a><a href=3D"#ref11" style=3D"text-decoration:none"><sp= an class=3D"awspan" style=3D"text-decoration:underline">11</a><p= style=3D"margin-right:1pt; margin-left:1pt">)</span= > en= Colombia el 50% <s= pan class=3D"awspan">de los pacientes</span= > en= UCI contraen neumon=C3=ADa<= /span> relacionada con la</span= > respiraci=C3=B3n ventilada = y <spa= n class=3D"awspan">M=C3=A9xico y Chile,</= span> por su parte, reportan</s= pan> un incremento de<sp= an class=3D"awspan" style=3D"letter-spacing:1.95pt"> la </= span>estancia hospitalaria<s= pan class=3D"awspan" style=3D"letter-spacing:1.95pt"> y </= span>de los costos= <span= class=3D"awspan">de atenci=C3=B3n derivado de la NAVM. </= span><sp= an class=3D"awspan">Esta situaci=C3=B3n r= equiere </span= >un mayor =C3=A9nfas= is, <sp= an class=3D"awspan">por parte del<sp= an class=3D"awspan" style=3D"letter-spacing:1.7pt"> personal de enfermer=C3=ADa,<= span class=3D"awspan" style=3D"letter-spacing:1.7pt"> en </= span>la prevenci=C3=B3n de<s= pan class=3D"awspan" style=3D"letter-spacing:1.65pt"> este= tipo de = complicaciones. Al explorar el </span= >conocimiento y = la <sp= an class=3D"awspan">pr=C3=A1ctica cl=C3=ADnica de<s= pan class=3D"awspan" style=3D"letter-spacing:0.25pt"> profesionales de enfermer=C3=ADa= <span= class=3D"awspan">en pa=C3=ADses del</spa= n> =C3=A1rea de estudio,= en Bolivia destacan las</spa= n> deficiencias relacionadas = con <s= pan class=3D"awspan">la manipulaci=C3=B3n del <= span class=3D"awspan">ventilador mec=C3=A1nico<span= class=3D"awspan" style=3D"letter-spacing:2.75pt"> (<a href=3D"#ref16" style=3D"text-decoration:none"></a><a href=3D"#ref= 16" style=3D"text-decoration:none">16</a>). En M=C3=A9xico<sp= an class=3D"awspan" style=3D"letter-spacing:3.5pt"> por </s= pan>su parte (</span= ><a href=3D"#ref17" style=3D"text-decoration:none"></a><a href=3D"#ref17" style=3D"= text-decoration:none">17</a><span= class=3D"awspan">) reporta pr=C3=A1cticas<= /span> inadecuadas en el<sp= an class=3D"awspan" style=3D"letter-spacing:3.5pt"> uso </s= pan>de barreras de p= rotecci=C3=B3n, la higiene bucal,= el lavado de = las manos y</spa= n> el dominio de<span= class=3D"awspan" style=3D"letter-spacing:-0.55pt"> t=C3=A9cnicas de aspiraci=C3=B3n= y del protocolo de prevenci=C3=B3n en sentido general.Ello </spa= n>explica la neces= idad <= span class=3D"awspan">de que se<sp= an class=3D"awspan" style=3D"letter-spacing:-0.4pt"> implementen programas de<s= pan class=3D"awspan" style=3D"letter-spacing:-0.4pt"> prevenci=C3=B3n en las<sp= an class=3D"awspan" style=3D"letter-spacing:-0.4pt"> ucis = que permitan conocer<s= pan class=3D"awspan" style=3D"letter-spacing:3.1pt"> y </sp= an>extender las buen= as <spa= n class=3D"awspan">pr=C3=A1cticas en la</sp= an> prestaci=C3=B3n de cuidados</s= pan> de enfermer=C3=ADa.En = consecuencia,= el presente estudio </s= pan>se propone com= o <spa= n class=3D"awspan">objetivo general: real= izar <= span class=3D"awspan">una revisi=C3=B3n sistem=C3=A1tica<= /span> de la literatura= sobre pr=C3=A1cticas de</span= > enfermer=C3=ADa en la<= span class=3D"awspan" style=3D"letter-spacing:1.45pt"> prevenci=C3=B3n de infecciones nosocomiales asociadas a la = ventilaci=C3=B3n mec=C3=A1nica,</s= pan> en hospitales de<sp= an class=3D"awspan" style=3D"letter-spacing:1.55pt"> tercer nivel en Am=C3=A9rica Latina.Objetivos= espec=C3=ADficos:Identificar estud= ios <= span class=3D"awspan">que muestren las<= /span> <span= class=3D"awspan">pr=C3=A1cticas de enf= ermer=C3=ADa= empleadas en la </sp= an>prevenci=C3=B3n de infecciones</= span> nosocomiales asociadas = a <spa= n class=3D"awspan">la ventilaci=C3=B3n = mec=C3=A1nica, en hospitales de </spa= n>tercer nivel en Am=C3=A9rica Latina.Explicar los hallazgos<spa= n class=3D"awspan" style=3D"letter-spacing:0.45pt"> y </sp= an>aspectos m=C3=A1s relevantes= dentro de = los <s= pan class=3D"awspan">estudios elegidos, = acerca de </s= pan>pr=C3=A1cticas de enfermer=C3=ADa empleadas en<s= pan class=3D"awspan" style=3D"letter-spacing:2.25pt"> la <= /span>prevenci=C3=B3n de<spa= n class=3D"awspan" style=3D"letter-spacing:2.25pt"> infecciones nosocomiales asociadas a la ventilaci= =C3=B3n mec=C3=A1nica, en hospitales de tercer nivel en Am=C3=A9rica Latina= .= 2.Metodolo= g=C3=ADaLa utilizaci=C3=B3n<s= pan class=3D"awspan" style=3D"letter-spacing:0.65pt"> de <= /span>la metodolog=C3=ADa<sp= an class=3D"awspan" style=3D"letter-spacing:0.65pt"> PICO = permiti=C3=B3 estructurar</s= pan> la pregunta orientadora</s= pan> que constituy=C3=B3 la gu=C3=ADa de la revisi=C3=B3n sistem= =C3=A1tica. Pregunta orientadora:</sp= an> =C2=BFCu=C3=A1les son las</spa= n> buenas pr=C3=A1cticas de= enfermer=C3=ADa que contribuyen= a la prevenci=C3=B3n de<= /span> infecciones nosocomiales en <s= pan class=3D"awspan">pacientes con ventil= aci=C3=B3n </= span>mec=C3=A1nica, en ucis de hospitales de tercer nivel de Am=C3=A9rica Latina?<= p class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt; margin-bottom= :10pt">Componentes metodolog=C3=ADa PICO:= <img src=3D"data:image/jpeg;base64,/9j/4AAQSkZJRgABAQEAYABgAAD/2wBDAAUDB= AQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8SEhEPERETFhwXExQaFRERGCEYGh0dHx8fExciJCIe= JBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4= eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAxoDASIAAhEBAxEB/8QAHAABAQACAwEBAAAAAAAAAA= AAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGCQMEAgMAAAECAwQFEQYSByExExQXQVFTVmGSlOMIF= SJUcYGT0TI3UnWRsyMzNkJydKGy0haCsRg4Q2IkwWNzg//EABsBAQEBAQEBAQEAAAAAAAAAAAAB= AgMEBQYH/8QANBEBAQACAgIABAIJAwQDAAAAAAECEQMSBFEFITFBE4EUIjI0YXGRsdGhwfAGMzX= 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Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" st= yle=3D"text-decoration:none"></a><a href=3D"http://www.anatomiadigi= tal.org" style=3D"text-decoration:none">www.anatomiadi= gital.org</a> <a href=3D"http= ://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a>= <a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decora= tion:none">www.cienciadigitaleditorial.com</a><= /p><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYA= AAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJREFUOI1tlM1= PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICjUKglBgndW= q0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5imiZSSj4vI= QRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGEYKgDP89jf= 32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3vD8+XMqlQp= KKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgzkSemZmH5G= 7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz+H6AEJK9v= b/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A8j1QqxbWh= IbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiYQRrYZBZiT= D4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFKkcV1tfXeL= rwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhbn4l8MBhEs= GQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZnJZEin0wA4= jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD2qIFD0el0= 6nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRBw8ekkql0H= WNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0= mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5QyMrqKCqUU= 7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR5KKeLxOLZ= tUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFTkSuQmCC" = width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:3.84pt; position:a= bsolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAA= ABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAyx= JREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6MjuYGYVHl3= TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhhPi5DP/3F= 601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQKNDpdBBC= MBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61Wo9Vq4Tg= OuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKhSLRQaDAb= Zts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJkcfeARPVz= WaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9VqlXA4zPLy= MouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398JBAK4rst= gMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+CwLYwxSSo= LBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kEsGKRCKsr= Kz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEwtTY81Wpc= XV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+65976cdojfI= UAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEolwdHQ0Ac= G3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80Gg0+Pj4Q= GtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width=3D"19" h= eight=3D"19" alt=3D"" style=3D"margin-left:3.84pt; position:absolute" /></s= pan><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAASCAYAAA= BWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI1VlM1PI= kkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPyMrAyofY= 2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycxDAMhxI9= DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpyeOjo4olU= o0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKtMz0wTUA= Le3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9Ho9Dg4O= mJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI6PX1lbO= zM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA4HGZ1dR= VN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26RO9bpd/W= 00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQTab5f7+= /n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm8dTv026= 30TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3xmWmaxv= T09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cjAYcHx8z= Pb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2B+FNk2T= zc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3QN7c7Xa= 5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" width=3D= "18" height=3D"18" alt=3D"" style=3D"margin-left:5.66pt; position:absolute"= />Revista Anatom=C3=ADa Digital<sp= an class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt"> = 0; Ambato =E2=80=93 Ecuador (Jard=C3= =ADn Ambate=C3=B1o) </span= >Tels. = (00593) 511262 y 0984058533 = Tel. Directo (00593) 0998-235-485 = ; <a href=3D"http://www.anatomiadigital.org" style=3D"text-dec= oration:none"></a><a href=3D"http://www.anatomiadigital.org" style= =3D"text-decoration:none">www.anatomiad= igital.org</a> <a href=3D"htt= p://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a></p= ><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decor= ation:none">www.cienciadigitaleditorial= .com</a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhE= UgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwA= AA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFA= UBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ= 0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicVi= CCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQq= CgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrK= ysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDc= rkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHM= DLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeV= uYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuL= jA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJ= DCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSS= RCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nM= XbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3= Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmB= jdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHny= hFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1u= jVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAA= AAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1= pt; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGg= oAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAAD= sQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQji= ybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEik= llmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNr= m8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOF= XieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4Ip= pahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJ= ks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZ= yJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBd= V3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v= 6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt= 4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDo= cnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1= lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS= 3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNf= rPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" = width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:abs= olute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= IAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJR= EFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmV= g1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUik= mJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJ= KnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQ= qCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2K= ZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H= 5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2= azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6= /z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1Kp= cHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6z= rOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzr= J4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5Uq= uM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/= aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8= XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQm= CC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position= :absolute" />Revista Anatom=C3=ADa Digital= = Ambato =E2=80=93 Ecuador (= Jard=C3=ADn Ambate=C3=B1o) = Tels. (00593) 511262 y 0984058533 = ; Tel. 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Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" st= yle=3D"text-decoration:none"></a><a href=3D"http://www.anatomiadigi= tal.org" style=3D"text-decoration:none">www.anatomiadigital.org</a> = <a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration= :none"></a><a href=3D"http://www.cienciadigitaleditorial.com" style= =3D"text-decoration:none">www.cienciadi= gitaleditorial.com</a><img src=3D"data:image/png;base64,iVBORw= 0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOx= AAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM= 3xfCue0huWAqFAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qe= npzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKR= aLFItFRkdHicViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk= 0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE= 43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbp= dEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n8= 3NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVA= LLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovP= Fvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSk= ECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/j= tse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIB= KZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJ= r1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd= 9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O1= 8z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcw= S6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqK= T0/sycXcKidnAAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"= margin-left:-1pt; position:absolute" /><img src=3D"data:image/png;bas= e64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAl= wSFlzAAAOxAAADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QT= d9hT5iVCBdFQjiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+= fmJMQa/34+UEikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBK= OQUVY2We59FsNrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8s= MBgMsy0JrPQGOFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM= 7OziiVSnieN4IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EE= KyurgKQz+fJZDJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFa= rUa328V6fX3FcZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/d= kMhmur6/Z2dnBdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8G= vIr8Avmi9N7u7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G= +vrzAQCaK2xLIt4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoR= CoWwpJRsb28TDocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT08= 5Pz9HKTVphgGM1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZp= QtITDagIAvNWqS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNpp= JT/2vNzOCqlqNfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAA= AElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt= ; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoA= AAANSUhEUgAAABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQ= BlSsOGwAAAztJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpC= shMtFl1sSPhFmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6= HQ6CCGIx+OkUikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzM= DIZheOkI13WllJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05= OTigUCrTb7dENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7= MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8= V/HWJaFlJJGo8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32G= wyF3d3cAKK1Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41= t2xweHqLrOv/U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIx= qNsrGxQa/Xo1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQ= OPj4yQSCT/Zo6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HG= xmL8/OEDruvyzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq= 1cIaO3yq5XG5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0= Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg= 3Q6zdraGplMxl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukF= AAAAAElFTkSuQmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" />Revista Anatom= =C3=ADa Digital <spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Ambato =E2= =80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) &#= xa0; Tels. 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(00593) 511262 y 0984058533<spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt"> = ; Tel. 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Para la misma<span= class=3D"awspan" style=3D"letter-spacing:0.35pt"> se </sp= an>consideraron los siguientes criterios de inclusi=C3=B3n: art=C3=ADculos cient= =C3=ADficos, con libre acceso,<s= pan class=3D"awspan" style=3D"letter-spacing:-0.25pt"> que aborden los<span= class=3D"awspan" style=3D"letter-spacing:-0.25pt"> cuidados de enfermer=C3=ADa</spa= n> en la prevenci=C3=B3n</sp= an> de infecciones nosocomiales asociadas a la ve= ntilaci=C3=B3n mec=C3=A1nica en<= span class=3D"awspan" style=3D"letter-spacing:-0.15pt"> ucis; publicados entre</spa= n> 2019 y 2024; en<= span class=3D"awspan" style=3D"letter-spacing:0.15pt"> idiomas espa=C3=B1ol, portugu= =C3=A9s </spa= n>e ingl=C3=A9s = y <spa= n class=3D"awspan">que las muestras</span= > pertenezcan a instituciones</= span> de salud de tercer nivel en Am=C3=A9rica Latina. </p= >Se= consider=C3=B3 el<spa= n class=3D"awspan" style=3D"letter-spacing:0.2pt"> empleo <= /span>como descriptores o <= span class=3D"awspan">palabras claves de</s= pan> las siguientes: neumon=C3=ADa= (Pneumoniae), infecci=C3=B3n hospitalari= a <spa= n class=3D"awspan">(Cross Infection), ven= tilaci=C3=B3n= mec=C3=A1nica (mechanical = ventilation),= cuidados de enfermer=C3=ADa (nursing care)<= span class=3D"awspan" style=3D"letter-spacing:0.05pt"> y= Unidades de Cuidados Intensivos (Intensive Care</spa= n> Units), como descriptores</span= > y = como texto e= n <span= class=3D"awspan">los campos de registro</s= pan> del t=C3=ADtulo y<span= class=3D"awspan" style=3D"letter-spacing:0.4pt"> el </span= >resumen, conformando la <s= pan class=3D"awspan">sintaxis de b=C3=BAsqu= eda <sp= an class=3D"awspan">final mediante los oper= adores booleanos de AND, OR, NOT.3.ResultadosLa b= =C3=BAsqueda </s= pan>inicial, en todas</s= pan> las = bases de datos,</= span> permiti=C3=B3 identificar 157</spa= n> registros. De ellos quedaron</s= pan> 146 para el<span= class=3D"awspan" style=3D"letter-spacing:-0.35pt"> proceso de selecci=C3=B3n,</span= > pues 11 registros= fueron identificados en m= =C3=A1s </sp= an>de una base</= span> de datos. De<sp= an class=3D"awspan" style=3D"letter-spacing:-0.15pt"> los= 146 registros disponibles en el proceso= de selecci=C3=B3n,<= span class=3D"awspan" style=3D"letter-spacing:-0.15pt"> 79 registros quedaron descart= ados, = al aplicar los</sp= an> siguientes filtros en</span= > el proceso de b=C3=BAsqueda:=EF= =83=98Art=C3=ADculos cient=C3=ADficos = =EF=83=98Publicados entre 2019 y 2024=EF=83=98Libre acceso </spa= n>=EF=83=98Idiomas: espa=C3=B1ol, portugu=C3=A9s e ingl=C3=A9s<= p class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt">Tras el descarte se </spa= n>procedi=C3=B3 a la <= span class=3D"awspan">lectura del t=C3=AD= tulo <= span class=3D"awspan">y resumen de= los 67 estudios restantes. Al tener en cuenta= el resto de <= span class=3D"awspan">los criterios de<= /span> <span= class=3D"awspan">inclusi=C3=B3n, se ex= cluyeron </s= pan>57 art=C3=ADculos por </= span>no desarrollarse en<spa= n class=3D"awspan" style=3D"letter-spacing:-0.1pt"> el </s= pan>=C3=A1rea de = Latinoam=C3=A9rica, por no abordar </= span>las pr=C3=A1cticas<span= class=3D"awspan" style=3D"letter-spacing:-0.1pt"> de </sp= an>enfermer=C3=ADa, por tratarse</s= pan> de revisiones sistem=C3=A1tic= as, <sp= an class=3D"awspan">por constituir estudios= puramente cl=C3=ADnicos o= por no mostrar resultados. Finalmente, se incluyeron= 10 estudios que = abordan la neumon= =C3=ADa </spa= n>asociada a la</s= pan> ventilaci=C3=B3n mec=C3=A1nica y<spa= n class=3D"awspan" style=3D"letter-spacing:-0.4pt"> refieren pr=C3=A1cticas cl=C3=ADni= cas <s= pan class=3D"awspan">de enfermer=C3=ADa = y <spa= n class=3D"awspan">organizativas dirigidas a <s= pan class=3D"awspan">garantizar la seguridad del <= span class=3D"awspan">paciente. La pertenen= cia <sp= an class=3D"awspan">de los estudios<= span class=3D"awspan" style=3D"letter-spacing:1.4pt"> seleccionados a las bases </span= >de datos en las</sp= an> que se realiz=C3=B3<spa= n class=3D"awspan" style=3D"letter-spacing:0.5pt"> la </spa= n>b=C3=BAsqueda fue la <s= pan class=3D"awspan">siguiente: Scielo (4</= span> estudios), LILACS (2 = <img src=3D"data:image/jpeg;base64,/9j/4AAQSkZJRgABAQEAYABgAAD/2wBDA= AUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8SEhEPERETFhwXExQaFRERGCEYGh0dHx8fExci= JCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4= eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAxoDASIAAhEBAxEB/8QAHAABAQACAwEBAAAAAA= AAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGCQMEAgMAAAECAwQFEQYSByExExQXQVFTVmGSl= OMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0haCsRg4Q2IkwWNzg//EABsBAQEBAQEBAQEAAAAAAAAA= AAABAgMEBQYH/8QANBEBAQACAgIABAIJAwQDAAAAAAECEQMSBFEFITFBE4EUIjI0YXGRsdGhwfA= GMzXhUlPx/9oADAMBAAIRAxEAPwDqXfGR5+77cnfGR5+77cuIf0nUfi91yzkX/P3fblO+L/n7vt= 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(00593) 511262 y 0984058533 = Tel. 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Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" st= yle=3D"text-decoration:none"></a><a href=3D"http://www.anatomiadigi= tal.org" style=3D"text-decoration:none">www.anatomiadigital.org</a> = <a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration= :none"></a><a href=3D"http://www.cienciadigitaleditorial.com" style= =3D"text-decoration:none">www.cienciadi= gitaleditorial.com</a><img src=3D"data:image/png;base64,iVBORw= 0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOx= AAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM= 3xfCue0huWAqFAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qe= npzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKR= aLFItFRkdHicViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk= 0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE= 43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbp= dEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n8= 3NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVA= LLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovP= Fvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSk= ECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/j= tse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIB= KZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJ= r1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd= 9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O1= 8z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcw= S6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqK= T0/sycXcKidnAAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"= margin-left:-1pt; position:absolute" /><img src=3D"data:image/png;bas= e64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAl= wSFlzAAAOxAAADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QT= d9hT5iVCBdFQjiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+= fmJMQa/34+UEikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBK= OQUVY2We59FsNrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8s= MBgMsy0JrPQGOFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM= 7OziiVSnieN4IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EE= KyurgKQz+fJZDJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFa= rUa328V6fX3FcZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/d= kMhmur6/Z2dnBdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8G= vIr8Avmi9N7u7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G= +vrzAQCaK2xLIt4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoR= CoWwpJRsb28TDocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT08= 5Pz9HKTVphgGM1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZp= QtITDagIAvNWqS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNpp= JT/2vNzOCqlqNfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAA= AElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt= ; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoA= AAANSUhEUgAAABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQ= BlSsOGwAAAztJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpC= shMtFl1sSPhFmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6= HQ6CCGIx+OkUikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzM= DIZheOkI13WllJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05= OTigUCrTb7dENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7= MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8= V/HWJaFlJJGo8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32G= wyF3d3cAKK1Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41= t2xweHqLrOv/U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIx= qNsrGxQa/Xo1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQ= OPj4yQSCT/Zo6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HG= xmL8/OEDruvyzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq= 1cIaO3yq5XG5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0= Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg= 3Q6zdraGplMxl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukF= AAAAAElFTkSuQmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" />Revista Anatom= =C3=ADa Digital <spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Ambato =E2= =80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) &#= xa0; Tels. 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(00593) 511262 y 098405= 8533 Tel. 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(00593= ) 511262 y 0984058533 </spa= n>Tel. = Directo (00593) 0998-235-485 = ; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decoratio= n:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"tex= t-decoration:none">www.anatomiadigital.= org</a>&#= xa0; <a href=3D"http://www= .cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><a= href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:n= one">www.cienciadigitaleditorial.com</s= pan></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABM= AAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJRE= FUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICj= UKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5i= miZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGE= YKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3v= D8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgz= kSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz= +H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A= 8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiY= QRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFK= kcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhb= n4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZn= JZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD= 2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRB= w8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kgh= aDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5Q= yMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR= 5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFT= kSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; pos= ition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANS= UhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsO= GwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mju= YGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhhP= i5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQK= NDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61W= o9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKhS= LRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJkc= feARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vql= XA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398J= BAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+Cw= LYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kEs= GKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEwt= TY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+6597= 6cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEol= wdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80G= g0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital</spa= n> = ; Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. 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Los pasos<span= class=3D"awspan" style=3D"letter-spacing:0.25pt"> realizados durante el proceso <= /span>de b=C3=BAsqueda y selecci=C3=B3n de los estudios se muestran en la <a href=3D"#= fig1" style=3D"text-decoration:none"></a><a href=3D"#fig1" style=3D"text-decoration= :none">figura 1</a>.<a id=3D"fig1"></a>Figura 1. <sp= an class=3D"awspan" style=3D"font-size:10pt; font-style:italic">Diagrama de= flujo para la selecci=C3=B3n de los estudiosEn</span= > la= <a href=3D"#tabla1" style=3D"text-decoration:none"></a><a href=3D"#tabla1" = style=3D"text-decoration:none">tabla </s= pan>1</a> por <= /span>su parte, se</= span> describen los estudios</span= > incluidos en la revisi=C3=B3n= sistem=C3=A1tica en cuanto a autores, a=C3= =B1o de publicaci=C3=B3n, t=C3=ADtulos y pa=C3=ADses de procedencia.= <a id=3D"tabla1"></a>Tabla 1. Estudios incluidos en la re= visi=C3=B3n sistem=C3=A1tica (2019-2024) No. <sp= an class=3D"awspan" style=3D"font-size:10pt">T=C3=ADtulo/Pa=C3=ADs</= p>&#= xa0;Autor/A= =C3=B1o Muestra Metodolog=C3=ADa Resultados1Infecciones nosocomiales en adulto mayor. Cuidados de Enfermer=C3=ADa. (Ecuador)Lam-Vivanco et al. (2021) (<a href=3D"#ref3" style=3D"text-= decoration:none"></a><a href=3D"#ref3" style=3D"text-decoration:non= e">3</a>)<spa= n class=3D"awspan" style=3D"font-size:10pt">Historias cl=C3=ADnicas de 25 adultos mayores<spa= n class=3D"awspan" style=3D"font-size:10pt">Cuantitativo. Descriptivo.</spa= n> = No experimental </sp= an>de tipo transver= salEl= </s= pan>16% de las infecciones nosocomiales lo constituyeron neumon=C3=ADas</s= pan>= asociadas al= </= span>ventilador mec=C3=A1ni= co. <img src=3D"data:image/jpeg;base64,/9j/4AAQSkZJRgABAQEAY= ABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8SEhEPERETFhwXExQaFRERGCEY= Gh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4eHh4eHh4eHh4eHh4eHh4eHh4= eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAxoDASIAAhEBAxEB/8QAHAABAQ= ACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGCQMEAgMAAAECAwQFEQYSByExE= xQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0haCsRg4Q2IkwWNzg//EABsBAQEBAQEB= AQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgIABAIJAwQDAAAAAAECEQMSBFEFITFBE4EUIjI= 0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPwDqXfGR5+77cnfGR5+77cuIf0nUfi91yzkX/P= 3fblO+L/n7vty4w1F3XJORf8/d9uU74yPP3fblhKGobrk74v8An7vtyd8ZHn7vty4w1Flrk74v+= fu+3KTkZHn7vtywSV1F3WffOR5+77cnfOR5+77cuMXUZ3XJ3zkefu+3K98ZHn7vty4hNRZaznJy= 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(00593) 511262 y 09840= 58533 Tel. 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(00593) 511= 262 y 0984058533 <sp= an class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Tel. 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(00593) 511262 y 0984058533 &#x= a0; Tel. 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Estudios incluidos en la revisi= =C3=B3n sistem=C3=A1tica (2019-2024) (continuaci=C3=B3n) </span= >No. </= span>T=C3=ADtulo/Pa= =C3=ADs Autor/A=C3=B1o Muestra Metodolog=C3=ADa = Resultados<s= pan class=3D"awspan" style=3D"font-size:10pt">A pesar de no estar prot= ocolizados, fueron realizados los = cuidados de enfer= mer=C3=ADa (cabec= ero elevado, preve= nci=C3=B3n de =C3= =BAlcera g=C3=A1s= trica, evaluaci=C3=B3n de la sedac= i=C3=B3n diaria,= terapia respirat= oria, aspiraci=C3=B3n endotraqueal y fijaci=C3=B3n del tubo endotraqueal).2Aplicaci=C3=B3n del bundle de = prevenci=C3=B3n d= e neumon=C3=ADas = en UCI pedi=C3=A1= trica. (Brasil)Vargas & Souza (2021) = 0; (<a href= =3D"#ref7" style=3D"text-decoration:none"></a><a href=3D"#ref7" st= yle=3D"text-decoration:none">7)</a>= 307 pacientes pedi=C3=A1tricos (28 d=C3=AD= as y 12 a=C3=B1os)Cuantitativo, descriptivo y cuasiexperimentalLa aplicaci=C3=B3n del bundle de prevenci=C3= =B3n (cabecero e= levado, prevenci=C3=B3n de =C3=BAl= cera g=C3=A1strica, higiene bucal, evaluaci=C3=B3n de la sedaci=C3= =B3n diaria) inci= de en<spa= n class=3D"awspan" style=3D"font-size:10pt; letter-spacing:19.85pt"> </span= >la disminuci=C3=B3n de la<= /span>incidencia</s= pan> de neumon=C3=ADas<= /span> y <span= class=3D"awspan" style=3D"font-size:10pt">en el tiempo medio de u= so del ventilador.3Efect= ividad de la hipe= rinsuflaci=C3=B3n manual como t=C3=A9cnica de fisioterapia respiratoria en neumon=C3=ADa nosocomial post ventilaci=C3=B3n mec=C3=A1nica</s= pan>= en pacientes= </sp= an>de 40 a 64 a=C3=B1os en =C3=A1rea de<= /span> UCI <sp= an class=3D"awspan" style=3D"font-size:10pt">del hospital Teodoro Maldonado= Heredia et = al. (2023) (<a href=3D"#ref8" style=3D"text-decoration:none"></a></p= ><a href=3D"#ref8" style=3D"text-decoration:none">8</a>)537 pacientes co= n diagn=C3=B3stico de neumon=C3=ADanosocomial u= sando t=C3=A9cnica de hiperinflaci=C3=B3n manual.Cuantitativo. No experimental. Descriptivo observacional <span= class=3D"awspan" style=3D"font-size:10pt">y transversal.<sp= an class=3D"awspan" style=3D"font-size:10pt">La t=C3=A9cnica de hiperinflaci=C3=B3n es 10% m=C3=A1s efectiva que el = drenaje y acorta l= a estanciahospitalaria.<img src=3D"data:image/jpeg;= base64,/9j/4AAQSkZJRgABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkM= EQ8SEhEPERETFhwXExQaFRERGCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBE= UHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCA= RjAxoDASIAAhEBAxEB/8QAHAABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDC= wgGCQMEAgMAAAECAwQFEQYSByExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0haC= sRg4Q2IkwWNzg//EABsBAQEBAQEBAQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgIABAIJAwQ= DAAAAAAECEQMSBFEFITFBE4EUIjI0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPwDqXfGR5+= 77cnfGR5+77cuIf0nUfi91yzkX/P3fblO+L/n7vty4w1F3XJORf8/d9uU74yPP3fblhKGobrk74= v8An7vtyd8ZHn7vty4w1Flrk74v+fu+3KTkZHn7vtywSV1F3WffOR5+77cnfOR5+77cuMXUZ3XJ= 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(00593) 511262 y 09840= 58533 Tel. 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(00593) 511= 262 y 0984058533 <sp= an class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Tel. 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(00593) 511262 y 0984058533 &#x= a0; Tel. 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Estudios incluidos en la revisi= =C3=B3n sistem=C3=A1tica (2019-2024) (continuaci=C3=B3n) </span= >No. </= span>T=C3=ADtulo/Pa= =C3=ADs Autor/A=C3=B1o Muestra Metodolog=C3=ADa = Resultados<s= pan class=3D"awspan" style=3D"font-size:10pt">Carbo IESS desde el a=C3=B1o 2020 a 202= 2. (Ecuador)= 4<sp= an class=3D"awspan" style=3D"font-size:10pt">Estrategias para disminuir infecciones en</span= >terapia intensiva = pedi=C3=A1trica polivalente. (Argentina)Fortini(2021) (<a href=3D"#ref9" style=3D"text-decoration:none"></a></p= ><a href=3D"#ref9" style=3D"text-decoration:none">9</a>)575 profesionales de la salud</s= pan> = (m=C3=A9dicos, enfer= meros, kinesi=C3=B3logos, radi=C3=B3logos, nutricionistas)<s= pan class=3D"awspan" style=3D"font-size:10pt">ni=C3=B1os con CVC,SV y/o en asiste= ncia respiratoria mec=C3=A1nica (ARM) (de 6</span= > <= /span>meses <spa= n class=3D"awspan" style=3D"font-size:10pt">a 16 a=C3=B1os) durante 2019Cuantitativo. Cuasiexperimental (antes-despu=C3=A9s= ) de intervenci=C3= =B3n con an=C3= =A1lisis de seriestemporales (prospectivo).Las estrategias destinadas a modificarpr=C3=A1cticas y cond= uctas en los</span= > </s= pan>profesionales de= </s= pan>la salud, junto a los procesos = de registros y m= onitoreo, aumentaron la efectividad en la prevenci= =C3=B3n de infec= ciones intrahospitalarias. Post intervenci=C3=B3n, se registra una disminuci=C3=B3n la ta= sa de neumon=C3= =ADas asociadas a= la ventilaci=C3= =B3n mec=C3=A1nica= y de<span= class=3D"awspan" style=3D"font-size:10pt; letter-spacing:0.65pt"> <= span class=3D"awspan" style=3D"font-size:10pt">la utilizaci=C3=B3n de los dispositivos, evitando prolongar su uso innecesario.<s= pan class=3D"awspan" style=3D"font-size:10pt">5Impacto de una intervenci=C3=B3n educativa dirigida al personal de enfermer=C3=ADa sobre sobre los cuidados de higieneoral en la i= ncidencia de neu= mon=C3=ADa asociada a ventiladoren adultos en S=C3=A1nchez et al. (2021) (= <a href=3D"#ref10" style=3D"text-decoration:none"></a><a h= ref=3D"#ref10" style=3D"text-decoration:none">10</a>) = profesionales de = enfermer=C3=ADa (= 40 enfermeros y<= /span> 20 auxiliares</s= pan> de enfermer=C3=ADa= ). Se tomaron</sp= an>= datos <s= pan class=3D"awspan" style=3D"font-size:10pt">de 171 pacientes.Cuantitativo. Cuasiexperimental pre</s= pan> <= /span>y posintervenci=C3=B3= neducativa.<= /span>Se redujo</s= pan> <= /span>la incidencia<= span class=3D"awspan" style=3D"font-size:10pt; letter-spacing:4.3pt"> </spa= n>de NAV en los adultos conectados a ventilador en UCI.<img src=3D"data:image/j= peg;base64,/9j/4AAQSkZJRgABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8L= CwkMEQ8SEhEPERETFhwXExQaFRERGCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4= eFBEUHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wA= ARCARjAxoDASIAAhEBAxEB/8QAHAABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDA= gIDCwgGCQMEAgMAAAECAwQFEQYSByExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy= 0haCsRg4Q2IkwWNzg//EABsBAQEBAQEBAQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgIABAI= JAwQDAAAAAAECEQMSBFEFITFBE4EUIjI0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPwDqXf= GR5+77cnfGR5+77cuIf0nUfi91yzkX/P3fblO+L/n7vty4w1F3XJORf8/d9uU74yPP3fblhKGob= rk74v8An7vtyd8ZHn7vty4w1Flrk74v+fu+3KTkZHn7vtywSV1F3WffOR5+77cnfOR5+77cuMXU= 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(00593) 511262 y 09840= 58533 Tel. 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(00593) 511= 262 y 0984058533 <sp= an class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Tel. 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(00593) 511262 y 0984058533 &#x= a0; Tel. 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wWi4WFCxei0+k4d+4cJ06cwOv1snjxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4= cM0Nzff1E5WVhbTp0/n4sWLNDcHC2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1Y= BhOK/67+/0b36rX/FXvXmzN47GY2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII= =3D" width=3D"77" height=3D"28" alt=3D"" style=3D"margin-left:441.05pt; pos= ition:absolute" />Tabla 1. Estudios incluidos en la revisi= =C3=B3n sistem=C3=A1tica (2019-2024) (continuaci=C3=B3n) </span= >No. </= span>T=C3=ADtulo/Pa= =C3=ADs Autor/A=C3=B1o Muestra Metodolog=C3=ADa = Resultados<s= pan class=3D"awspan" style=3D"font-size:10pt">Unidad de Cuidado Intensivo. (Colombia)6Conocimiento y pr=C3=A1cticas del profesional de enfermer=C3=ADa sobre prevenci=C3=B3n<span= class=3D"awspan" style=3D"font-size:10pt; letter-spacing:8.65pt"> <= span class=3D"awspan" style=3D"font-size:10pt">de neumon=C3=ADa asociada</s= pan> a ventilaci=C3=B3n= mec=C3=A1nica. (Ec= uador)Graniz= o et al.<= span class=3D"awspan" style=3D"font-size:10pt; letter-spacing:13.65pt"> </s= pan>(2020) (<a href= =3D"#ref17" style=3D"text-decoration:none"></a><a href=3D"#ref17" s= tyle=3D"text-decoration:none">17</a>)22 = enfermerosCu= antitativo. No ex= perimental descriptivo y transversal.Se ident= ific=C3=B3 un ad= ecuado conocimiento te=C3=B3rico y = desempe=C3=B1o pr=C3=A1ctico del p= ersonal deen= fermer=C3=ADa en<= /span> la atenci=C3=B3n<= /span> al paciente cr=C3=ADtico ventilado</= span>7<p= class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt; font-size:10pt= ">Neumon=C3=ADa asociada</s= pan>= a la ventilaci=C3=B3n mec=C3=A1nica<= /span> en la Unidad de cuidados intermedios. (<spa= n class=3D"awspan" style=3D"font-size:10pt">Cuba)Montielo et al. (2023) (<a href=3D"#ref18" style=3D"text-decorat= ion:none"></a><a href=3D"#ref18" style=3D"text-decoration:none"><sp= an class=3D"awspan" style=3D"font-size:10pt; text-decoration:underline">18)= </a>73</span= > </s= pan>pacientes <spa= n class=3D"awspan" style=3D"font-size:10pt">que desarrollaron <s= pan class=3D"awspan" style=3D"font-size:10pt">una neumon=C3=ADa<span= class=3D"awspan" style=3D"font-size:10pt; letter-spacing:1.3pt"> <s= pan class=3D"awspan" style=3D"font-size:10pt">asociada a la ventilaci=C3=B3n<s= pan class=3D"awspan" style=3D"font-size:10pt">mec=C3=A1nica.= Cuantitativo. <sp= an class=3D"awspan" style=3D"font-size:10pt">No experimantal.Observacional, descriptivo= , transversalLas neumon=C3= =ADas asociadas a= la ventilaci=C3= =B3n mec=C3=A1nica= fueron m=C3=A1s = frecuentes en pac= ientes masculinos = mayores de<= span class=3D"awspan" style=3D"font-size:10pt; letter-spacing:1.4pt"> </spa= n>60 a=C3=B1os. La mitad de los pacien= tes egresaron fal= lecidos 8</s= pan>Implementaci=C3= =B3n de medidas = preventivas de la= s Infecciones Asoc= iadas a<spa= n class=3D"awspan" style=3D"font-size:10pt; letter-spacing:3.6pt"> <= span class=3D"awspan" style=3D"font-size:10pt">la Atenci=C3=B3n<span= class=3D"awspan" style=3D"font-size:10pt; letter-spacing:16.4pt"> <= span class=3D"awspan" style=3D"font-size:10pt">de Salud (IAAS) en un departamento de cuidados intensivos. (<spa= n class=3D"awspan" style=3D"font-size:10pt">Paraguay)Ozuna et al. (2019) (<a href=3D"#ref19" style=3D"text-decorat= ion:none"></a><a href=3D"#ref19" style=3D"text-decoration:none"><sp= an class=3D"awspan" style=3D"font-size:10pt; text-decoration:underline">19<= /span></a>)Se revisaron 300 historias cl=C3=ADnicasde pacientes pedi=C3=A1tricos.Cuantitativo. No experimental. Descriptivo, observacional, r= etrospectivo de c= orte trasversal concomponente anal=C3=ADticoLas medidas implementadas (elevaci=C3=B3n del cabecero, higiene bucal, higiene de = las manos y= </sp= an>aspiraci=C3=B3n endotraq= ueal) contribuyeron a la disminuci= =C3=B3n de= </s= pan>la neumon=C3=ADa asocia= daal ventila= dor.9= Buenas pr=C3=A1ctic= as en <sp= an class=3D"awspan" style=3D"font-size:10pt">la prevenci=C3=B3n<span= class=3D"awspan" style=3D"font-size:10pt; letter-spacing:-0.55pt"> = de la neumon=C3=ADa asociada <s= pan class=3D"awspan" style=3D"font-size:10pt">a la ventilaci=C3=B3n mec=C3=A1nica.<sp= an class=3D"awspan" style=3D"font-family:Calibri; font-size:10pt"> (= Brasil)<spa= n class=3D"awspan" style=3D"font-size:10pt">Alecrim et al. (2019) (<a href=3D"#ref20" style=3D"text-decoration:none"></a><a h= ref=3D"#ref20" style=3D"text-decoration:none">20</a>)La r= ecolecci=C3=B3n de= datos 92 pac= ientes a trav=C3= =A9s de<sp= an class=3D"awspan" style=3D"font-size:10pt; letter-spacing:0.75pt"> </span= >consulta de archivos.Cuantitativo. No experimental, descriptivo<s= pan class=3D"awspan" style=3D"font-size:10pt; letter-spacing:22.9pt"> </spa= n>de cohorte prospectivo.</= span>A mayor</sp= an> = adhesi=C3=B3n= </s= pan>a las medidas de buenas pr=C3=A1cticas (elevaci=C3=B3n del cabecero, higiene bucal, evaluaci=C3=B3n de la sedaci=C3=B3n diaria y uso de tubos <img src=3D"data:image/jpeg;base= 64,/9j/4AAQSkZJRgABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8S= EhEPERETFhwXExQaFRERGCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4= eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAx= oDASIAAhEBAxEB/8QAHAABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGC= QMEAgMAAAECAwQFEQYSByExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0haCsRg4= Q2IkwWNzg//EABsBAQEBAQEBAQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgIABAIJAwQDAAA= AAAECEQMSBFEFITFBE4EUIjI0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPwDqXfGR5+77cn= fGR5+77cuIf0nUfi91yzkX/P3fblO+L/n7vty4w1F3XJORf8/d9uU74yPP3fblhKGobrk74v8An= 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(00593) 511262 y 0984058= 533 Tel. 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(00593) 511262 y 0984058533 &#x= a0; Tel. 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wWi4WFCxei0+k4d+4cJ06cwOv1snjxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4= cM0Nzff1E5WVhbTp0/n4sWLNDcHC2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1Y= BhOK/67+/0b36rX/FXvXmzN47GY2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII= =3D" width=3D"77" height=3D"28" alt=3D"" style=3D"margin-left:441.05pt; pos= ition:absolute" />Tabla 1. Estudios incluidos en la revisi= =C3=B3n sistem=C3=A1tica (2019-2024) (continuaci=C3=B3n) </span= >No. </= span>T=C3=ADtulo/Pa= =C3=ADs Autor/A=C3=B1o Muestra Metodolog=C3=ADa = Resultados<s= pan class=3D"awspan" style=3D"font-size:10pt">endotraqueales <span= class=3D"awspan" style=3D"font-size:10pt">con bal=C3=B3n manteniendo la adecuada insuflaci=C3=B3n del bal=C3=B3n), menor riesgo de Neumon=C3=ADa Asociada a la Ventilaci=C3=B3n Mec=C3=A1nica.10Buenas pr=C3=A1cticas de enfermer=C3=ADa a pacientes en ventilaci=C3=B3n mec=C3=A1nica invasiva<= span class=3D"awspan" style=3D"font-size:10pt; letter-spacing:19.75pt"> </s= pan>en emergencia hospitala= ria. (Brasil)</span= >dos <spa= n class=3D"awspan" style=3D"font-size:10pt">Santos et al. (2020) (<a href=3D"#ref21" style=3D"text-de= coration:none"></a><a href=3D"#ref21" style=3D"text-decoration:none= ">21</a>)<spa= n class=3D"awspan" style=3D"font-size:10pt">16 enfermeros de la emergencia general de un= = hospital<spa= n class=3D"awspan" style=3D"font-size:10pt; letter-spacing:2pt"> <sp= an class=3D"awspan" style=3D"font-size:10pt">de la regi=C3=B3n Sur de Brasil.<sp= an class=3D"awspan" style=3D"font-size:10pt">Estudio cualitativo y descriptivo.<= span class=3D"awspan" style=3D"font-size:10pt">Los enfermeros consideraron como buenas pr=C3=A1cticas, para pacientes con ventilaci=C3=B3n mec=C3=A1nica invasiva, 13 cuidados, relacionados<span= class=3D"awspan" style=3D"font-size:10pt; letter-spacing:4.3pt"> <s= pan class=3D"awspan" style=3D"font-size:10pt">con el tubo endotraqueal, el ventilador y circuito, la pre= venci=C3=B3n de</= span> la broncoaspiraci= =C3=B3n, el contro= l de<span= class=3D"awspan" style=3D"font-size:10pt; letter-spacing:-0.55pt"> = infecci=C3=B3n <= span class=3D"awspan" style=3D"font-size:10pt">y la sedaci=C3=B3n, la analgesia/el sue=C3=B1o, la vigilia/dolor.3.1. Caracter=C3=ADsticas generales de los estudios<= /span><s= pan class=3D"awspan">De los 10<s= pan class=3D"awspan" style=3D"letter-spacing:-0.55pt"> estudios incluidos, los</sp= an> pa=C3=ADses con mayor</s= pan> representaci=C3=B3n fueron Brasil <= /span>y Ecuador con 3 <sp= an class=3D"awspan">estudios cada uno.</spa= n> Argentina, Cuba, Colombia</span= > y = Paraguay tambi=C3=A9n</span= > estuvieron representados. Respecto<span= class=3D"awspan" style=3D"letter-spacing:0.75pt"> a </spa= n>las muestras, = se <sp= an class=3D"awspan">trabaj=C3=B3 con mues= tras <= span class=3D"awspan">pedi=C3=A1tricas (<a href= =3D"#ref7" style=3D"text-decoration:none"></a><a href=3D"#ref7" style=3D"text-deco= ration:none">7</= span></a>, </s= pan><a href=3D"#ref9" style=3D"text-decoration:none"></a><a href=3D"#ref9" style=3D= "text-decoration:none">9</a><span= class=3D"awspan">, <a href=3D"#ref20" style=3D"text-decoration:none"></a><a href=3D"#ref= 20" style=3D"text-decoration:none">20</a>) y adultas. Dos <= span class=3D"awspan">estudios (<a href=3D"#ref18" s= tyle=3D"text-decoration:none"></a><a href=3D"#ref18" style=3D"text-decoration:none"= >18</a></= p>,</= span> <a href= =3D"#ref22" style=3D"text-decoration:none"></a><a href=3D"#ref22" style=3D"text-dec= oration:none">22= </a>) = indagaron sobre las </span= >buenas pr=C3=A1cticas en <= span class=3D"awspan">la prevenci=C3=B3n NAVM a trav=C3=A9s</sp= an> la percepci=C3=B3n y= el conocimiento del<sp= an class=3D"awspan" style=3D"letter-spacing:-0.3pt"> personal de enfermer=C3=ADa</span= > y= se present=C3=B3 un<= span class=3D"awspan" style=3D"letter-spacing:-0.15pt"> estudio (<a href=3D"#ref10" style=3D"t= ext-decoration:none"></a><a href=3D"#ref10" style=3D"text-decoration:none">10</a>)<spa= n class=3D"awspan" style=3D"letter-spacing:-0.15pt"> en <= /span>el cual el= <spa= n class=3D"awspan">conocimiento mostrado por </span= >los enfermeros y <s= pan class=3D"awspan">la evoluci=C3=B3n de los </spa= n>pacientes permitieron<span= class=3D"awspan" style=3D"letter-spacing:0.35pt"> constatar la efectividad<spa= n class=3D"awspan" style=3D"letter-spacing:0.35pt"> de </s= pan>una intervenci=C3=B3n<sp= an class=3D"awspan" style=3D"letter-spacing:0.35pt"> educativa dirigida al personal</s= pan> de enfermer=C3=ADa. Dicha<= /span> intervenci=C3=B3n se cen= tr=C3=B3 </sp= an>en la incidenci= a <spa= n class=3D"awspan">de los cuidados de hig= iene oral en la prevenci=C3=B3n de NAVM.El </= span>tama=C3=B1o de las </s= pan>muestras fue variable. <= /span>Los estudios cuyas </s= pan>muestras estaban constituidas por profesionales de</spa= n> la= salud, esencialmente<= span class=3D"awspan" style=3D"letter-spacing:0.2pt"> enfermeros, utilizaron tama=C3=B1o= s <span= class=3D"awspan">de muestras variables que van desde 16 ha= sta 575 profesionales. En los estudios dirigidos a pacientes pedi=C3=A1tric= os <sp= an class=3D"awspan">el tama=C3=B1o de</sp= an> las muestras fue<spa= n class=3D"awspan" style=3D"letter-spacing:-0.2pt"> m=C3=A1s homog=C3=A9neo, con</span= > valores de 300 a = 307. Los estudios cen= trados <s= pan class=3D"awspan">en pacientes adultos,</spa= n> por = su parte, mostrar= on los valores muestrales que var= iaron desde 25 hasta 537 pacientes. <img src=3D"data:image/jp= eg;base64,/9j/4AAQSkZJRgABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LC= wkMEQ8SEhEPERETFhwXExQaFRERGCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4e= FBEUHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAA= RCARjAxoDASIAAhEBAxEB/8QAHAABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAg= IDCwgGCQMEAgMAAAECAwQFEQYSByExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0= haCsRg4Q2IkwWNzg//EABsBAQEBAQEBAQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgIABAIJ= AwQDAAAAAAECEQMSBFEFITFBE4EUIjI0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPwDqXfG= R5+77cnfGR5+77cuIf0nUfi91yzkX/P3fblO+L/n7vty4w1F3XJORf8/d9uU74yPP3fblhKGobr= k74v8An7vtyd8ZHn7vty4w1Flrk74v+fu+3KTkZHn7vtywSV1F3WffOR5+77cnfOR5+77cuMXUZ= 3XJ3zkefu+3K98ZHn7vty4hNRZaznJyPP3fbk75yPP3fblxz2hqFtcnfOR5+77cnfOR5+77cuMN= 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(00593) 511262 y 09840= 58533 Tel. 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(00593) 511= 262 y 0984058533 <sp= an class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Tel. 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(00593) 511262 y 0984058533 &#x= a0; Tel. 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dXV03dN5oNBIREYHD4QgRmC6Xi+TkZBRF4dKlS6H8eyMJDw8nLS2Nzs5Ompub0ev1IZqpr6/vJp= oCKbiy5YBgY/nBu++x6sFV5ORMYEhsHIcOHOJ4xXFOnvwavd6AXq9H07TgAkKQmmpjyQ+Xckv2O= ExGI9u3lXLwOoABxMXF8corr1BfX09vby9VVVVMmjQp9Hh/8803OXHixA3dHjNmDKtWreKtt94i= Ozubnp4ePB4Pd999N36/n927d7Nr165Qz3g9KS4uxu/3o6oqW7ZswWQysXr1al566SVOnDhx3R5= ysFwDmuYPUHP2LP/98susWLGCsWPH8pMlP2HOvDk0NjTSdOkidrsdnaLDZrMxLNVGSnIK4eZwXK= 5e/ra5hH2f7MPnvf6JBWlyK8ePHycrK4uamhqKiop49dVXkVJSXV19U4fNZjNjxoxh+fLlOJ1OW= lpamDBhAps2baKtrY2IiAh0Ot1NbUyfPp2dO3dy+vRpuru7mTlzJhaLhby8PKqrq783Uq8BrR+4= pvoLvLjhJebcNoeC2QXExccyJCmByUou/VSJpmlogQDuXhdHv/qKXWW7qK2tveJhfrVIKVFVlai= oKBITEzEYDPz+97/niy++YNy4cVewHdcTIQRHjhwhIyODsLAw9u7dS2RkJK2trXR1deH3+2+6vq= IoFBcXk5+fz8qVK9m3bx/Jyck0NTVRVFRESUnJDUEL0vc3AC04A9zOXnb9fSdHPv+SMWPHMmLkC= GJiYggzGdECAXp6nDRfvMSpU6c4V1t30yvRL5qm0d3dTWtr6+UHPdTW1nLp0iXq6+tDdNGNxOfz= 0dnZycaNG1m7di0Oh4ODBw+ybNky/H4/TU1NvPvuuzf0RVVVli1bxq5duwgEAowaNYq+vj5qa2t= JTU0lMzOTL7/88sawSImorq6WWVlZ37tZIQSKomAwGEKNrMfjwe/3f28OGCwWi4WFCxei0+k4d+= 4cJ06cwOv1snjxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1E5WVhbTp= 0/n4sWLNDcHC2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+/0b36rX/= FXvXmzN47GY2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" width=3D"77= " height=3D"28" alt=3D"" style=3D"margin-left:441.05pt; position:absolute" = />Se observa una = prevalencia de est= udios = cuantitativos, con dise=C3=B1os= no experimentales<sp= an class=3D"awspan" style=3D"letter-spacing:1.05pt"> y fines descriptivos, 6<span= class=3D"awspan" style=3D"letter-spacing:3.8pt"> de </span= >los 10 estudios</sp= an> incluidos. Tres estudios</span= > tuvieron dise=C3=B1os cuasiexperimentales</span= > (<a href=3D"#ref7" style=3D"text-decoration:none"></a></= p><a href=3D= "#ref7" style=3D"text-decoration:none">7</a>, <a href=3D"#ref9" style=3D"text-decoration:non= e"></a><= a href=3D"#ref9" style=3D"text-decoration:none">9</a>, <a href=3D"#ref10" style=3D"text-deco= ration:none"></a><a href=3D"#ref10" style=3D"text-decoration:none">10</a>) y= s=C3=B3lo uno respondi=C3= =B3 <sp= an class=3D"awspan">al enfoque cualitativo<= /span> de investigaci=C3=B3n (<a href=3D"#ref22" style=3D"t= ext-decoration:none"></a><a href=3D"#ref22" style=3D"text-decoration:none">22</a>).</p= >3.2. Buenas pr=C3=A1cticas para prevenir las neumon=C3=ADas asociadas a la ventilaci=C3=B3n mec=C3=A1nica en hospitales de tercer nivel en A= m=C3=A9rica LatinaLa lectura<s= pan class=3D"awspan" style=3D"letter-spacing:2.6pt"> cr=C3=ADtica de los estudios </s= pan>seleccionados permiti=C3=B3</spa= n> identificar las pr=C3=A1cticas<= /span> de enfermer=C3=ADa mayormente concebidas en la = prevenci=C3=B3n de infecciones<spa= n class=3D"awspan" style=3D"letter-spacing:1.55pt"> nosocomiales, en pacientes con</spa= n> ventilaci=C3=B3n mec=C3=A1nica, en <sp= an class=3D"awspan">ucis de hospitales</spa= n> de= tercer nivel de <sp= an class=3D"awspan">Am=C3=A9rica Latina. En la = <a href=3D"#tabla2" style=3D"text-decoration:none"></a><a href=3D"#tabla2" style=3D= "text-decoration:none">tabla <span= class=3D"awspan" style=3D"font-weight:bold; text-decoration:underline">2</= span></a> se <s= pan class=3D"awspan">exponen las pr=C3=A1= cticas </span= >identificadas, en orden </sp= an>de prevalencia, y los estudios que las tuvieron en consideraci=C3=B3n.<a i= d=3D"tabla2"></a>Tabla 2. Evidencia <sp= an class=3D"awspan" style=3D"font-size:10pt; font-style:italic">Cient=C3=AD= fica de las <= span class=3D"awspan" style=3D"font-size:10pt; font-style:italic">buenas</s= pan> pr=C3=A1cticas en </sp= an>la</s= pan> prevenci=C3=B3n de </s= pan>la</= span> neumon=C3=ADa asociada a la ventilaci=C3=B3n mec=C3=A1nica<spa= n class=3D"awspan" style=3D"font-size:10pt">Buenas pr=C3=A1cticas</p= >Estudios <p= class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt; font-size:10pt= ">1Elevar el cabecero de la cama </span= >1, 2,3,5,7,8,9,10<= /span>2<= p class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt; font-size:10p= t">Higiene bucal regular co= n clorhexidina 1,2, 4,5,8,9,103Evalu= aci=C3=B3n de la sedaci=C3=B3n diaria1,2,3,9,104Higiene de las manos1,2,5,8,105Prevenci=C3=B3n de =C3=BAlcera g=C3=A1strica1,2,3,7 6Realizaci=C3=B3n correcta de la aspiraci=C3=B3n= endotraqueal5,7,8,107</= span>Uso de tubos e= ndotraqueales manteniendo laadecuada insuflaci=C3=B3n del bal=C3=B3n <sp= an class=3D"awspan" style=3D"font-size:10pt">2,5,9,108Control constante de par=C3=A1metros del vent= ilador mec=C3=A1nico3,5,109No trasla= dos innecesarios2,710</s= pan>No vol=C3=BAmen= es g=C3=A1stricos excesivos2,511Fija= ci=C3=B3n de tubo endotraqueal3,1012Uso de terapia respiratoria3,613Ca= mbios de circuito del ventilador5,10La elevaci= =C3=B3n </spa= n>del cabecero de<= /span> la cama y la = higiene bucal con<= /span> clorhexidina figuran com= o las = pr=C3=A1cticas de = enfermer=C3=ADa mejor valoradas<= span class=3D"awspan" style=3D"letter-spacing:6.25pt"> en la prevenci=C3=B3n<= span class=3D"awspan" style=3D"letter-spacing:6.25pt"> de infecciones nosocomiales. = Se <sp= an class=3D"awspan">observa un consenso</= span> en que la elevaci=C3=B3n adecuada del<spa= n class=3D"awspan" style=3D"letter-spacing:0.55pt"> cabecero de la cama, para estos pa= cientes, debe ser entre 30 y 45o. En<= span class=3D"awspan" style=3D"letter-spacing:0.5pt"> cuanto al uso de</= span> la clor= hexidina </spa= n>para el mantenimie= nto <sp= an class=3D"awspan">de la higiene<sp= an class=3D"awspan" style=3D"letter-spacing:0.5pt"> bucal, = s=C3=B3lo dos observaciones<= /span> relacionadas con los= niveles de clorhexidina</span= > a = utilizar y = la <spa= n class=3D"awspan">frecuencia de uso. La</spa= n> mayor=C3=ADa de los e= studios <= span class=3D"awspan">que tienen en<span= class=3D"awspan" style=3D"letter-spacing:2pt"> consideraci=C3=B3n esta pr=C3=A1ctica= (<a href=3D"#ref8" style=3D"text-decoration:none"></a><p= class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt"><a href=3D"#re= f8" style=3D"text-decoration:none">8</a>, <a href=3D"#ref9" style=3D"text-decoration:none"></a= ><a href= =3D"#ref9" style=3D"text-decoration:none">9,</a> </= span><a href=3D"#ref22" style=3D"text-decoration:none"></a><a href=3D"#ref22" style= =3D"text-decoration:none">22</a><= span class=3D"awspan">) sugieren el uso</= span> del 0.12 %, (<a href=3D"#ref10" style=3D"text-decoration:none"></a><a href=3D"#ref10= " style=3D"text-decoration:none">10</a>, <a href=3D"#ref18" style=3D"text-decoration:none">= </a><a h= ref=3D"#ref18" style=3D"text-decoration:none">18</a>) ofrecen</span= > un rango de = 0.12% = a 0.2%, mientras</= span> que (<a href=3D"#ref7" style=3D"tex= t-decoration:none"></a><a href=3D"#ref7" style=3D"text-decoration:none">7</a>) y (<a href=3D"#ref20" style=3D"text-decoration:none"></a><a href=3D"#ref= 20" style=3D"text-decoration:none">20</a>) no esp= ecifican </s= pan>los niveles a <s= pan class=3D"awspan">usar. Por su</span= > parte s=C3=B3lo (<a= href=3D"#ref21" style=3D"text-decoration:none"></a><a href=3D"#ref21" style=3D"tex= t-decoration:none">21</a>) ofrece recomendaciones de frecuencia de</sp= an> higiene bucal con clorhexidina, en este c= aso <sp= an class=3D"awspan">recomienda tres frecuen= cias diarias.<img src=3D"data:image/jpeg;base64,/9j/4AAQSkZJR= gABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8SEhEPERETFhwXExQa= FRERGCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4eHh4eHh4eHh4eHh4= eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAxoDASIAAhEBAxEB/8= QAHAABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGCQMEAgMAAAECAwQFE= QYSByExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0haCsRg4Q2IkwWNzg//EABsB= AQEBAQEBAQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgIABAIJAwQDAAAAAAECEQMSBFEFITF= BE4EUIjI0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPwDqXfGR5+77cnfGR5+77cuIf0nUfi= 91yzkX/P3fblO+L/n7vty4w1F3XJORf8/d9uU74yPP3fblhKGobrk74v8An7vtyd8ZHn7vty4w1= 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(00593) 511262 y 0984058533</spa= n> = ; Tel. 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(00593) 511262 y 098= 4058533 Tel. 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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= MAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJR= EFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReIC= jUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5= imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoG= EYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3= vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPg= zkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7N= z+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/= A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomi= YQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMF= KkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUh= bn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZ= nJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsU= D2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iR= Bw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kg= haDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5= QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvhe= R5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElF= TkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; po= sition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAAN= SUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSs= OGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mj= uYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhh= Pi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQ= KNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61= Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKh= SLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJk= cfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vq= lXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398= JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+C= wLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kE= sGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEw= tTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+659= 76cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEo= lwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80= Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital</spa= n> = ; Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. (00593) 511262 y 0984058533 &#x= a0; Tel. Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-= decoration:none"></a><a href=3D"http://www.anatomiadigital.org" sty= le=3D"text-decoration:none">www.anatomi= adigital.org</a> <a href=3D"h= ttp://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= /p><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-dec= oration:none">www.cienciadigitaleditori= al.com</a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSU= hEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOG= wAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAq= FAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgB= DQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHic= ViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEg= QqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDab= rKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwx= Dcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4O= HMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1y= eVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185Oemy= uLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpB= MJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJ= SSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5= nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2i= x3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3Pj= mBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPH= nyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW= 1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidn= AAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0K= GgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAA= ADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQ= jiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UE= ikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59Fs= Nrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQG= OFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4= IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZ= DJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3F= cZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dn= BdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u= 7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xL= It4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28T= DocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgG= M1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNW= qS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlq= NfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC= " width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:a= bsolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAA= ABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAzt= JREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhF= mVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkU= ikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13Wl= lJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dE= NQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/= 2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo= 8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1W= i2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/= U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1= KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo= 6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvy= zrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5= UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7+= +/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMx= l8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSu= QmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; positi= on:absolute" />Revista Anatom=C3=ADa</span= > Digital<= /span>&= #xa0; Ambato =E2=80=93 Ecuador (J= ard=C3=ADn Ambate=C3=B1o) = = Tels. (00593) 511262 y 0984058533 = Tel. 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/88sawSImorq6WWVlZ37tZIQSKomAwGEKNrMfjwe/3f28OGCwWi4WFCxei0+k4d+4cJ06cwOv1s= njxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1E5WVhbTp0/n4sWLNDcH= C2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+/0b36rX/FXvXmzN47GY= 2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" width=3D"77" height=3D= "28" alt=3D"" style=3D"margin-left:441.05pt; position:absolute" /><s= pan class=3D"awspan">La higiene de= las manos constituye= una medida clave,<spa= n class=3D"awspan" style=3D"letter-spacing:0.55pt"> del </= span>personal de = enfermer=C3=ADa, en la prevenci=C3=B3n</s= pan> de NAVM. Es una </span= >pr=C3=A1ctica tenida en </span= >consideraci=C3=B3n en el </spa= n>50% de los</span= > estudios. Significar que (</spa= n><a href=3D"#ref7" style=3D"text-decoration:none"></a><a href=3D"#ref7" style=3D"t= ext-decoration:none">7</a>, <a href=3D"#ref9" style=3D"text-decoration:none"></a><a href=3D"#ref9" s= tyle=3D"text-decoration:none">9</a>) especifican que<= /span> debe realizarse en<s= pan class=3D"awspan" style=3D"letter-spacing:0.3pt"> cinco = momentos protocolizados: an= tes <s= pan class=3D"awspan">del contacto con</sp= an> el paciente, antes<s= pan class=3D"awspan" style=3D"letter-spacing:0.55pt"> de <= /span>realizar tarea as=C3=A9ptica, despu=C3=A9s del= contacto con fluidos corporales= , <span= class=3D"awspan">despu=C3=A9s del contacto= con el paciente<sp= an class=3D"awspan" style=3D"letter-spacing:0.5pt"> y </spa= n>despu=C3=A9s del c= ontacto </span= >con el entorno.La<spa= n class=3D"awspan" style=3D"letter-spacing:0.85pt"> realizaci=C3=B3n correcta de</span= > la aspiraci=C3=B3n endotraque= al <sp= an class=3D"awspan">y el uso de </spa= n>tubos endotraqueales, con<= span class=3D"awspan" style=3D"letter-spacing:1.2pt"> una <= /span>adecuada insuflaci=C3=B3n</spa= n> del bal=C3=B3n, constituyen</sp= an> otras pr=C3=A1cticas de= enfermer=C3=ADa que destacan e= n <span= class=3D"awspan">la prevenci=C3=B3n de</sp= an> infecciones nosocomiales. En</= span> relaci=C3=B3n con ellas,</sp= an> s=C3=B3lo hay que destacar</= span> que, como adecuada</sp= an> insuflaci=C3=B3n,= (<a href=3D"#ref9" style=3D"text-decoration:none"></a></= p><a href=3D= "#ref9" style=3D"text-decoration:none">9</a>) considera<span= class=3D"awspan" style=3D"letter-spacing:-0.75pt"> una <= /span>presi=C3=B3n de 20 </s= pan>a 25 cmH</sp= an>2O mientras (<a href=3D"#ref18" style=3D"text-decoration:none">= </a><a h= ref=3D"#ref18" style=3D"text-decoration:none">18</a>, <a href=3D"#ref21" styl= e=3D"text-decoration:none"></a><a href=3D"#ref21" style=3D"text-decoration:none"><s= pan class=3D"awspan" style=3D"text-decoration:underline">21</a><= p style=3D"margin-right:1pt; margin-left:1pt">, </sp= an><a href=3D"#ref22" style=3D"text-decoration:none"></a><a href=3D"#ref22" style= =3D"text-decoration:none">22</a><= span class=3D"awspan">) asumen una presi=C3=B3n de hasta 30 cmH<span= class=3D"awspan" style=3D"font-size:8pt">2O.= <= span class=3D"awspan">Mantener un control= <span= class=3D"awspan">constante de los= par=C3=A1metros del ventilado= r, <sp= an class=3D"awspan">la fijaci=C3=B3n del<= /span> tubo endotraqueal y los</s= pan> cambios de circuito<sp= an class=3D"awspan" style=3D"letter-spacing:3.3pt"> del </s= pan>ventilador son p= r=C3=A1cticas = de enfermer=C3=ADa concebidas= <span= class=3D"awspan">en algunos estudios</sp= an> (<a href=3D"#ref3" style=3D"text-decoration:none"></a>= <a href= =3D"#ref3" style=3D"text-decoration:none">3</a>, <a href=3D"#ref18" style=3D"text-decorat= ion:none"></a><a href=3D"#ref18" style=3D"text-decoration:none">18</a>, <a href=3D"#ref22" style=3D= "text-decoration:none"></a><a href=3D"#ref22" style=3D"text-decoration:none">22</a>).<= span class=3D"awspan" style=3D"letter-spacing:0.45pt"> De igual manera otros </s= pan>autores (<a href=3D"#ref= 8" style=3D"text-decoration:none"></a><a href=3D"#ref8" style=3D"text-decoration:no= ne">8</a>= ,= <a hr= ef=3D"#ref9" style=3D"text-decoration:none"></a><a href=3D"#ref9" style=3D"text-dec= oration:none">9,= </a> <a href=3D"#ref18"= style=3D"text-decoration:none"></a><a href=3D"#ref18" style=3D"text-decoration:non= e">18</a>= ,= <a hr= ef=3D"#ref19" style=3D"text-decoration:none"></a><a href=3D"#ref19" style=3D"text-d= ecoration:none">= 19</a>) consideran importante evitar<= /span> los traslados innecesarios,= los vol=C3=BAmenes g=C3=A1= stricos excesivos y realizar terapia respiratoria. La= <spa= n class=3D"awspan">efectividad de las</= span> intervenciones descritas (<a href=3D"#ref9" style=3D"text-decoration:none"></a><a href=3D"#ref9" s= tyle=3D"text-decoration:none">9</a>, <a href=3D"#ref10" style=3D"text-decoration:none"></a= ><a href= =3D"#ref10" style=3D"text-decoration:none">10</a>, <a href=3D"#ref21" style=3D"text-decora= tion:none"></a><a href=3D"#ref21" style=3D"text-decoration:none">21)</a> constatan que = a mayor adhesi= =C3=B3n, de = los profesionales<sp= an class=3D"awspan" style=3D"letter-spacing:-0.75pt"> de = enfermer=C3=ADa, a<s= pan class=3D"awspan" style=3D"letter-spacing:-0.75pt"> las buenas pr=C3=A1cticas</= span> de prevenci=C3=B3n men= or <s= pan class=3D"awspan">es el riesgo de NA= VM. Desde la perc= epci=C3=B3n = de los pr= ofesionales = de enfermer=C3=ADa<s= pan class=3D"awspan" style=3D"letter-spacing:-0.65pt"> sobre el deber<spa= n class=3D"awspan" style=3D"letter-spacing:-0.65pt"> ser = en la pre= venci=C3=B3n de NAVM, hay que destacar el estudio realizado por (<a = href=3D"#ref22" style=3D"text-decoration:none"></a><a href=3D"#ref22" style=3D"text= -decoration:none">22</a>), con el prop=C3=B3sito de identificar los cuidados </= span>concebidos como<span= class=3D"awspan" style=3D"letter-spacing:-0.25pt"> buenas pr=C3=A1cticas. En= este caso, se consideraron un total<spa= n class=3D"awspan" style=3D"letter-spacing:-0.25pt"> de 13 </= span>cuidados como bue= nas <span= class=3D"awspan">pr=C3=A1cticas, en pacientes<= /span> con ventilaci=C3=B3n mec=C3=A1nic= a invasiva. Constan, entre e= llas, <= span class=3D"awspan">pr=C3=A1cticas relacionadas<sp= an class=3D"awspan" style=3D"letter-spacing:0.2pt"> con </s= pan>el tubo endotraq= ueal, <= span class=3D"awspan">con el ventilador</sp= an> y circuito, con la<sp= an class=3D"awspan" style=3D"letter-spacing:0.25pt"> prevenci=C3=B3n de la<span= class=3D"awspan" style=3D"letter-spacing:0.25pt"> broncoaspiraci=C3=B3n, el control</= span> de infecci=C3=B3n y</span= > la sedaci=C3=B3n, la analgesia/el sue=C3=B1o, = la vigilia/dolor.De manera<spa= n class=3D"awspan" style=3D"letter-spacing:1.7pt"> general,= todos los e= studios </span= >consideran modificables<span= class=3D"awspan" style=3D"letter-spacing:1.7pt"> los </spa= n>factores de riesgo= externos </sp= an>que originan NAVM= y, lo m=C3=A1s<sp= an class=3D"awspan" style=3D"letter-spacing:2.4pt"> importante, prevenibles desde= la= puesta en pr=C3=A1ctica</spa= n> de= protocolos de atenci=C3=B3n espec=C3=ADficos. La= educaci=C3=B3n del personal</sp= an> de enfermer=C3=ADa, en cuant= o <sp= an class=3D"awspan">a la adherencia</sp= an> a buenas pr=C3=A1cticas,= <spa= n class=3D"awspan">y la vigilancia</spa= n> epidemiol=C3=B3gica constituyeron ejes cent= rales en la prevenci=C3=B3n de NAV. 4.Discusi=C3=B3n En<s= pan class=3D"awspan" style=3D"letter-spacing:0.95pt"> los = estudios con muestras = de pacientes pedi=C3=A1tricos <a href=3D"#ref7" style=3D"text-decoration:none"></a><a href=3D"#ref7"= style=3D"text-decoration:none">(7</a>, <a href=3D"#ref9" style=3D"text-decoration:none"></= a><a hre= f=3D"#ref9" style=3D"text-decoration:none">9</a>, <a href=3D"#ref20" style=3D"text-decorat= ion:none"></a><a href=3D"#ref20" style=3D"text-decoration:none">20</a>) la</= span> implementaci=C3=B3n del paquete<spa= n class=3D"awspan" style=3D"letter-spacing:1.6pt"> de </spa= n>medidas incidi=C3=B3 en <= span class=3D"awspan">el descenso significa= tivo <s= pan class=3D"awspan">del n=C3=BAmero de</sp= an> pacientes que desarrollaron = NAVM <= span class=3D"awspan">y en el<span= class=3D"awspan" style=3D"letter-spacing:0.55pt"> tiempo = de hospitalizaci=C3=B3n.</sp= an> En el estudio de </span= >(<a href=3D"#ref7" style=3D"text-decoration:= none"></a><a href=3D"#ref7" style=3D"text-decoration:none">7</a>)<= span class=3D"awspan" style=3D"letter-spacing:0.55pt"> se reporta, <img src=3D"data:ima= ge/jpeg;base64,/9j/4AAQSkZJRgABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcH= Bw8LCwkMEQ8SEhEPERETFhwXExQaFRERGCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4= ICA4eFBEUHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh= 7/wAARCARjAxoDASIAAhEBAxEB/8QAHAABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABA= AEDAgIDCwgGCQMEAgMAAAECAwQFEQYSByExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJy= dKGy0haCsRg4Q2IkwWNzg//EABsBAQEBAQEBAQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgI= ABAIJAwQDAAAAAAECEQMSBFEFITFBE4EUIjI0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPw= 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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= MAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJR= EFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReIC= jUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5= imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoG= EYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3= vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPg= zkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7N= z+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/= A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomi= YQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMF= KkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUh= bn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZ= nJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsU= D2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iR= Bw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kg= haDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5= QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvhe= R5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElF= TkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; po= sition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAAN= SUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSs= OGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mj= uYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhh= Pi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQ= KNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61= Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKh= SLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJk= cfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vq= lXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398= JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+C= wLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kE= sGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEw= tTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+659= 76cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEo= lwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80= Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital</spa= n> = ; Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. (00593) 511262 y 0984058533 &#x= a0; Tel. 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Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" st= yle=3D"text-decoration:none"></a><a href=3D"http://www.anatomiadigi= tal.org" style=3D"text-decoration:none">www.anatomiadigital.org</a> = <a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration= :none"></a><a href=3D"http://www.cienciadigitaleditorial.com" style= =3D"text-decoration:none">www.cienciadi= gitaleditorial.com</a><img src=3D"data:image/png;base64,iVBORw= 0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOx= AAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM= 3xfCue0huWAqFAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qe= npzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKR= aLFItFRkdHicViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk= 0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE= 43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbp= dEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n8= 3NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVA= LLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovP= Fvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSk= ECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/j= tse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIB= KZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJ= r1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd= 9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O1= 8z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcw= S6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqK= T0/sycXcKidnAAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"= margin-left:-1pt; position:absolute" /><img src=3D"data:image/png;bas= e64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAl= wSFlzAAAOxAAADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QT= d9hT5iVCBdFQjiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+= fmJMQa/34+UEikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBK= OQUVY2We59FsNrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8s= MBgMsy0JrPQGOFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM= 7OziiVSnieN4IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EE= KyurgKQz+fJZDJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFa= rUa328V6fX3FcZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/d= kMhmur6/Z2dnBdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8G= vIr8Avmi9N7u7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G= +vrzAQCaK2xLIt4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoR= CoWwpJRsb28TDocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT08= 5Pz9HKTVphgGM1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZp= QtITDagIAvNWqS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNpp= JT/2vNzOCqlqNfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAA= AElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt= ; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoA= AAANSUhEUgAAABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQ= BlSsOGwAAAztJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpC= shMtFl1sSPhFmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6= HQ6CCGIx+OkUikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzM= DIZheOkI13WllJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05= OTigUCrTb7dENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7= MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8= V/HWJaFlJJGo8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32G= wyF3d3cAKK1Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41= t2xweHqLrOv/U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIx= qNsrGxQa/Xo1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQ= OPj4yQSCT/Zo6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HG= xmL8/OEDruvyzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq= 1cIaO3yq5XG5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0= Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg= 3Q6zdraGplMxl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukF= AAAAAElFTkSuQmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" />Revista Anatom= =C3=ADa Digital <spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Ambato =E2= =80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) &#= xa0; Tels. 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(00593) 511262 y 0984058533 = 0; Tel. 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ei0+k4d+4cJ06cwOv1snjxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1= E5WVhbTp0/n4sWLNDcHC2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+= /0b36rX/FXvXmzN47GY2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" wid= th=3D"77" height=3D"28" alt=3D"" style=3D"margin-left:441.05pt; position:ab= solute" />adem=C3=A1s, que</s= pan> desciende el tiempo<sp= an class=3D"awspan" style=3D"letter-spacing:0.4pt"> de </sp= an>ventilaci=C3=B3n mec=C3=A1nica;</= span> el consumo de antibi=C3=B3ticos y de los costos de los servicios de sal= ud. Estos resultados = coinciden </sp= an>con los encontrad= os <spa= n class=3D"awspan">por (<a href=3D"#ref23" style=3D"= text-decoration:none"></a><a href=3D"#ref23" style=3D"text-decoration:none">23</a>),<s= pan class=3D"awspan" style=3D"letter-spacing:1.9pt"> en </s= pan>una exhaustiva r= evisi=C3=B3n, donde se aprecia<sp= an class=3D"awspan" style=3D"letter-spacing:-0.3pt"> que <= /span>el uso de</s= pan> paquetes de cuidados</span= > de enfermer=C3=ADa que= incluyen acciones para el</sp= an> mantenimiento de la<= span class=3D"awspan" style=3D"letter-spacing:5.45pt"> higiene bucal, empleando</spa= n> clorhexidina al 0,12%, acomp= a=C3=B1ado </= span>por la elevac= i=C3=B3n </sp= an>del cabecero = de <sp= an class=3D"awspan">la cama y<span= class=3D"awspan" style=3D"letter-spacing:0.85pt"> buenas = pr=C3=A1cticas en<spa= n class=3D"awspan" style=3D"letter-spacing:0.85pt"> el </s= pan>uso del tubo endotraqueal que favorecen<span= class=3D"awspan" style=3D"letter-spacing:-0.45pt"> la </= span>prevenci=C3=B3n de<spa= n class=3D"awspan" style=3D"letter-spacing:-0.45pt"> infecciones relacionadas con</s= pan> el empleo de respiraci= =C3=B3n </spa= n>asistida. No obs= tante, </span= >los resultados = sugieren </sp= an>la necesidad = de <sp= an class=3D"awspan">incorporar otras acciones inherentes = a buenas pr= =C3=A1cticas <= /span>en los cuidado= s <span= class=3D"awspan">de enfermer=C3=ADa como</= span> el cumplimiento de los</sp= an> protocolos para el<s= pan class=3D"awspan" style=3D"letter-spacing:0.15pt"> aseo= de las man= os <sp= an class=3D"awspan">y las acciones= de capacitaci=C3=B3n del personal de enfermer= =C3=ADa.Entre los = estudios </sp= an>que exponen res= ultados </spa= n>de intervenciones educativas,= (<a href=3D"#ref10" style=3D"text-dec= oration:none"></a><a href=3D"#ref10" style=3D"text-decoration:none">10</a>) = se <sp= an class=3D"awspan">centran en los cuidad= os <sp= an class=3D"awspan">de higiene bucal</spa= n> y reportan que la </span= >adhesi=C3=B3n de = los <s= pan class=3D"awspan">enfermeros a esta pr= =C3=A1ctica <= /span>incide de = manera </span= >positiva en la</s= pan> evoluci=C3=B3n de los</spa= n> pacientes. Los estudios</spa= n> (<a href=3D"#ref21" style=3D"text-decoration:none"></a>= <a href= =3D"#ref21" style=3D"text-decoration:none">21</a>, <a href=3D"#ref22" style=3D"text-decorat= ion:none"></a><a href=3D"#ref22" style=3D"text-decoration:none">22</a>) conciben paquetes m= =C3=A1s completos en cuanto a cuidados de enfermer=C3=ADa. Aunque = ning=C3=BAn estudio<s= pan class=3D"awspan" style=3D"letter-spacing:-0.1pt"> reporta adhesi=C3=B3n total</spa= n> a las intervenciones<= span class=3D"awspan" style=3D"letter-spacing:-0.1pt"> implementadas, en los dirigid= os <sp= an class=3D"awspan">a pacientes adultos</= span> que reciben atenci=C3=B3n= <span= class=3D"awspan">en UCI, se observa = una reducci=C3=B3n<sp= an class=3D"awspan" style=3D"letter-spacing:0.55pt"> de los= d=C3=ADas de estancia </sp= an>hospitalaria (<a href=3D= "#ref8" style=3D"text-decoration:none"></a><a href=3D"#ref8" style=3D"text-decorati= on:none">8,</spa= n></a> <a href=3D"#ref18" style= =3D"text-decoration:none"></a><a href=3D"#ref18" style=3D"text-decoration:none"><sp= an class=3D"awspan" style=3D"text-decoration:underline">18</a><p= style=3D"margin-right:1pt; margin-left:1pt">).</spa= n> El= incremento de la <s= pan class=3D"awspan">adhesi=C3=B3n al conju= nto <sp= an class=3D"awspan">de las buenas pr=C3=A1= cticas </span= >enfermeras implementadas<sp= an class=3D"awspan" style=3D"letter-spacing:0.75pt"> en </= span>la UCI se</sp= an> expres=C3=B3 en una<= span class=3D"awspan" style=3D"letter-spacing:0.75pt"> reducci=C3=B3n del riesgo de<= /span> neumon=C3=ADas, en pacie= ntes <= span class=3D"awspan">con ventilaci=C3=B3n asistida </= span>(<a href=3D"#ref21" style=3D"text-decora= tion:none"></a><a href=3D"#ref21" style=3D"text-decoration:none">21</a>). = Estos = resultados coinciden con<spa= n class=3D"awspan" style=3D"letter-spacing:0.65pt"> los </= span>reportados por (<a href=3D"#ref24" style=3D"text-decoration:none"></a><a href=3D"#ref24= " style=3D"text-decoration:none">24</a>) quienes = encontraron, = en una revi= si=C3=B3n </s= pan>sistem=C3=A1tica, que el= cumplimiento global de= un paquete de enfermer=C3=ADa tiene una incidencia positiva al reportar</spa= n> decrecimiento en el<span= class=3D"awspan" style=3D"letter-spacing:0.1pt"> total </s= pan>de pacientes c= on <spa= n class=3D"awspan">NAV, as=C3=AD como</span= > reducci=C3=B3n en los<sp= an class=3D"awspan" style=3D"letter-spacing:0.1pt"> d=C3=ADas de hospitalizaci=C3=B3n.Tambi=C3=A9n= se reporta eficacia= en= los programas de <s= pan class=3D"awspan">capacitaci=C3=B3n encaminados= a = lograr buenas pr=C3=A1cticas<= /span> de enfermer=C3=ADa (10).</s= pan> Ello coincide con<span= class=3D"awspan" style=3D"letter-spacing:1.3pt"> los </spa= n>resultados de (24)= quienes, como resultado = de <sp= an class=3D"awspan">una revisi=C3=B3n sis= tem=C3=A1tica, reportan que las </spa= n>intervenciones educativas, dirig= idas <s= pan class=3D"awspan">a objetivos espec=C3= =ADficos, </sp= an>pueden disminuir = las <sp= an class=3D"awspan">tasas de neumon=C3=ADa<= /span> asociada al ventilador.De los estudios revisados (<a href=3D"#ref10" style=3D"text-decor= ation:none"></a><a href=3D"#ref10" style=3D"text-decoration:none">10</a>, <a href=3D"#= ref18" style=3D"text-decoration:none"></a><a href=3D"#ref18" style=3D"text-decorati= on:none">18</spa= n></a>, <a href=3D"#ref21" style=3D"text-decoration:none"></a><a href=3D"#ref= 21" style=3D"text-decoration:none">21</a>) coinciden con (<a href=3D"#ref24" s= tyle=3D"text-decoration:none"></a><a href=3D"#ref24" style=3D"text-decoration:none"= >24</a></= p>) e= n la importancia y efectividad de las med= idas <= span class=3D"awspan">de higiene bucal,</= span> elevaci=C3=B3n del cabece= ro <sp= an class=3D"awspan">y la observancia</spa= n> de los protocolos para</span= > la aspiraci=C3=B3n en<= span class=3D"awspan" style=3D"letter-spacing:0.65pt"> pacientes con NAV.<spa= n class=3D"awspan" style=3D"letter-spacing:0.65pt"> Por </= span>su parte los<= /span> estudios en poblaci=C3= =B3n <= span class=3D"awspan">adulto mayor (<a href=3D"#re= f3" style=3D"text-decoration:none"></a><a href=3D"#ref3" style=3D"text-decoration:n= one">3</a= >= , <a = href=3D"#ref19" style=3D"text-decoration:none"></a><a href=3D"#ref19" style=3D"text= -decoration:none">19</a>) evidencian que<s= pan class=3D"awspan" style=3D"letter-spacing:-0.35pt"> junto a la administraci=C3=B3n de medicamentos,<= /span> <span= class=3D"awspan">los cuidados de enfer= mer=C3=ADa potencian el empleo de la terapia respiratoria. 4.1. Limitaciones<span= class=3D"awspan">Constituyen limitaciones de esta revisi=C3=B3n sistem=C3= =A1tica: <img src=3D"data:image/jpeg;base64,/9j/4AAQSkZJRgABA= QEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8SEhEPERETFhwXExQaFRER= GCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4eHh4eHh4eHh4eHh4eHh4= eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAxoDASIAAhEBAxEB/8QAHA= ABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGCQMEAgMAAAECAwQFEQYSB= yExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0haCsRg4Q2IkwWNzg//EABsBAQEB= AQEBAQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgIABAIJAwQDAAAAAAECEQMSBFEFITFBE4E= UIjI0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPwDqXfGR5+77cnfGR5+77cuIf0nUfi91yz= kX/P3fblO+L/n7vty4w1F3XJORf8/d9uU74yPP3fblhKGobrk74v8An7vtyd8ZHn7vty4w1Flrk= 74v+fu+3KTkZHn7vtywSV1F3WffOR5+77cnfOR5+77cuMXUZ3XJ3zkefu+3K98ZHn7vty4hNRZa= znJyPP3fbk75yPP3fblxz2hqFtcnfOR5+77cnfOR5+77cuMNRN1yTkZG39fd9uWPfOR5+57csJR= 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(00593) 511262 y 0984058533</spa= n> = ; Tel. 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(00593) 511262 y 098= 4058533 Tel. 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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= MAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJR= EFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReIC= jUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5= imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoG= EYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3= vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPg= zkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7N= z+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/= A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomi= YQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMF= KkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUh= bn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZ= nJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsU= D2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iR= Bw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kg= haDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5= QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvhe= R5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElF= TkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; po= sition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAAN= SUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSs= OGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mj= uYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhh= Pi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQ= KNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61= Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKh= SLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJk= cfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vq= lXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398= JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+C= wLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kE= sGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEw= tTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+659= 76cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEo= lwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80= Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital</spa= n> = ; Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. (00593) 511262 y 0984058533 &#x= a0; Tel. Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-= decoration:none"></a><a href=3D"http://www.anatomiadigital.org" sty= le=3D"text-decoration:none">www.anatomi= adigital.org</a> <a href=3D"h= ttp://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= /p><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-dec= oration:none">www.cienciadigitaleditori= al.com</a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSU= hEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOG= wAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAq= FAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgB= DQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHic= ViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEg= QqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDab= rKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwx= Dcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4O= HMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1y= eVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185Oemy= uLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpB= MJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJ= SSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5= nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2i= x3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3Pj= mBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPH= nyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW= 1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidn= AAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0K= GgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAA= ADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQ= jiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UE= ikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59Fs= Nrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQG= OFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4= IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZ= DJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3F= cZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dn= BdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u= 7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xL= It4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28T= DocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgG= M1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNW= qS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlq= NfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC= " width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:a= bsolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAA= ABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAzt= JREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhF= mVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkU= ikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13Wl= lJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dE= NQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/= 2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo= 8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1W= i2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/= U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1= KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo= 6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvy= zrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5= UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7+= +/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMx= l8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSu= QmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; positi= on:absolute" />Revista Anatom=C3=ADa</span= > Digital<= /span>&= #xa0; Ambato =E2=80=93 Ecuador (J= ard=C3=ADn Ambate=C3=B1o) = = Tels. (00593) 511262 y 0984058533 = Tel. 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/88sawSImorq6WWVlZ37tZIQSKomAwGEKNrMfjwe/3f28OGCwWi4WFCxei0+k4d+4cJ06cwOv1s= njxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1E5WVhbTp0/n4sWLNDcH= C2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+/0b36rX/FXvXmzN47GY= 2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" width=3D"77" height=3D= "28" alt=3D"" style=3D"margin-left:441.05pt; position:absolute" /><s= pan class=3D"awspan">La inclusi=C3=B3n = de <sp= an class=3D"awspan">estudios que describe= n <spa= n class=3D"awspan">intervenciones efectivas, sin </spa= n>dise=C3=B1ar etapas de seguimiento para las mismas.La i= nclusi=C3=B3n </= span>de estudios centrad= os en un solo pro= ceder <sp= an class=3D"awspan">preventivo de NAVM<s= pan class=3D"awspan" style=3D"letter-spacing:1pt"> como </spa= n>la higiene bucal y la terapia respiratoria.= La util= izaci=C3=B3n = de instrumentos autoinformes para conocer<sp= an class=3D"awspan" style=3D"letter-spacing:1.15pt"> el </= span>conocimiento y proceder pr=C3=A1ctico del personal</sp= an> de enfermer=C3=ADa en</span= > la prevenci=C3=B3n de<= span class=3D"awspan" style=3D"letter-spacing:1.35pt"> NAVM en ucis. Este </span= >aspecto puede restar validez y confiabilidad a los = resultados que se exponen.4.2. L=C3=ADneas futuras Se justif= ica <= span class=3D"awspan">realizar otras re= visiones </s= pan>donde la tot= alidad </spa= n>de estudios mu= estren </spa= n>resultados de paquetes<sp= an class=3D"awspan" style=3D"letter-spacing:1.5pt"> de </sp= an>intervenciones y, de <sp= an class=3D"awspan">ser posible, que= consideren una fase<span= class=3D"awspan" style=3D"letter-spacing:1.5pt"> de </span= >seguimiento posterior a las intervenciones.<= /p>Los paquetes de intervenciones, con demostrada<= span class=3D"awspan" style=3D"letter-spacing:0.9pt"> eficacia en la r= educci=C3=B3n = de riesgos d= e NAVM </span= >y dise=C3=B1os = cuasi-experimentales, deben ser<sp= an class=3D"awspan" style=3D"letter-spacing:1.55pt"> promovidos y extrapolados<= span class=3D"awspan" style=3D"letter-spacing:1.55pt"> a= otros contextos.5.Conclusiones=EF=82=B7Lo= s <spa= n class=3D"awspan">paquetes de intervenci= =C3=B3n </spa= n>que se aplican</= span> en las UCI de </span= >Am=C3=A9rica Latina, en </span= >la atenci=C3=B3n de pacientes con neumon=C3=ADa= asociada a la ventilaci=C3=B3n mec=C3=A1nica, co= inciden en </spa= n>incluir como principal= es acciones de cuidados<sp= an class=3D"awspan" style=3D"letter-spacing:1pt"> de <= span class=3D"awspan">enfermer=C3=ADa las med= idas <spa= n class=3D"awspan">de higiene bucal, la</sp= an> elevaci=C3=B3n del cabecero</s= pan> de las camas = y <span= class=3D"awspan">la observancia de<= span class=3D"awspan" style=3D"letter-spacing:1.7pt"> los protocolos para la aspiraci=C3=B3n endotraqueal.=EF=82=B7Aunque no se log= ra <sp= an class=3D"awspan">una adhesi=C3=B3n tot= al, <s= pan class=3D"awspan">las intervenciones = implementadas favorecen la reducci=C3=B3n</= span> de la estancia hospitalaria y la reducc= i=C3=B3n </spa= n>del riesgo de neum= on=C3=ADas en pacientes con ventilaci=C3=B3n asistida. =EF=82=B7Los </span= >resultados sugieren la = necesidad de incor= porar = otras acciones rel= acionadas </s= pan>con buenas pr=C3=A1cticas</span= > de enfermer=C3=ADa, como</spa= n> el cumplimiento de<sp= an class=3D"awspan" style=3D"letter-spacing:0.65pt"> los <= /span>protocolos para el aseo de las manos y capacitaci=C3=B3n del personal de enfermer=C3= =ADa.6.Conf= licto de interesesLos autores<= span class=3D"awspan" style=3D"letter-spacing:2.1pt"> declaran que no e= xiste <= span class=3D"awspan">conflicto de interese= s <span= class=3D"awspan">en relaci=C3=B3n con</spa= n> el= art=C3=ADculo presentado.7.Declaraci=C3=B3n de contribu= ci=C3=B3n de los autoresTodos aut= ores contribuyeron significativamente en la elaboraci=C3=B3n del art=C3=ADc= ulo.<img src=3D"data:image/jpeg;base64,/9j/4AAQSkZJRgABAQEAYA= BgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8SEhEPERETFhwXExQaFRERGCEYG= h0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4eHh4eHh4eHh4eHh4eHh4eHh4e= Hh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAxoDASIAAhEBAxEB/8QAHAABAQA= CAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGCQMEAgMAAAECAwQFEQYSByExEx= 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Directo (00593) 0998-235-485 &= #xa0; <a href=3D"http://www.anatomiadigital.org" s= tyle=3D"text-decoration:none"></a><a href=3D"http://www.anatomiadig= ital.org" style=3D"text-decoration:none">www.anatomiadigital.org</a> </span= ><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoratio= n:none"></a><a href=3D"http://www.cienciadigitaleditorial.com" styl= e=3D"text-decoration:none">www.cienciad= igitaleditorial.com</a><img src=3D"data:image/png;base64,iVBOR= w0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAO= xAAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3L= M3xfCue0huWAqFAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9q= enpzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nK= RaLFItFRkdHicViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9P= k0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fv= E43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIb= pdEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n= 83NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoV= ALLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFov= PFvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHS= kECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/= jtse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cI= BKZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXR= Jr1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wv= d9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O= 18z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJc= wS6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5Stq= KT0/sycXcKidnAAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D= "margin-left:-1pt; position:absolute" /><img src=3D"data:image/png;ba= se64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAA= lwSFlzAAAOxAAADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/Q= Td9hT5iVCBdFQjiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx= +fmJMQa/34+UEikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEB= KOQUVY2We59FsNrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8= sMBgMsy0JrPQGOFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxH= M7OziiVSnieN4IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2E= EKyurgKQz+fJZDJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKF= arUa328V6fX3FcZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/= dkMhmur6/Z2dnBdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8= GvIr8Avmi9N7u7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8= G+vrzAQCaK2xLIt4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUo= RCoWwpJRsb28TDocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT0= 85Pz9HKTVphgGM1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZ= pQtITDagIAvNWqS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNp= pJT/2vNzOCqlqNfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAA= AAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1p= t; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgo= AAAANSUhEUgAAABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADs= QBlSsOGwAAAztJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwp= CshMtFl1sSPhFmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e= 6HQ6CCGIx+OkUikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMz= MDIZheOkI13WllJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF0= 5OTigUCrTb7dENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys= 7MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM= 8V/HWJaFlJJGo8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32= GwyF3d3cAKK1Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn4= 1t2xweHqLrOv/U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbI= xqNsrGxQa/Xo1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZH= QOPj4yQSCT/Zo6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1H= GxmL8/OEDruvyzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0G= q1cIaO3yq5XG5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg= 0Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAM= g3Q6zdraGplMxl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhuk= FAAAAAElFTkSuQmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left= :-1pt; position:absolute" />Revista Anatom= =C3=ADa Digital <spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Ambato =E2= =80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) &#= xa0; Tels. (00593) 511262 y 0984058533 &= #xa0; Tel. 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(00593) 511262 y 0984058533 = Tel. 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(00593) 511262 y 0984058533= = Tel. 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position:absolute" />Revista Anatom=C3=ADa Digital &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) = = Tels. (00593) 511262 y 098= 4058533 Tel. 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(00593) 5112= 62 y 0984058533 <spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Tel. 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(00593= ) 511262 y 0984058533 </spa= n>Tel. = Directo (00593) 0998-235-485 = ; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decoratio= n:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"tex= t-decoration:none">www.anatomiadigital.= org</a>&#= xa0; <a href=3D"http://www= .cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><a= href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:n= one">www.cienciadigitaleditorial.com</s= pan></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABM= AAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJRE= FUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICj= UKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5i= miZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGE= YKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3v= D8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgz= kSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz= +H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A= 8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiY= QRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFK= kcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhb= n4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZn= JZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD= 2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRB= w8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kgh= aDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5Q= yMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR= 5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFT= kSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; pos= ition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANS= UhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsO= GwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mju= YGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhhP= i5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQK= NDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61W= o9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKhS= LRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJkc= feARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vql= XA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398J= BAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+Cw= LYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kEs= GKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEwt= TY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+6597= 6cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEol= wdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80G= g0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital<= span class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt"> &#= xa0; Ambato =E2=80=93 Ecuador (Jard=C3= =ADn Ambate=C3=B1o) </span= >Tels. = (00593) 511262 y 0984058533 = Tel. 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(00593) 511262 y 0984058533 = ; Tel. 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Conocimientos y pr=C3=A1cticas del profesional de enferm= er=C3=ADa sobre la prevenci=C3=B3n de neumon=C3=ADa asociada a ventilaci=C3= =B3n mec=C3=A1nica en la unidad de cuidados intensivos de un hospital nacio= nal de Lima, 2024 [Tesis de Especialidad, Universidad Privada Norbert Wiene= r, Lima, Per=C3=BA] [Internet]. 2024 [citado 05 de enero 2025]. 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position:absolute" /><= span class=3D"awspan" style=3D"font-family:Calibri; font-size:9pt; font-wei= ght:bold; color:#4472c4">Revista Anatom=C3=ADa Digital &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3= =B1o) Tels. 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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= MAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJR= EFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReIC= jUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5= imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoG= EYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3= vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPg= zkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7N= z+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/= A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomi= YQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMF= KkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUh= bn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZ= nJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsU= D2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iR= Bw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kg= haDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5= QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvhe= R5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElF= TkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; po= sition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAAN= SUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSs= OGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mj= uYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhh= Pi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQ= KNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61= Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKh= SLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJk= cfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vq= lXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398= JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+C= wLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kE= sGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEw= tTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+659= 76cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEo= lwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80= Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital</spa= n> = ; Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. (00593) 511262 y 0984058533 &#x= a0; Tel. 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Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" st= yle=3D"text-decoration:none"></a><a href=3D"http://www.anatomiadigi= tal.org" style=3D"text-decoration:none">www.anatomiadigital.org</a> = <a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration= :none"></a><a href=3D"http://www.cienciadigitaleditorial.com" style= =3D"text-decoration:none">www.cienciadi= gitaleditorial.com</a><img src=3D"data:image/png;base64,iVBORw= 0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOx= AAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM= 3xfCue0huWAqFAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qe= npzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKR= aLFItFRkdHicViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk= 0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE= 43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbp= dEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n8= 3NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVA= LLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovP= Fvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSk= ECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/j= tse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIB= KZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJ= r1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd= 9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O1= 8z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcw= S6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqK= T0/sycXcKidnAAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"= margin-left:-1pt; position:absolute" /><img src=3D"data:image/png;bas= e64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAl= wSFlzAAAOxAAADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QT= d9hT5iVCBdFQjiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+= fmJMQa/34+UEikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBK= OQUVY2We59FsNrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8s= MBgMsy0JrPQGOFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM= 7OziiVSnieN4IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EE= KyurgKQz+fJZDJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFa= rUa328V6fX3FcZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/d= kMhmur6/Z2dnBdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8G= vIr8Avmi9N7u7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G= +vrzAQCaK2xLIt4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoR= CoWwpJRsb28TDocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT08= 5Pz9HKTVphgGM1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZp= QtITDagIAvNWqS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNpp= JT/2vNzOCqlqNfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAA= AElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt= ; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoA= AAANSUhEUgAAABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQ= BlSsOGwAAAztJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpC= shMtFl1sSPhFmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6= HQ6CCGIx+OkUikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzM= DIZheOkI13WllJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05= OTigUCrTb7dENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7= MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8= V/HWJaFlJJGo8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32G= wyF3d3cAKK1Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41= t2xweHqLrOv/U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIx= qNsrGxQa/Xo1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQ= OPj4yQSCT/Zo6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HG= xmL8/OEDruvyzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq= 1cIaO3yq5XG5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0= Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg= 3Q6zdraGplMxl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukF= AAAAAElFTkSuQmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" />Revista Anatom= =C3=ADa Digital <spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Ambato =E2= =80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) &#= xa0; Tels. 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(00593) 511262 y 0984058533 = 0; Tel. 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te" />ISSN: <s= pan class=3D"awspan" style=3D"font-weight:bold; color:#ffffff">2697-3391</s= pan>Vol. 8 No. 2, pp. 6 =E2= =80=93 25, abril - junio 2025Revista en ciencias m=C3=A9dicas, salud p=C3= =BAblicaArt=C3=ADculo de revisi=C3=B3n bibliogr=C3=A1fica.<svg font-fa= mily=3D"Times New Roman" font-size=3D"16" height=3D"41.33" version=3D"1.1" = width=3D"209.31" xmlns=3D"http://www.w3.org/2000/svg" style=3D"width:209.31= px; height:41.33px; font-family:'Times New Roman'; font-size:16px" xmlns:xl= ink=3D"http://www.w3.org/1999/xlink"><defs /><g><g><path d=3D"M0,0 L209,0 L= 209,0 L209,41 L209,41 L0,41 Z" fill=3D"#7d7d7d" fill-rule=3D"evenodd" /></g= ></g></svg>www.anatomiadigital.org<spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:9pt; font-weight= :bold; color:#4472c4">Revista Anatom=C3=ADa Digital = Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1= o) Tels. 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(00593) 511262 y 0984058533</spa= n> = ; Tel. 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(00593) 511262 y 098= 4058533 Tel. 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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= MAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJR= EFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReIC= jUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5= imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoG= EYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3= vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPg= zkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7N= z+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/= A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomi= YQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMF= KkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUh= bn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZ= nJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsU= D2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iR= Bw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kg= haDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5= QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvhe= R5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElF= TkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; po= sition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAAN= SUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSs= OGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mj= uYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhh= Pi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQ= KNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61= Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKh= SLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJk= cfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vq= lXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398= JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+C= wLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kE= sGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEw= tTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+659= 76cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEo= lwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80= Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital</spa= n> = ; Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. (00593) 511262 y 0984058533 &#x= a0; Tel. 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d+4cJ06cwOv1snjxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1E5WVhb= Tp0/n4sWLNDcHC2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+/0b36r= X/FXvXmzN47GY2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" width=3D"= 77" height=3D"28" alt=3D"" style=3D"margin-left:441.05pt; position:absolute= " />Centro [Internet]. 2018 [citado 5 enero 2= 025]; 12(3). 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position:absolute" /><sp= an class=3D"awspan" style=3D"font-family:Calibri; font-size:9pt; font-weigh= t:bold; color:#4472c4">Revista Anatom=C3=ADa Digital = ; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3= =B1o) Tels. 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Direct= o (00593) 0998-235-485 </sp= an><a href=3D"http://www.anatomiadigital.org" style=3D"text-decoration:none= "></a><a href=3D"http://www.anatomiadigital.org" style=3D"text-deco= ration:none">www.anatomiadigital.org</s= pan></a><= span class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt"> &#= xa0; <a href=3D"http://www.cienc= iadigitaleditorial.com" style=3D"text-decoration:none"></a><a href= =3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:none">= www.cienciadigitaleditorial.com<= /a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAA= TCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJREFUOI= 1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICjUKgl= BgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5imiZS= Sj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGEYKgD= P89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3vD8+X= MqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgzkSem= ZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz+H6A= EJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A8j1Q= qxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiYQRrY= ZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFKkcV1= tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhbn4l8= MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZnJZEi= n0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD2qIF= D0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRBw8ek= kql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kghaDQd= PtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5QyMrq= KCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR5KKe= LxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFTkSuQ= mCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; 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position:absolute= " />Revista Anatom=C3=ADa Digital<s= pan class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt"> &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3= =ADn Ambate=C3=B1o) </span= >Tels. = (00593) 511262 y 0984058533 = Tel. Directo (00593) 0998-235-485 = ; <a href=3D"http://www.anatomiadigital.org" style=3D"text-dec= oration:none"></a><a href=3D"http://www.anatomiadigital.org" style= =3D"text-decoration:none">www.anatomiad= igital.org</a> <a href=3D"htt= p://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a></p= ><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decor= ation:none">www.cienciadigitaleditorial= .com</a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUh= EUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGw= AAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqF= AUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBD= Q0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicV= iCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQ= qCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabr= KysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxD= crkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OH= MDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1ye= VuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185Oemyu= LjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBM= JDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJS= SRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5n= MXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix= 3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3Pjm= Bjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHn= yhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1= ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnA= AAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-= 1pt; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0K= GgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAA= ADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQ= jiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UE= ikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59Fs= Nrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQG= OFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4= IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZ= DJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3F= cZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dn= BdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u= 7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xL= It4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28T= DocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgG= M1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNW= qS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlq= NfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC= " width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:a= bsolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgA= AABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAz= tJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPh= FmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+Ok= UikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13W= llJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7d= ENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f= /2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJG= o8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1= Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv= /U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo= 1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Z= o6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruv= yzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG= 5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7= ++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplM= xl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkS= uQmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; posit= ion:absolute" />Revista Anatom=C3=ADa Digi= tal Ambato =E2=80=93 Ecuado= r (Jard=C3=ADn Ambate=C3=B1o) &#x= a0; Tels. (00593) 511262 y 0984058533 &#= xa0; Tel. 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(00593) 511262 y 0984058533 &= #xa0; Tel. 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(00593) 511262 y 0984058533 &#= xa0; Tel. Directo (00593) 0998-235-485= &= #xa0; <a href=3D"http://www.anat= omiadigital.org" style=3D"text-decoration:none"></a><a href=3D"http= ://www.anatomiadigital.org" style=3D"text-decoration:none">www.anatomiadigital.org</a> = ; <a href=3D"http://www.cienciadigitaleditorial.com" sty= le=3D"text-decoration:none"></a><a href=3D"http://www.cienciadigita= leditorial.com" style=3D"text-decoration:none">www.cienciadigitaleditorial.com</a><img src=3D"data:i= mage/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAg= IfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEp= Ng1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZa= fT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlh= dXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyA= MQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1W= o4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL1= 6//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQk= SimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQ= ZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtux= Gs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycA= KAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++T= TKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRA= wCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6f= V6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4= eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2= ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLq= uUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0= HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFTkSuQmCC" width=3D"19" height=3D"= 19" alt=3D"" style=3D"margin-left:-1pt; position:absolute" /><img sr= c=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAA= BHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9= bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8= 887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQS= mHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbW= FqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQ= zM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1y= Ofz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0= Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdx= aLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp35= 4fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz= +fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQ= sdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cY= QzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQT= BYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh= 8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0P= wfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" st= yle=3D"margin-left:-1pt; position:absolute" /><img src=3D"data:image= /png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAh= kiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9= zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89b= wk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKy= LFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH1= 9nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8Ho= CAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUI= p/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8= P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7= jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihP= AfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEY= jGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyD= ubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6V= c/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKS= WhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5= eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTT= aUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" width=3D"18" height=3D"18" alt=3D= "" style=3D"margin-left:-1pt; position:absolute" />Revista Anatom=C3=ADa </spa= n>Digital = 0; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) &= #xa0; Tels. (00593) 511262 y 0984058533</span= > = Tel. 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(00593) 511262 y 098405= 8533 Tel. 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(00593) 511262 y 0984058= 533 Tel. 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Direc= to (00593) 0998-235-485 </s= pan><a href=3D"http://www.anatomiadigital.org" style=3D"text-decoration:non= e"></a><a href=3D"http://www.anatomiadigital.org" style=3D"text-dec= oration:none">www.anatomiadigital.org</= span></a>= &= #xa0; <a href=3D"http://www.cien= ciadigitaleditorial.com" style=3D"text-decoration:none"></a><a href= =3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:none">= www.cienciadigitaleditorial.com<= /a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAA= TCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJREFUOI= 1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICjUKgl= BgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5imiZS= Sj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGEYKgD= P89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3vD8+X= MqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgzkSem= ZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz+H6A= EJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A8j1Q= qxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiYQRrY= ZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFKkcV1= tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhbn4l8= MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZnJZEi= n0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD2qIF= D0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRBw8ek= kql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kghaDQd= PtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5QyMrq= KCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR5KKe= LxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFTkSuQ= mCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; positio= n:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhE= UgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwA= AAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6MjuYGY= VHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhhPi5D= P/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQKNDp= dBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61Wo9V= q4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKhSLRQ= aDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJkcfeA= RPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9VqlXA4= zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398JBAK= 4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+CwLYw= xSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kEsGKR= CKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEwtTY8= 1WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+65976cd= ojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEolwdH= Q0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80Gg0+= Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width=3D"1= 9" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute" /><= /span><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAASCAY= AAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI1VlM= 1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPyMrAy= ofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycxDAMh= xI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpyeOjo4= olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKtMz0w= TUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9Ho9D= g4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI6PX1= lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA4HGZ= 1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26RO9bp= d/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQTab5= f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm8dTv= 02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3xmWm= axvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cjAYcH= x8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2B+FN= k2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3QN7c= 7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" width= =3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " />Revista Anatom=C3=ADa Digital<s= pan class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt"> &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3= =ADn Ambate=C3=B1o) </span= >Tels. = (00593) 511262 y 0984058533 = Tel. Directo (00593) 0998-235-485 = ; <a href=3D"http://www.anatomiadigital.org" style=3D"text-dec= oration:none"></a><a href=3D"http://www.anatomiadigital.org" style= =3D"text-decoration:none">www.anatomiad= igital.org</a> <a href=3D"htt= p://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a></p= ><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decor= ation:none">www.cienciadigitaleditorial= .com</a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUh= EUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGw= AAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqF= AUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBD= Q0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicV= iCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQ= qCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabr= KysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxD= crkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OH= MDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1ye= VuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185Oemyu= LjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBM= JDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJS= SRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5n= MXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix= 3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3Pjm= Bjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHn= yhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1= ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnA= AAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-= 1pt; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0K= GgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAA= ADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQ= jiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UE= ikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59Fs= Nrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQG= OFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4= IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZ= DJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3F= cZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dn= BdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u= 7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xL= It4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28T= DocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgG= M1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNW= qS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlq= NfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC= " width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:a= bsolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgA= AABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAz= tJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPh= FmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+Ok= UikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13W= llJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7d= ENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f= /2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJG= o8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1= Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv= /U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo= 1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Z= o6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruv= yzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG= 5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7= ++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplM= xl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkS= uQmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; posit= ion:absolute" />Revista Anatom=C3=ADa Digi= tal Ambato =E2=80=93 Ecuado= r (Jard=C3=ADn Ambate=C3=B1o) &#x= a0; Tels. (00593) 511262 y 0984058533 &#= xa0; Tel. 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(00593) 511262 y 0984058533 &= #xa0; Tel. 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(00593) 511262 y 0984058533 = ; Tel. 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(00593) 511262 y 0984058533= &= #xa0; Tel. 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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABM= AAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJRE= FUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICj= UKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5i= miZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGE= YKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3v= D8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgz= kSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz= +H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A= 8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiY= QRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFK= kcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhb= n4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZn= JZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD= 2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRB= w8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kgh= aDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5Q= yMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR= 5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFT= kSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; pos= ition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSU= hEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOG= wAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6MjuY= GYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhhPi= 5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQKN= DpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61Wo= 9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKhSL= RQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJkcf= eARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9VqlX= A4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398JB= AK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+CwL= YwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kEsG= KRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEwtT= Y81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+65976= cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEolw= dHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80Gg= 0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width=3D= "19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute" /= ><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAASCAY= AAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI1VlM= 1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPyMrAy= ofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycxDAMh= xI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpyeOjo4= olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKtMz0w= TUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9Ho9D= g4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI6PX1= lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA4HGZ= 1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26RO9bp= d/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQTab5= f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm8dTv= 02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3xmWm= axvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cjAYcH= x8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2B+FN= k2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3QN7c= 7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" width= =3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " />Revista Anatom=C3=ADa Digital<s= pan class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt"> &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3= =ADn Ambate=C3=B1o) </span= >Tels. = (00593) 511262 y 0984058533 = Tel. 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(00593) 511262 y 0984058533 &#= xa0; Tel. 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(00593) 511262 y 0984058533 &= #xa0; Tel. 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(00593) 511262 y 0984058533 &= #xa0; Tel. 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(00593) 511262 y 0984058533 &= #xa0; Tel. 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(00593) 511262 y 0984058533 = 0; Tel. 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q5duwgEAowaNYq+vj5qa2tJTU0lMzOTL7/88sawSImorq6WWVlZ37tZIQSKomAwGEKNrMfjwe/3= f28OGCwWi4WFCxei0+k4d+4cJ06cwOv1snjxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQ= ghODw4cM0Nzff1E5WVhbTp0/n4sWLNDcHC2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/= +XNz1YBhOK/67+/0b36rX/FXvXmzN47GY2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVOR= K5CYII=3D" width=3D"77" height=3D"28" alt=3D"" style=3D"margin-left:441.05p= t; position:absolute" />Buenas pr=C3=A1cticas de enfermer=C3=ADa en la preven= ci=C3=B3n de neumon=C3=ADas asociadas a la ventilaci=C3=B3n mec=C3=A1nica e= n hospitales de tercer nivel de Am=C3=A9rica LatinaGood nursing prac= tices in the prevention of pneumonia associated with mechanical ventilation= at third level hospitals in Latin America1Indira Anabel S=C3=A1nchez Estrada</= span>https://orcid.= org/0009-0003-1551-1890Universidad Estatal de Bol=C3=ADvar (UEB), Guaranda, Ecuador.</s= pan>Maestr=C3=ADa e= n Salud P=C3=BAbicaanabel.sanchez<a href=3D"mailto:molalla@ueb.ed= u.ec" style=3D"text-decoration:none"></a><a href=3D"mailto:molalla@= ueb.edu.ec" style=3D"text-decoration:none">@ueb.edu.ec</span= ></a>2Mar= =C3=ADa Humbelina Olalla Garc=C3=ADa https://orcid.org/0000-0002-8358-9273<p= class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt; font-size:10pt= ">Universidad Estatal de Bo= l=C3=ADvar (UEB), Guaranda, Ecuador.<a href=3D"mailto:molalla@ueb.edu.ec" st= yle=3D"text-decoration:none">molalla@ueb.edu.ec</a></= p>Art= =C3=ADculo de Investigaci=C3=B3n Cient=C3=ADfica y Tecnol=C3=B3gica<= /p>Enviado: 17/12/2024<= /span>Revisado: 15/= 01/2025Acept= ado: 27/02/2025Publicado:03/04/2025DOI: <a href=3D"https://doi.org/10.33262/anatomiadigital= .v8i2.3373" style=3D"text-decoration:none"></a><a href=3D"https://d= oi.org/10.33262/anatomiadigital.v8i2.3373" style=3D"text-decoration:none"><= span class=3D"awspan" style=3D"font-size:10pt; font-weight:bold; text-decor= ation:underline; color:#0563c1">https://doi.org/10.33262/anatomiadigital.v8= i2.3373</a> C=C3=ADtese: S=C3=A1nchez Estrada, I. A., &= Olalla<spa= n class=3D"awspan" style=3D"font-size:10pt; letter-spacing:2.7pt"> <= span class=3D"awspan" style=3D"font-size:10pt">Garc=C3=ADa , M. H. (2025= ). Buenas<s= pan class=3D"awspan" style=3D"font-size:10pt; letter-spacing:2.7pt"> </span= >pr=C3=A1cticas<span= class=3D"awspan" style=3D"font-size:10pt; letter-spacing:2.7pt"> <s= pan class=3D"awspan" style=3D"font-size:10pt">de enfermer=C3=ADa<spa= n class=3D"awspan" style=3D"font-size:10pt; letter-spacing:1.05pt"> = en la prevenci=C3=B3n de neumon=C3=ADas asociadas a</= span> la <span= class=3D"awspan" style=3D"font-size:10pt">ventilaci=C3=B3n <span= class=3D"awspan" style=3D"font-size:10pt">mec=C3=A1nica en hospitales de tercer nivel = de Am=C3=A9rica</s= pan> = Latina. <sp= an class=3D"awspan" style=3D"font-size:10pt">Anatom=C3=ADa Digital, 8(2), 6-25. <a href=3D"https://doi.org/10.33262/anatom= iadigital.v8i2.3373" style=3D"text-decoration:none"></a><a href=3D"= https://doi.org/10.33262/anatomiadigital.v8i2.3373" style=3D"text-decoratio= n:none">https://doi.org/10.33262/anatomiadigital.v8i2.3373</= span></a>ANATOM=C3=8D= A DIGITAL,<s= pan class=3D"awspan" style=3D"font-size:8pt; letter-spacing:0.45pt"> </span= >es una Revista Electr=C3=B3nica, Trimestral, = que se <sp= an class=3D"awspan" style=3D"font-size:8pt">publicar=C3=A1 en soporte electr=C3=B3nico tiene como misi=C3=B3n co= ntribuir a<s= pan class=3D"awspan" style=3D"font-size:8pt; letter-spacing:-0.5pt"> </span= >la formaci=C3=B3n de profesionales co= mpetentes con</span= > </s= pan>visi=C3=B3n <sp= an class=3D"awspan" style=3D"font-size:8pt">human=C3=ADstica <span= class=3D"awspan" style=3D"font-size:8pt">y cr=C3=ADtica que sean capaces de= exponer sus= </sp= an>resultados <span= class=3D"awspan" style=3D"font-size:8pt">investigativos y cient=C3=ADficos en la misma</spa= n> </= span>medida que se promueva mediante su intervenci=C3=B3n cambios = positivos en la sociedad. <a href=3D"https://anatomiadigital.org" st= yle=3D"text-decoration:none"></a><a href=3D"https://anatomiadigital.= org" style=3D"text-decoration:none">https://anatomiadigital.o= rg</a> La revista es editada<= /span>= por la Editorial Ciencia = Digital (Editorial</= span> = de prestigio registrada en la C=C3=A1mara E= cuatoriana de Libro con No de Afiliaci=C3=B3n 663) <a href=3D"http:/= /www.celibro.org.ec" style=3D"text-decoration:none"></a><a href=3D"h= ttp://www.celibro.org.ec" style=3D"text-decoration:none">www.= celibro.org.ec</a>Esta revista</= span> est=C3=A1<sp= an class=3D"awspan" style=3D"font-size:8pt; letter-spacing:-0.05pt"> </span= >protegida bajo una licencia Creative Commo= ns Atribuci=C3=B3n= -NoComercial-CompartirIgual 4.0 International. 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(00593) 511262 y 0984= 058533 Tel. Directo (0059= 3) 0998-235-485 <a h= ref=3D"http://www.anatomiadigital.org" style=3D"text-decoration:none"></a><= /p><a href=3D"http://www.anatomiadigital.org" style=3D"text-decoration:= none">www.anatomiadigital.org</a= > &#x= a0; <a href=3D"http://www.cienciadigit= aleditorial.com" style=3D"text-decoration:none"></a><a href=3D"http= ://www.cienciadigitaleditorial.com" style=3D"text-decoration:none">www.cienciadigitaleditorial.com</a><= p class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt; font-size:9pt= ">= <img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByU= DbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cY= xn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICjUKglBgndWq0/lj= bCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCK= FfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGEYKgDP89jf32dpa= YmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzL= wh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkq= J7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t= 7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr= 2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8H= ZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8= /vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeX= nYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxv= c7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/= 1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5b= LvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2Cc= MQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7Xabc= rnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqV= KBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; 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position:absolute" /><sp= an class=3D"awspan" style=3D"font-family:Calibri; font-size:9pt; font-weigh= t:bold; color:#4472c4">Revista Anatom=C3=ADa Digital = ; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3= =B1o) Tels. (00593) 5112= 62 y 0984058533 <spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Tel. Direct= o (00593) 0998-235-485 </sp= an><a href=3D"http://www.anatomiadigital.org" style=3D"text-decoration:none= "></a><a href=3D"http://www.anatomiadigital.org" style=3D"text-deco= ration:none">www.anatomiadigital.org</s= pan></a><= span class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt"> &#= xa0; <a href=3D"http://www.cienc= iadigitaleditorial.com" style=3D"text-decoration:none"></a><a href= =3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:none">= www.cienciadigitaleditorial.com<= /a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATC= AYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJREFUOI1t= lM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICjUKglBg= ndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5imiZSSj= 4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGEYKgDP8= 9jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3vD8+XMq= lQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgzkSemZm= H5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz+H6AEJ= K9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A8j1Qqx= bWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiYQRrYZB= ZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFKkcV1tf= XeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhbn4l8MB= hEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZnJZEin0= wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD2qIFD0= el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRBw8ekkq= l0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kghaDQdPt= Y+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5QyMrqKC= qUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR5KKeLx= OLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFTkSuQmC= C" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:= absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAA= ABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAyx= JREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6MjuYGYVHl3= TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhhPi5DP/3F= 601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQKNDpdBBC= MBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61Wo9Vq4Tg= OuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKhSLRQaDAb= Zts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJkcfeARPVz= WaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9VqlXA4zPLy= MouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398JBAK4rst= gMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+CwLYwxSSo= LBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kEsGKRCKsr= Kz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEwtTY81Wpc= XV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+65976cdojfI= UAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEolwdHQ0Ac= G3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80Gg0+Pj4Q= GtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width=3D"19" h= eight=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute" /></spa= n>= <img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAASCAYAAABWz= o5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI1VlM1PIkkY= xn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPyMrAyofY2tB= de2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycxDAMhxI9DBP= geUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpyeOjo4olUo0m= 01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKtMz0wTUALe3= t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJq= aGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI6PX1lbOzM1= +DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA4HGZ1dRVN0= 4hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26RO9bpd/W00K= +3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQTab5f7+/n/= /CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm8dTv02630T= SNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3xmWmaxvT09= AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cjAYcHx8zPb2= Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1= NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3QN7c7Xa5vr= 6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" width=3D"18= " height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:absolute" /></= span>Revista Anatom=C3=ADa Digital &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Amb= ate=C3=B1o) Tels. (00593) = 511262 y 0984058533 = Tel. 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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= MAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJR= EFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReIC= jUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5= imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoG= EYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3= vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPg= zkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7N= z+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/= A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomi= YQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMF= KkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUh= bn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZ= nJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsU= D2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iR= Bw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kg= haDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5= QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvhe= R5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElF= TkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; po= sition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAAN= SUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSs= OGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mj= uYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhh= Pi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQ= KNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61= Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKh= SLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJk= cfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vq= lXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398= JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+C= wLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kE= sGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEw= tTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+659= 76cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEo= lwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80= Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAAS= CAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI1= VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPyM= rAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycxD= AMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpyeO= jo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKtM= z0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9H= o9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI6= PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA4= HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26RO= 9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQT= ab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm8= dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3x= mWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cjA= YcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2B= +FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3Q= N7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" wi= dth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:absol= ute" />Revista Anatom=C3=ADa Digital</span= > = Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. (00593) 511262 y 0984058533 &#x= a0; Tel. Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-= decoration:none"></a><a href=3D"http://www.anatomiadigital.org" sty= le=3D"text-decoration:none">www.anatomi= adigital.org</a> <a href=3D"h= ttp://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= /p><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-dec= oration:none">www.cienciadigitaleditori= al.com</a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSU= hEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOG= wAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAq= FAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgB= DQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHic= ViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEg= QqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDab= rKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwx= Dcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4O= HMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1y= eVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185Oemy= uLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpB= MJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJ= SSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5= nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2i= x3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3Pj= mBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPH= nyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW= 1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidn= AAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0K= GgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAA= ADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQ= jiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UE= ikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59Fs= Nrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQG= OFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4= IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZ= DJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3F= cZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dn= BdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u= 7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xL= It4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28T= DocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgG= M1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNW= qS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlq= NfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC= " width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:a= bsolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAA= ABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAzt= JREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhF= mVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkU= ikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13Wl= lJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dE= NQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/= 2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo= 8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1W= i2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/= U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1= KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo= 6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvy= zrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5= UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7+= +/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMx= l8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSu= QmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; positi= on:absolute" />Revista Anatom=C3=ADa</span= > Digital<= /span>&= #xa0; Ambato =E2=80=93 Ecuador (J= ard=C3=ADn Ambate=C3=B1o) = = Tels. (00593) 511262 y 0984058533 = Tel. 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/88sawSImorq6WWVlZ37tZIQSKomAwGEKNrMfjwe/3f28OGCwWi4WFCxei0+k4d+4cJ06cwOv1s= njxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1E5WVhbTp0/n4sWLNDcH= C2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+/0b36rX/FXvXmzN47GY= 2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" width=3D"77" height=3D= "28" alt=3D"" style=3D"margin-left:441.05pt; position:absolute" /><s= pan class=3D"awspan" style=3D"font-weight:bold">Palabras claves: </p= >buenas pr=C3=A1cticas, infecci=C3=B3n, paciente, respiraci=C3= =B3n artificial.ResumenIntroducci=C3= =B3n: <sp= an class=3D"awspan">Las Neumon=C3=ADas = Asociadas </s= pan>a la Ventilaci= =C3=B3n Mec=C3=A1nica (NAVM), son<= span class=3D"awspan" style=3D"letter-spacing:4.15pt"> las infecciones nosocomiales</= span> de mayor prevalencia en</= span> las Unidades de<sp= an class=3D"awspan" style=3D"letter-spacing:2.25pt"> Cuidados Intensivos (UCI).<= span class=3D"awspan" style=3D"letter-spacing:0.2pt"> Para = su prevenci=C3=B3n,<sp= an class=3D"awspan" style=3D"letter-spacing:0.2pt"> las </= span>buenas pr=C3=A1cticas<s= pan class=3D"awspan" style=3D"letter-spacing:0.35pt"> de <= /span>enfermer=C3=ADa resultan</spa= n> indispensables. Obje= tivo: <spa= n class=3D"awspan" style=3D"letter-spacing:0.1pt">realizar una revisi=C3=B3n<spa= n class=3D"awspan" style=3D"letter-spacing:0.1pt"> sistem=C3=A1tica<= span class=3D"awspan" style=3D"letter-spacing:5.4pt"> sobre buenas= pr=C3=A1cticas de enfermer=C3= =ADa <= span class=3D"awspan">en la prevenci=C3= =B3n <= span class=3D"awspan">de infecciones nosocom= iales <sp= an class=3D"awspan">asociadas a la<sp= an class=3D"awspan" style=3D"letter-spacing:0.2pt"> ventilaci=C3=B3n mec=C3=A1nica, y</= span> evaluar la efectividad</s= pan> de su implementaci=C3=B3n, en <s= pan class=3D"awspan">hospitales de tercer= <span= class=3D"awspan">nivel en Am=C3=A9rica L= atina. = Metodolog=C3=ADa<s= pan class=3D"awspan" style=3D"font-weight:bold; color:#767171">:<spa= n class=3D"awspan" style=3D"letter-spacing:1.8pt"> se </sp= an>realiz=C3=B3 una revisi=C3=B3n sistem=C3=A1tica de estudio= s <span= class=3D"awspan">publicados entre los</spa= n> a=C3=B1os 2019 y 2024. </span= >El proceso de b=C3= =BAsqueda </s= pan>se realiz=C3=B3 en <= span class=3D"awspan">las bases de= datos Scielo, LILACS<s= pan class=3D"awspan" style=3D"letter-spacing:1.25pt"> y Redalyc y permiti=C3=B3= seleccionar 10 art=C3=ADculos= , <spa= n class=3D"awspan">de 6 pa=C3=ADses</span= > de Latinoam=C3=A9rica, cuyas<= /span> muestras fueron paciente= s <spa= n class=3D"awspan">pedi=C3=A1tricos, adultos y<span= class=3D"awspan" style=3D"letter-spacing:4.25pt"> adultos= mayores. Resultados: en los pacientes pedi=C3=A1tr= icos <= span class=3D"awspan">se aplica un= paquete de intervenciones</s= pan> que pone =C3=A9nfasis en</s= pan> el mantenimiento de<sp= an class=3D"awspan" style=3D"letter-spacing:0.1pt"> la </sp= an>higiene bucal y <spa= n class=3D"awspan">la elevaci=C3=B3n del</= span> cabecero de las<spa= n class=3D"awspan" style=3D"letter-spacing:1.5pt"> camas. = Estas intervenciones<s= pan class=3D"awspan" style=3D"letter-spacing:1.4pt"> se </s= pan>conciben tambi=C3=A9n en<= span class=3D"awspan" style=3D"letter-spacing:4.2pt"> pacientes adultos y adultos </sp= an>mayores. En los</= span> estudios en poblaci=C3=B3n adulta, aunque = no se logra una adhesi=C3=B3n total a las</span= > intervenciones implementadas, = se <spa= n class=3D"awspan">observa una reducci=C3= =B3n <s= pan class=3D"awspan">del riesgo de<s= pan class=3D"awspan" style=3D"letter-spacing:1.4pt"> neumon=C3=ADas y de los <s= pan class=3D"awspan">d=C3=ADas de estancia= <span= class=3D"awspan">hospitalaria. Conclusiones: <= /span>los paquetes de <s= pan class=3D"awspan">intervenci=C3=B3n de enfermer=C3=AD= a, <spa= n class=3D"awspan">que se aplican<sp= an class=3D"awspan" style=3D"letter-spacing:0.9pt"> en </sp= an>las UCI de= Am=C3=A9rica Latina, en atenci= =C3=B3n </span= >de pacientes con</= span> NAVM, coinciden en<= span class=3D"awspan" style=3D"letter-spacing:0.65pt"> incluir como principales</spa= n> acciones de cuidados</spa= n> de enfermer=C3=ADa,<= span class=3D"awspan" style=3D"letter-spacing:-0.45pt"> las medidas de higiene</spa= n> bucal, la elevaci=C3=B3n</s= pan> del cabecero y<span= class=3D"awspan" style=3D"letter-spacing:-0.5pt"> la </sp= an>observancia de = los protocolos para la = aspiraci=C3=B3n endotraqueal. =C3=81rea de estudio general: medicina.= =C3=81rea de estudio espec=C3=ADfica: unidad de cuidados intensivos. Tipo de estudio: Revisi=C3=B3n Bibliogr=C3=A1fica Keywords: Good practice= s, infection, patient, artificial respirationAbstractIntroduction: Ventilator-A= ssociated </sp= an>Pneumonia (VAP) i= s <span= class=3D"awspan">the most prevalent nosoco= mial <s= pan class=3D"awspan">infection in Intensive= Care Units (ICU). Good</s= pan> nursing practices are</spa= n> essential for its<spa= n class=3D"awspan" style=3D"letter-spacing:0.45pt"> prevention. Objective: </sp= an>to conduct a</s= pan> systematic review of</span= > good nursing practices in</sp= an> the prevention of<sp= an class=3D"awspan" style=3D"letter-spacing:-0.1pt"> nosocomial infections associated = with <= span class=3D"awspan">mechanical ventilation, and </sp= an>to evaluate the= <span= class=3D"awspan">effectiveness of its implementation in third-level<s= pan class=3D"awspan" style=3D"letter-spacing:-0.15pt"> hospitals in Latin<s= pan class=3D"awspan" style=3D"letter-spacing:-0.15pt"> America. <img src=3D"data:image/jpeg;base64,/9j/4= AAQSkZJRgABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8SEhEPERET= FhwXExQaFRERGCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4eHh4eHh4= eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAxoDASIAAh= EBAxEB/8QAHAABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGCQMEAgMAA= AECAwQFEQYSByExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0haCsRg4Q2IkwWNz= 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position:absolute" />Revista Anatom=C3=ADa Digital &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) = = Tels. (00593) 511262 y 098= 4058533 Tel. 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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= MAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJR= EFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReIC= jUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5= imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoG= EYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3= vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPg= zkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7N= z+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/= A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomi= YQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMF= KkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUh= bn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZ= nJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsU= D2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iR= Bw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kg= haDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5= QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvhe= R5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElF= TkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; po= sition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAAN= SUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSs= OGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mj= uYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhh= Pi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQ= KNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61= Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKh= SLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJk= cfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vq= lXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398= JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+C= wLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kE= sGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEw= tTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+659= 76cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEo= lwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80= Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital</spa= n> = ; Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. (00593) 511262 y 0984058533 &#x= a0; Tel. Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-= decoration:none"></a><a href=3D"http://www.anatomiadigital.org" sty= le=3D"text-decoration:none">www.anatomi= adigital.org</a> <a href=3D"h= ttp://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= /p><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-dec= oration:none">www.cienciadigitaleditori= al.com</a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSU= hEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOG= wAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAq= FAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgB= DQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHic= ViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEg= QqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDab= rKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwx= Dcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4O= HMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1y= eVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185Oemy= uLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpB= MJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJ= SSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5= nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2i= x3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3Pj= mBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPH= nyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW= 1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidn= AAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0K= GgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAA= ADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQ= jiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UE= ikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59Fs= Nrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQG= OFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4= IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZ= DJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3F= cZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dn= BdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u= 7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xL= It4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28T= DocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgG= M1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNW= qS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlq= NfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC= " width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:a= bsolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAA= ABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAzt= JREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhF= mVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkU= ikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13Wl= lJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dE= NQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/= 2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo= 8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1W= i2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/= U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1= KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo= 6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvy= zrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5= UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7+= +/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMx= l8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSu= QmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; positi= on:absolute" />Revista Anatom=C3=ADa</span= > Digital<= /span>&= #xa0; Ambato =E2=80=93 Ecuador (J= ard=C3=ADn Ambate=C3=B1o) = = Tels. (00593) 511262 y 0984058533 = Tel. 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/88sawSImorq6WWVlZ37tZIQSKomAwGEKNrMfjwe/3f28OGCwWi4WFCxei0+k4d+4cJ06cwOv1s= njxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1E5WVhbTp0/n4sWLNDcH= C2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+/0b36rX/FXvXmzN47GY= 2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" width=3D"77" height=3D= "28" alt=3D"" style=3D"margin-left:441.05pt; position:absolute" /><s= pan class=3D"awspan" style=3D"font-weight:bold">Methodology: a systematic review </spa= n>of studies publish= ed between </= span>2019 and 2024= <span= class=3D"awspan">was conducted. The</spa= n> search process was conducted= <span= class=3D"awspan">in the Scielo,<s= pan class=3D"awspan" style=3D"letter-spacing:0.85pt"> LILACS and Redalyc databases and allowed the<span= class=3D"awspan" style=3D"letter-spacing:-0.1pt"> selection of 10 = articles </sp= an>from 6 Latin</s= pan> American countries, whose s= amples = were pediatric patie= nts, <s= pan class=3D"awspan">adults, and older adu= lts. <= span class=3D"awspan" style=3D"font-weight:bold">Results: a package of <= span class=3D"awspan">interventions is = applied </spa= n>in pediatric patients<spa= n class=3D"awspan" style=3D"letter-spacing:-0.65pt"> that= emphasizes maintaining</sp= an> oral hygiene and raising= <span= class=3D"awspan">the head of<span= class=3D"awspan" style=3D"letter-spacing:3.65pt"> the </s= pan>bed. These int= erventions </= span>are also conceived<span= class=3D"awspan" style=3D"letter-spacing:1pt"> for <s= pan class=3D"awspan">adult and older<spa= n class=3D"awspan" style=3D"letter-spacing:1pt"> adult </span= >patients. In studies</s= pan> in <= /span>the adult population,<s= pan class=3D"awspan" style=3D"letter-spacing:1pt"> although <= /span>full adherence to<= /span> the implemented interventions = is <sp= an class=3D"awspan">not achieved, a</span= > reduction in the risk </s= pan>of pneumonia and in= the length of hos= pital <sp= an class=3D"awspan">stay is observed. <s= pan class=3D"awspan" style=3D"font-weight:bold">Conclusions: t= he <spa= n class=3D"awspan">nursing intervention p= ackages, </spa= n>which are applied in <s= pan class=3D"awspan">the ICUs of<s= pan class=3D"awspan" style=3D"letter-spacing:1.05pt"> Latin America, in the </span= >care of patients = with <s= pan class=3D"awspan">VAP, coincide in</span= > including as main nursing </s= pan>care actions, oral hygiene <= /span>measures, elevation<= span class=3D"awspan" style=3D"letter-spacing:1.55pt"> of the head = of <sp= an class=3D"awspan">the bed and observanc= e <span= class=3D"awspan">of protocols for<s= pan class=3D"awspan" style=3D"letter-spacing:1.1pt"> endotracheal aspiration. General Area of</= span> Study:<= span class=3D"awspan" style=3D"font-weight:bold; letter-spacing:1.25pt"> </= span>Medicine. Specific area of</s= pan> study<sp= an class=3D"awspan" style=3D"font-weight:bold; color:#767171">:<span= class=3D"awspan" style=3D"letter-spacing:1.25pt"> Intensive care unit. Type of study: = Bibliography Review.1.Introducci=C3=B3nLa Neumo= n=C3=ADa </sp= an>Asociada a la</= span> Ventilaci=C3=B3n Mec=C3=A1nica<span= class=3D"awspan" style=3D"letter-spacing:2.95pt"> (NAVM) = constituye una de </span= >las infecciones nosocomiales</spa= n> de mayor incidencia= en UCIS a = nivel = mundial (<a href=3D"#ref1" s= tyle=3D"text-decoration:none"></a><a href=3D"#ref1" style=3D"text-decoration:none">= 1</a>= ).</s= pan> Clasifica dentro de las</spa= n> Infecciones Asociadas a<= span class=3D"awspan" style=3D"letter-spacing:0.1pt"> la </= span>Atenci=C3=B3n en Salud </span= >(IAAS) dado que</sp= an> el paciente no la presenta <= /span>al momento d= e <span= class=3D"awspan">su entrada al<span= class=3D"awspan" style=3D"letter-spacing:2.2pt"> hospital,= ni se encuen= tra <sp= an class=3D"awspan">en proceso de incubaci= =C3=B3n.La NAVM es<= /span> una infecci=C3=B3n del</= span> tracto respiratorio infer= ior <s= pan class=3D"awspan">que evoluciona al</s= pan> menos 48 horas despu=C3=A9= s <spa= n class=3D"awspan">de la intubaci=C3=B3n<= /span> endotraqueal o en= las primeras 48 horas </s= pan>de la extubaci= =C3=B3n (<a href=3D"#ref2" style=3D"text-decoration:none"></a><p= class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt"><a href=3D"#re= f2" style=3D"text-decoration:none">2</a>). Al ser</= span> la ventilaci=C3=B3n mec= =C3=A1nica </= span>un tratamiento de <= span class=3D"awspan">soporte vital de</s= pan> uso habitual en<spa= n class=3D"awspan" style=3D"letter-spacing:0.25pt"> las ucis, las neumon=C3=ADas asociadas a este tratamiento invasivo s= on bastante frecuentes. Las NAVM</sp= an> pueden ser originadas</span= > por factores internos<= span class=3D"awspan" style=3D"letter-spacing:1.35pt"> y= externos. Entre<span= class=3D"awspan" style=3D"letter-spacing:1.35pt"> los </s= pan>factores externos constan= el= manejo inadecuado<spa= n class=3D"awspan" style=3D"letter-spacing:0.6pt"> de </spa= n>equipos y material= es <spa= n class=3D"awspan">y el incumplimiento</sp= an> de las normas de bioseguridad por los p= rofesionales <= /span>de la salud</s= pan> (<a href=3D"#ref3" style=3D"text-decoration:none"></a>= <a href= =3D"#ref3" style=3D"text-decoration:none">3</a>). Es <sp= an class=3D"awspan">comprensible, entonces, que<span= class=3D"awspan" style=3D"letter-spacing:0.2pt"> la </span= >NAVM represente u= n <span= class=3D"awspan">desaf=C3=ADo cl=C3=ADnico que <s= pan class=3D"awspan">pondera, entre otras</= span> acciones, <img src=3D"data:image/jpeg;base64,/= 9j/4AAQSkZJRgABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8SEhEP= ERETFhwXExQaFRERGCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4eHh4= eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAxoDAS= IAAhEBAxEB/8QAHAABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGCQMEA= gMAAAECAwQFEQYSByExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0haCsRg4Q2Ik= wWNzg//EABsBAQEBAQEBAQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgIABAIJAwQDAAAAAAE= CEQMSBFEFITFBE4EUIjI0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPwDqXfGR5+77cnfGR5= +77cuIf0nUfi91yzkX/P3fblO+L/n7vty4w1F3XJORf8/d9uU74yPP3fblhKGobrk74v8An7vty= d8ZHn7vty4w1Flrk74v+fu+3KTkZHn7vtywSV1F3WffOR5+77cnfOR5+77cuMXUZ3XJ3zkefu+3= 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Ecuador (Jard=C3=ADn Amb= ate=C3=B1o) Tels. (00593) = 511262 y 0984058533 = Tel. Di= recto (00593) 0998-235-485 = <a href=3D"http://www.anatomiadigital.org" style=3D"text-decoration:= none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"text-= decoration:none">www.anatomiadigital.org</a></p= > = <a href=3D"http://www.cienciadigitale= ditorial.com" style=3D"text-decoration:none"></a><a href=3D"http://= www.cienciadigitaleditorial.com" style=3D"text-decoration:none">www.cienciadigitaleditorial.com</a><img src=3D"data:= image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICA= gIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpE= pNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZ= afT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dl= hdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAy= AMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1= Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL= 16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQ= kSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0z= QZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtu= xGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJyc= AKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++= TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraR= AwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6= fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h= 4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx= 2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFL= quUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl= 0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFTkSuQmCC" width=3D"19" height=3D= "19" alt=3D"" style=3D"margin-left:3.84pt; position:absolute" /><spa= n style=3D"height:0pt; display:block; position:absolute; z-index:194"><img = src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAA= AABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zO= n9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbn= N8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XR= QSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwN= bWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFB= DQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev= 1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlR= K0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQM= dxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp= 354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaW= pz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3A= kQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38= cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+I= QTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FR= Rh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj= 0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" = style=3D"margin-left:3.84pt; position:absolute" /><img src=3D"data:im= age/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgI= fAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozs= BD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE= 89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6u= sKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKR= YH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl= 8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SC= gUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIR= CI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jP= Fo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVI= ihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJ= TEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KM= wyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUc= x6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10= XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2L= bN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkM= qTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" width=3D"18" height=3D"18" alt= =3D"" style=3D"margin-left:5.66pt; position:absolute" />Revista Anatom=C3=ADa Digital &= #xa0; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) </sp= an> = 0; Tels. (00593) 511262 y 0984058= 533 Tel. 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position:absolute" />Revista Anatom=C3=ADa Digital &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) = = Tels. (00593) 511262 y 098= 4058533 Tel. 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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= MAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJR= EFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReIC= jUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5= imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoG= EYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3= vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPg= zkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7N= z+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/= A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomi= YQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMF= KkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUh= bn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZ= nJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsU= D2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iR= Bw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kg= haDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5= QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvhe= R5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElF= TkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; po= sition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAAN= SUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSs= OGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mj= uYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhh= Pi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQ= KNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61= Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKh= SLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJk= cfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vq= lXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398= JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+C= wLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kE= sGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEw= tTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+659= 76cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEo= lwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80= Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital</spa= n> = ; Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. (00593) 511262 y 0984058533 &#x= a0; Tel. Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-= decoration:none"></a><a href=3D"http://www.anatomiadigital.org" sty= le=3D"text-decoration:none">www.anatomi= adigital.org</a> <a href=3D"h= ttp://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= /p><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-dec= oration:none">www.cienciadigitaleditori= al.com</a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSU= hEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOG= wAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAq= FAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgB= DQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHic= ViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEg= QqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDab= rKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwx= Dcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4O= HMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1y= eVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185Oemy= uLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpB= MJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJ= SSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5= nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2i= x3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3Pj= mBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPH= nyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW= 1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidn= AAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0K= GgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAA= ADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQ= jiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UE= ikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59Fs= Nrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQG= OFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4= IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZ= DJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3F= cZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dn= BdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u= 7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xL= It4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28T= DocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgG= M1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNW= qS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlq= NfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC= " width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:a= bsolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAA= ABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAzt= JREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhF= mVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkU= ikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13Wl= lJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dE= NQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/= 2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo= 8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1W= i2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/= U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1= KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo= 6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvy= zrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5= UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7+= +/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMx= l8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSu= QmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; positi= on:absolute" />Revista Anatom=C3=ADa</span= > Digital<= /span>&= #xa0; Ambato =E2=80=93 Ecuador (J= ard=C3=ADn Ambate=C3=B1o) = = Tels. (00593) 511262 y 0984058533 = Tel. 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/88sawSImorq6WWVlZ37tZIQSKomAwGEKNrMfjwe/3f28OGCwWi4WFCxei0+k4d+4cJ06cwOv1s= njxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1E5WVhbTp0/n4sWLNDcH= C2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+/0b36rX/FXvXmzN47GY= 2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" width=3D"77" height=3D= "28" alt=3D"" style=3D"margin-left:441.05pt; position:absolute" /><s= pan class=3D"awspan">la necesidad de</spa= n> mantener la vigilancia</span= > epidemiol=C3=B3gica, cumplimiento de </spa= n>los protocolos de prevenci=C3=B3n= de infecciones y la capacitaci=C3=B3n continua del personal de salud (</sp= an><a href=3D"#ref4" style=3D"text-decoration:none"></a><a href=3D"#ref4" style=3D"= text-decoration:none">4</a>). Es una<spa= n class=3D"awspan" style=3D"letter-spacing:2.1pt"> patolog=C3=ADa compleja pero<s= pan class=3D"awspan" style=3D"letter-spacing:2.1pt"> prevenible desde el quehacer </sp= an>del personal sani= tario, especialmente, del personal= de enfermer=C3=ADa. A<= span class=3D"awspan" style=3D"letter-spacing:1.65pt"> decir de (<a href=3D"#= ref5" style=3D"text-decoration:none"></a><a href=3D"#ref5" style=3D"text-decoration= :none">5<= /a>) <s= pan class=3D"awspan">el papel de<s= pan class=3D"awspan" style=3D"letter-spacing:1.65pt"> los = enfermeros resulta decisivo<= /span> en la prevenci=C3=B3n</= span> de NMVA por ser </spa= n>estos los profes= ionales </spa= n>que prestan la a= tenci=C3=B3n = directa a = los <s= pan class=3D"awspan">pacientes y los</spa= n> que manipulan los<spa= n class=3D"awspan" style=3D"letter-spacing:-0.5pt"> sistemas de ventilaci=C3=B3n</span= > mec=C3=A1nica. En consec= uencia </span= >es crucial que</s= pan> las enfermeras y<sp= an class=3D"awspan" style=3D"letter-spacing:0.05pt"> enfermeros realicen un<spa= n class=3D"awspan" style=3D"letter-spacing:0.05pt"> manejo= correcto de la<span= class=3D"awspan" style=3D"letter-spacing:-0.15pt"> ventilaci=C3=B3n mec=C3=A1nica, que = eleven el conoci= miento </spa= n>relacionado con la = prevenci=C3=B3n de infecciones,<= /span> dominen las t=C3=A9cnica= s <spa= n class=3D"awspan">de aspiraci=C3=B3n de<= /span> secreciones, usen barrer= as <sp= an class=3D"awspan">de protecci=C3=B3n y hagan </= span>uso adecuado del </span= >lavado de mano<= /span> <span= class=3D"awspan">y la bioseguridad,</s= pan> de manera general (</sp= an><a href=3D"#ref6" style=3D"text-decoration:none"></a><a href=3D"#ref6" style=3D"= text-decoration:none">6</a>). En otros estudios <= /span>(<a href=3D"#ref3" style=3D"text-decora= tion:none"></a><a href=3D"#ref3" style=3D"text-decoration:none">3</a><a href=3D"#ref7" style= =3D"text-decoration:none"></a><a href=3D"#ref7" style=3D"text-decoration:none"><spa= n class=3D"awspan" style=3D"text-decoration:underline">, </sp= an>7</a><= a href=3D"#ref8" style=3D"text-decoration:none"></a><a href=3D"#ref8" style=3D"text= -decoration:none">, 8</a><spa= n class=3D"awspan">), como buenas<sp= an class=3D"awspan" style=3D"letter-spacing:0.7pt"> pr=C3=A1cticas del personal<s= pan class=3D"awspan" style=3D"letter-spacing:0.7pt"> de </s= pan>enfermer=C3=ADa en la prevenci=C3=B3n de NAVM, se = pondera la elevaci= =C3=B3n </span= >del cabecero de</sp= an> las camas, la higiene bucal, la evaluaci=C3=B3n de la sedaci=C3=B3n diaria y la realizac= i=C3=B3n de terapia respiratoria. Otros autores </s= pan>(<a href=3D"#ref9" style=3D"text-decorati= on:none"></a><a href=3D"#ref9" style=3D"text-decoration:none">9</a>, <a href=3D"#ref10" style=3D"tex= t-decoration:none"></a><a href=3D"#ref10" style=3D"text-decoration:none">10</a>),<spa= n class=3D"awspan" style=3D"letter-spacing:0.6pt"> previo <= /span>desarrollo de programas </s= pan>de intervenci=C3=B3n,<spa= n class=3D"awspan" style=3D"letter-spacing:0.6pt"> han </sp= an>comprobado la efectividad= de= la aplicaci=C3=B3n<sp= an class=3D"awspan" style=3D"letter-spacing:0.3pt"> de </sp= an>paquetes de medid= as <spa= n class=3D"awspan">en la prevenci=C3=B3n</s= pan> de neumon=C3=ADa en pacientes= con ventilaci=C3=B3n mec=C3=A1nica. A pesar </span= >de ello, son= escasos los informes<sp= an class=3D"awspan" style=3D"letter-spacing:0.5pt"> que </s= pan>dan cuenta de</s= pan> la totalidad de pr=C3=A1cticas de enfermer=C3=ADa que</= span> es posible aplicar= en la prevenci=C3=B3n<= span class=3D"awspan" style=3D"letter-spacing:5.55pt"> de NAVM. Los estudios, generalmente, se dirigen</span= > a= la caracterizaci=C3=B3n</sp= an> del diagn=C3=B3stico cl=C3= =ADnico </spa= n>y a las<s= pan class=3D"awspan" style=3D"letter-spacing:-0.7pt"> condicionantes de las infeccione= s <spa= n class=3D"awspan">nosocomiales asociadas a <sp= an class=3D"awspan">ventilaci=C3=B3n mec=C3=A1nica,= sin evaluar el quehacer preventivo de los profesionales de enfermer=C3=ADa.<= p class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt">Ante tal vac=C3=ADo<span= class=3D"awspan" style=3D"letter-spacing:2.9pt"> en </span= >la literatura cient= =C3=ADfica, </= span>resulta relevante conocer </s= pan>=C2=BFCu=C3=A1les son<spa= n class=3D"awspan" style=3D"letter-spacing:2.9pt"> las pr=C3=A1cticas de enfermer=C3=ADa= que contribuyen a<s= pan class=3D"awspan" style=3D"letter-spacing:1.6pt"> la </s= pan>prevenci=C3=B3n de infecciones= nosocomiales asociadas a la ventilaci=C3=B3n= mec=C3=A1nica, en hospitales de tercer nivel en Am=C3=A9rica Latina?</span= >La prevenci=C3=B3n de</= span> esta infecci=C3=B3n no= <spa= n class=3D"awspan">es posible mediante<= /span> <span= class=3D"awspan">la pr=C3=A1ctica de</= span> una medida aislada o</= span> un n=C3=BAmero reducido</spa= n> de= ellas. El p= resente </span= >estudio permitir=C3=A1 identificar las buenas pr=C3=A1cticas</= span> de enfermer=C3=ADa que</s= pan> se emplean en ucis </s= pan>de Am=C3=A9rica Latina </sp= an>para prevenir = la NAVM </spa= n>y, en consecuenc= ia, <s= pan class=3D"awspan">permitir=C3=A1 realizar una </spa= n>valoraci=C3=B3n cr=C3=ADtica</spa= n> del uso las mismas, en cada UCI de la regi=C3=B3n. La<spa= n class=3D"awspan" style=3D"letter-spacing:1.45pt"> NAVM <= /span>est=C3=A1 presentes<= span class=3D"awspan" style=3D"letter-spacing:1.45pt"> en pa=C3=ADses de<span= class=3D"awspan" style=3D"letter-spacing:1.45pt"> todos <= /span>los continentes, llegando= a alcanzar a <sp= an class=3D"awspan">la cuarta parte de<s= pan class=3D"awspan" style=3D"letter-spacing:1pt"> los </span= >pacientes que ingresan<= /span> en= cuidados intensivos<sp= an class=3D"awspan" style=3D"letter-spacing:1pt"> (<a href=3D"#ref11" style=3D"text-decoration:none"></a><a href=3D"#ref1= 1" style=3D"text-decoration:none">11</a>). </span= >A decir de (<a href=3D"#ref4" style=3D"text-decoration:none"></a><a href=3D"#ref4" st= yle=3D"text-decoration:none">4</a>) infecci=C3=B3n afecta entre el 20 y el 50 % de lo= s pacientes sometidos a ventilaci=C3=B3n mec=C3=A1nica, provocando<s= pan class=3D"awspan" style=3D"letter-spacing:0.45pt"> un <= /span>aumento significativo<= span class=3D"awspan" style=3D"letter-spacing:0.45pt"> en la morbimortalidad<= span class=3D"awspan" style=3D"letter-spacing:0.45pt"> y= en los cos= tos <s= pan class=3D"awspan">de atenci=C3=B3n m=C3=A9dica.<= span class=3D"awspan" style=3D"letter-spacing:0.55pt"> Basados en estad=C3=ADsticas= <span= class=3D"awspan">recientes (<a href=3D"#ref12" sty= le=3D"text-decoration:none"></a><a href=3D"#ref12" style=3D"text-decoration:none"><= span class=3D"awspan" style=3D"text-decoration:underline">12</a>= ) reportan que<span= class=3D"awspan" style=3D"letter-spacing:0.55pt"> en </sp= an>Latinoam=C3=A9rica la<spa= n class=3D"awspan" style=3D"letter-spacing:0.55pt"> tasa <= /span>de neumon=C3=ADa asociada</s= pan> a ventilaci=C3=B3n mec= =C3=A1nica <= /span>es 10 vece= s <sp= an class=3D"awspan">mayor que en= pa=C3=ADses desarrollados, alcanzando 11.47 p= or cada 1,000 d=C3=ADas de ventilaci=C3=B3n.<img src=3D"data:= image/jpeg;base64,/9j/4AAQSkZJRgABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIB= 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position:absolute" /><= span class=3D"awspan" style=3D"font-family:Calibri; font-size:9pt; font-wei= ght:bold; color:#4472c4">Revista Anatom=C3=ADa Digital &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3= =B1o) Tels. 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(00593) 511262 y 0984058533 &#x= a0; Tel. 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Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" st= yle=3D"text-decoration:none"></a><a href=3D"http://www.anatomiadigi= tal.org" style=3D"text-decoration:none">www.anatomiadigital.org</a> = <a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration= :none"></a><a href=3D"http://www.cienciadigitaleditorial.com" style= =3D"text-decoration:none">www.cienciadi= gitaleditorial.com</a><img src=3D"data:image/png;base64,iVBORw= 0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOx= AAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM= 3xfCue0huWAqFAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qe= npzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKR= aLFItFRkdHicViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk= 0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE= 43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbp= dEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n8= 3NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVA= LLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovP= Fvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSk= ECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/j= tse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIB= KZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJ= r1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd= 9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O1= 8z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcw= S6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqK= T0/sycXcKidnAAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"= margin-left:-1pt; position:absolute" /><img src=3D"data:image/png;bas= e64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAl= wSFlzAAAOxAAADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QT= d9hT5iVCBdFQjiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+= fmJMQa/34+UEikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBK= OQUVY2We59FsNrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8s= MBgMsy0JrPQGOFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM= 7OziiVSnieN4IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EE= KyurgKQz+fJZDJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFa= rUa328V6fX3FcZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/d= kMhmur6/Z2dnBdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8G= vIr8Avmi9N7u7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G= +vrzAQCaK2xLIt4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoR= CoWwpJRsb28TDocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT08= 5Pz9HKTVphgGM1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZp= QtITDagIAvNWqS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNpp= JT/2vNzOCqlqNfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAA= AElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt= ; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoA= AAANSUhEUgAAABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQ= BlSsOGwAAAztJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpC= shMtFl1sSPhFmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6= HQ6CCGIx+OkUikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzM= DIZheOkI13WllJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05= OTigUCrTb7dENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7= MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8= V/HWJaFlJJGo8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32G= wyF3d3cAKK1Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41= t2xweHqLrOv/U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIx= qNsrGxQa/Xo1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQ= OPj4yQSCT/Zo6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HG= xmL8/OEDruvyzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq= 1cIaO3yq5XG5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0= Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg= 3Q6zdraGplMxl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukF= AAAAAElFTkSuQmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" />Revista Anatom= =C3=ADa Digital <spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Ambato =E2= =80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) &#= xa0; Tels. 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(00593) 511262 y 0984058533 = 0; Tel. 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ei0+k4d+4cJ06cwOv1snjxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1= E5WVhbTp0/n4sWLNDcHC2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+= /0b36rX/FXvXmzN47GY2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" wid= th=3D"77" height=3D"28" alt=3D"" style=3D"margin-left:441.05pt; position:ab= solute" />Varios estudios</s= pan> (<a href=3D"#ref13" style=3D"text-decoration:none"></= a><a hre= f=3D"#ref13" style=3D"text-decoration:none">13</a>, <a href=3D"#ref14" style=3D"text-decora= tion:none"></a><a href=3D"#ref14" style=3D"text-decoration:none">14,</a> <a href=3D"#ref15" style=3D"text-decoration:none"><= /a><a hr= ef=3D"#ref15" style=3D"text-decoration:none">15</a>) dan<sp= an class=3D"awspan" style=3D"letter-spacing:0.65pt"> cuenta de la sig= nificativa </= span>incidencia de las </span= >infecciones nosocomiales, relaciona= das <sp= an class=3D"awspan">con la ventilaci=C3=B3n= mec=C3=A1nica, en hospital= es <spa= n class=3D"awspan">de tercer nivel<s= pan class=3D"awspan" style=3D"letter-spacing:0.3pt"> de Am=C3=A9rica Latina. Seg=C3=BAn<= /span> describe (<a href=3D"#ref11" style= =3D"text-decoration:none"></a><a href=3D"#ref11" style=3D"text-decoration:none"><sp= an class=3D"awspan" style=3D"text-decoration:underline">11</a><p= style=3D"margin-right:1pt; margin-left:1pt">)</span= > en= Colombia el 50% <s= pan class=3D"awspan">de los pacientes</span= > en= UCI contraen neumon=C3=ADa<= /span> relacionada con la</span= > respiraci=C3=B3n ventilada = y <spa= n class=3D"awspan">M=C3=A9xico y Chile,</= span> por su parte, reportan</s= pan> un incremento de<sp= an class=3D"awspan" style=3D"letter-spacing:1.95pt"> la </= span>estancia hospitalaria<s= pan class=3D"awspan" style=3D"letter-spacing:1.95pt"> y </= span>de los costos= <span= class=3D"awspan">de atenci=C3=B3n derivado de la NAVM. </= span><sp= an class=3D"awspan">Esta situaci=C3=B3n r= equiere </span= >un mayor =C3=A9nfas= is, <sp= an class=3D"awspan">por parte del<sp= an class=3D"awspan" style=3D"letter-spacing:1.7pt"> personal de enfermer=C3=ADa,<= span class=3D"awspan" style=3D"letter-spacing:1.7pt"> en </= span>la prevenci=C3=B3n de<s= pan class=3D"awspan" style=3D"letter-spacing:1.65pt"> este= tipo de = complicaciones. Al explorar el </span= >conocimiento y = la <sp= an class=3D"awspan">pr=C3=A1ctica cl=C3=ADnica de<s= pan class=3D"awspan" style=3D"letter-spacing:0.25pt"> profesionales de enfermer=C3=ADa= <span= class=3D"awspan">en pa=C3=ADses del</spa= n> =C3=A1rea de estudio,= en Bolivia destacan las</spa= n> deficiencias relacionadas = con <s= pan class=3D"awspan">la manipulaci=C3=B3n del <= span class=3D"awspan">ventilador mec=C3=A1nico<span= class=3D"awspan" style=3D"letter-spacing:2.75pt"> (<a href=3D"#ref16" style=3D"text-decoration:none"></a><a href=3D"#ref= 16" style=3D"text-decoration:none">16</a>). En M=C3=A9xico<sp= an class=3D"awspan" style=3D"letter-spacing:3.5pt"> por </s= pan>su parte (</span= ><a href=3D"#ref17" style=3D"text-decoration:none"></a><a href=3D"#ref17" style=3D"= text-decoration:none">17</a><span= class=3D"awspan">) reporta pr=C3=A1cticas<= /span> inadecuadas en el<sp= an class=3D"awspan" style=3D"letter-spacing:3.5pt"> uso </s= pan>de barreras de p= rotecci=C3=B3n, la higiene bucal,= el lavado de = las manos y</spa= n> el dominio de<span= class=3D"awspan" style=3D"letter-spacing:-0.55pt"> t=C3=A9cnicas de aspiraci=C3=B3n= y del protocolo de prevenci=C3=B3n en sentido general.Ello </spa= n>explica la neces= idad <= span class=3D"awspan">de que se<sp= an class=3D"awspan" style=3D"letter-spacing:-0.4pt"> implementen programas de<s= pan class=3D"awspan" style=3D"letter-spacing:-0.4pt"> prevenci=C3=B3n en las<sp= an class=3D"awspan" style=3D"letter-spacing:-0.4pt"> ucis = que permitan conocer<s= pan class=3D"awspan" style=3D"letter-spacing:3.1pt"> y </sp= an>extender las buen= as <spa= n class=3D"awspan">pr=C3=A1cticas en la</sp= an> prestaci=C3=B3n de cuidados</s= pan> de enfermer=C3=ADa.En = consecuencia,= el presente estudio </s= pan>se propone com= o <spa= n class=3D"awspan">objetivo general: real= izar <= span class=3D"awspan">una revisi=C3=B3n sistem=C3=A1tica<= /span> de la literatura= sobre pr=C3=A1cticas de</span= > enfermer=C3=ADa en la<= span class=3D"awspan" style=3D"letter-spacing:1.45pt"> prevenci=C3=B3n de infecciones nosocomiales asociadas a la = ventilaci=C3=B3n mec=C3=A1nica,</s= pan> en hospitales de<sp= an class=3D"awspan" style=3D"letter-spacing:1.55pt"> tercer nivel en Am=C3=A9rica Latina.Objetivos= espec=C3=ADficos:Identificar estud= ios <= span class=3D"awspan">que muestren las<= /span> <span= class=3D"awspan">pr=C3=A1cticas de enf= ermer=C3=ADa= empleadas en la </sp= an>prevenci=C3=B3n de infecciones</= span> nosocomiales asociadas = a <spa= n class=3D"awspan">la ventilaci=C3=B3n = mec=C3=A1nica, en hospitales de </spa= n>tercer nivel en Am=C3=A9rica Latina.Explicar los hallazgos<spa= n class=3D"awspan" style=3D"letter-spacing:0.45pt"> y </sp= an>aspectos m=C3=A1s relevantes= dentro de = los <s= pan class=3D"awspan">estudios elegidos, = acerca de </s= pan>pr=C3=A1cticas de enfermer=C3=ADa empleadas en<s= pan class=3D"awspan" style=3D"letter-spacing:2.25pt"> la <= /span>prevenci=C3=B3n de<spa= n class=3D"awspan" style=3D"letter-spacing:2.25pt"> infecciones nosocomiales asociadas a la ventilaci= =C3=B3n mec=C3=A1nica, en hospitales de tercer nivel en Am=C3=A9rica Latina= .= 2.Metodolo= g=C3=ADaLa utilizaci=C3=B3n<s= pan class=3D"awspan" style=3D"letter-spacing:0.65pt"> de <= /span>la metodolog=C3=ADa<sp= an class=3D"awspan" style=3D"letter-spacing:0.65pt"> PICO = permiti=C3=B3 estructurar</s= pan> la pregunta orientadora</s= pan> que constituy=C3=B3 la gu=C3=ADa de la revisi=C3=B3n sistem= =C3=A1tica. Pregunta orientadora:</sp= an> =C2=BFCu=C3=A1les son las</spa= n> buenas pr=C3=A1cticas de= enfermer=C3=ADa que contribuyen= a la prevenci=C3=B3n de<= /span> infecciones nosocomiales en <s= pan class=3D"awspan">pacientes con ventil= aci=C3=B3n </= span>mec=C3=A1nica, en ucis de hospitales de tercer nivel de Am=C3=A9rica Latina?<= p class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt; margin-bottom= :10pt">Componentes metodolog=C3=ADa PICO:= <img src=3D"data:image/jpeg;base64,/9j/4AAQSkZJRgABAQEAYABgAAD/2wBDAAUDB= AQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8SEhEPERETFhwXExQaFRERGCEYGh0dHx8fExciJCIe= JBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4= eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAxoDASIAAhEBAxEB/8QAHAABAQACAwEBAAAAAAAAAA= AAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGCQMEAgMAAAECAwQFEQYSByExExQXQVFTVmGSlOMIF= SJUcYGT0TI3UnWRsyMzNkJydKGy0haCsRg4Q2IkwWNzg//EABsBAQEBAQEBAQEAAAAAAAAAAAAB= AgMEBQYH/8QANBEBAQACAgIABAIJAwQDAAAAAAECEQMSBFEFITFBE4EUIjI0YXGRsdGhwfAGMzX= 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Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" st= yle=3D"text-decoration:none"></a><a href=3D"http://www.anatomiadigi= tal.org" style=3D"text-decoration:none">www.anatomiadi= gital.org</a> <a href=3D"http= ://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a>= <a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decora= tion:none">www.cienciadigitaleditorial.com</a><= /p><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYA= AAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJREFUOI1tlM1= PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICjUKglBgndW= q0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5imiZSSj4vI= QRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGEYKgDP89jf= 32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3vD8+XMqlQp= KKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgzkSemZmH5G= 7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz+H6AEJK9v= b/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A8j1QqxbWh= IbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiYQRrYZBZiT= D4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFKkcV1tfXeL= rwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhbn4l8MBhEs= GQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZnJZEin0wA4= jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD2qIFD0el0= 6nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRBw8ekkql0H= WNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0= mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5QyMrqKCqUU= 7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR5KKeLxOLZ= tUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFTkSuQmCC" = width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:3.84pt; position:a= bsolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAA= ABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAyx= JREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6MjuYGYVHl3= TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhhPi5DP/3F= 601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQKNDpdBBC= MBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61Wo9Vq4Tg= OuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKhSLRQaDAb= Zts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJkcfeARPVz= WaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9VqlXA4zPLy= MouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398JBAK4rst= gMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+CwLYwxSSo= LBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kEsGKRCKsr= Kz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEwtTY81Wpc= XV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+65976cdojfI= UAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEolwdHQ0Ac= G3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80Gg0+Pj4Q= GtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width=3D"19" h= eight=3D"19" alt=3D"" style=3D"margin-left:3.84pt; position:absolute" /></s= pan><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAASCAYAAA= BWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI1VlM1PI= kkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPyMrAyofY= 2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycxDAMhxI9= DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpyeOjo4olU= o0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKtMz0wTUA= Le3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9Ho9Dg4O= mJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI6PX1lbO= zM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA4HGZ1dR= VN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26RO9bpd/W= 00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQTab5f7+= /n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm8dTv026= 30TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3xmWmaxv= T09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cjAYcHx8z= Pb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2B+FNk2T= zc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3QN7c7Xa= 5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" width=3D= "18" height=3D"18" alt=3D"" style=3D"margin-left:5.66pt; position:absolute"= />Revista Anatom=C3=ADa Digital<sp= an class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt"> = 0; Ambato =E2=80=93 Ecuador (Jard=C3= =ADn Ambate=C3=B1o) </span= >Tels. = (00593) 511262 y 0984058533 = Tel. Directo (00593) 0998-235-485 = ; <a href=3D"http://www.anatomiadigital.org" style=3D"text-dec= oration:none"></a><a href=3D"http://www.anatomiadigital.org" style= =3D"text-decoration:none">www.anatomiad= igital.org</a> <a href=3D"htt= p://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a></p= ><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decor= ation:none">www.cienciadigitaleditorial= .com</a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhE= UgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwA= AA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFA= UBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ= 0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicVi= CCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQq= CgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrK= ysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDc= rkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHM= DLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeV= uYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuL= jA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJ= DCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSS= RCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nM= XbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3= Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmB= jdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHny= hFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1u= jVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAA= AAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1= pt; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGg= oAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAAD= sQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQji= ybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEik= llmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNr= m8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOF= XieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4Ip= pahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJ= ks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZ= yJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBd= V3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v= 6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt= 4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDo= cnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1= lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS= 3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNf= rPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" = width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:abs= olute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= IAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJR= EFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmV= g1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUik= mJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJ= KnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQ= qCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2K= ZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H= 5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2= azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6= /z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1Kp= cHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6z= rOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzr= J4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5Uq= uM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/= aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8= XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQm= CC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position= :absolute" />Revista Anatom=C3=ADa Digital= = Ambato =E2=80=93 Ecuador (= Jard=C3=ADn Ambate=C3=B1o) = Tels. (00593) 511262 y 0984058533 = ; Tel. 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Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" st= yle=3D"text-decoration:none"></a><a href=3D"http://www.anatomiadigi= tal.org" style=3D"text-decoration:none">www.anatomiadigital.org</a> = <a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration= :none"></a><a href=3D"http://www.cienciadigitaleditorial.com" style= =3D"text-decoration:none">www.cienciadi= gitaleditorial.com</a><img src=3D"data:image/png;base64,iVBORw= 0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOx= AAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM= 3xfCue0huWAqFAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qe= npzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKR= aLFItFRkdHicViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk= 0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE= 43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbp= dEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n8= 3NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVA= LLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovP= Fvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSk= ECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/j= tse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIB= KZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJ= r1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd= 9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O1= 8z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcw= S6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqK= T0/sycXcKidnAAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"= margin-left:-1pt; position:absolute" /><img src=3D"data:image/png;bas= e64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAl= wSFlzAAAOxAAADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QT= d9hT5iVCBdFQjiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+= fmJMQa/34+UEikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBK= OQUVY2We59FsNrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8s= MBgMsy0JrPQGOFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM= 7OziiVSnieN4IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EE= KyurgKQz+fJZDJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFa= rUa328V6fX3FcZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/d= kMhmur6/Z2dnBdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8G= vIr8Avmi9N7u7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G= +vrzAQCaK2xLIt4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoR= CoWwpJRsb28TDocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT08= 5Pz9HKTVphgGM1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZp= QtITDagIAvNWqS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNpp= JT/2vNzOCqlqNfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAA= AElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt= ; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoA= AAANSUhEUgAAABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQ= BlSsOGwAAAztJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpC= shMtFl1sSPhFmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6= HQ6CCGIx+OkUikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzM= DIZheOkI13WllJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05= OTigUCrTb7dENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7= MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8= V/HWJaFlJJGo8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32G= wyF3d3cAKK1Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41= t2xweHqLrOv/U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIx= qNsrGxQa/Xo1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQ= OPj4yQSCT/Zo6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HG= xmL8/OEDruvyzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq= 1cIaO3yq5XG5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0= Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg= 3Q6zdraGplMxl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukF= AAAAAElFTkSuQmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" />Revista Anatom= =C3=ADa Digital <spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Ambato =E2= =80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) &#= xa0; Tels. 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(00593) 511262 y 0984058533<spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt"> = ; Tel. 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Para la misma<span= class=3D"awspan" style=3D"letter-spacing:0.35pt"> se </sp= an>consideraron los siguientes criterios de inclusi=C3=B3n: art=C3=ADculos cient= =C3=ADficos, con libre acceso,<s= pan class=3D"awspan" style=3D"letter-spacing:-0.25pt"> que aborden los<span= class=3D"awspan" style=3D"letter-spacing:-0.25pt"> cuidados de enfermer=C3=ADa</spa= n> en la prevenci=C3=B3n</sp= an> de infecciones nosocomiales asociadas a la ve= ntilaci=C3=B3n mec=C3=A1nica en<= span class=3D"awspan" style=3D"letter-spacing:-0.15pt"> ucis; publicados entre</spa= n> 2019 y 2024; en<= span class=3D"awspan" style=3D"letter-spacing:0.15pt"> idiomas espa=C3=B1ol, portugu= =C3=A9s </spa= n>e ingl=C3=A9s = y <spa= n class=3D"awspan">que las muestras</span= > pertenezcan a instituciones</= span> de salud de tercer nivel en Am=C3=A9rica Latina. </p= >Se= consider=C3=B3 el<spa= n class=3D"awspan" style=3D"letter-spacing:0.2pt"> empleo <= /span>como descriptores o <= span class=3D"awspan">palabras claves de</s= pan> las siguientes: neumon=C3=ADa= (Pneumoniae), infecci=C3=B3n hospitalari= a <spa= n class=3D"awspan">(Cross Infection), ven= tilaci=C3=B3n= mec=C3=A1nica (mechanical = ventilation),= cuidados de enfermer=C3=ADa (nursing care)<= span class=3D"awspan" style=3D"letter-spacing:0.05pt"> y= Unidades de Cuidados Intensivos (Intensive Care</spa= n> Units), como descriptores</span= > y = como texto e= n <span= class=3D"awspan">los campos de registro</s= pan> del t=C3=ADtulo y<span= class=3D"awspan" style=3D"letter-spacing:0.4pt"> el </span= >resumen, conformando la <s= pan class=3D"awspan">sintaxis de b=C3=BAsqu= eda <sp= an class=3D"awspan">final mediante los oper= adores booleanos de AND, OR, NOT.3.ResultadosLa b= =C3=BAsqueda </s= pan>inicial, en todas</s= pan> las = bases de datos,</= span> permiti=C3=B3 identificar 157</spa= n> registros. De ellos quedaron</s= pan> 146 para el<span= class=3D"awspan" style=3D"letter-spacing:-0.35pt"> proceso de selecci=C3=B3n,</span= > pues 11 registros= fueron identificados en m= =C3=A1s </sp= an>de una base</= span> de datos. De<sp= an class=3D"awspan" style=3D"letter-spacing:-0.15pt"> los= 146 registros disponibles en el proceso= de selecci=C3=B3n,<= span class=3D"awspan" style=3D"letter-spacing:-0.15pt"> 79 registros quedaron descart= ados, = al aplicar los</sp= an> siguientes filtros en</span= > el proceso de b=C3=BAsqueda:=EF= =83=98Art=C3=ADculos cient=C3=ADficos = =EF=83=98Publicados entre 2019 y 2024=EF=83=98Libre acceso </spa= n>=EF=83=98Idiomas: espa=C3=B1ol, portugu=C3=A9s e ingl=C3=A9s<= p class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt">Tras el descarte se </spa= n>procedi=C3=B3 a la <= span class=3D"awspan">lectura del t=C3=AD= tulo <= span class=3D"awspan">y resumen de= los 67 estudios restantes. Al tener en cuenta= el resto de <= span class=3D"awspan">los criterios de<= /span> <span= class=3D"awspan">inclusi=C3=B3n, se ex= cluyeron </s= pan>57 art=C3=ADculos por </= span>no desarrollarse en<spa= n class=3D"awspan" style=3D"letter-spacing:-0.1pt"> el </s= pan>=C3=A1rea de = Latinoam=C3=A9rica, por no abordar </= span>las pr=C3=A1cticas<span= class=3D"awspan" style=3D"letter-spacing:-0.1pt"> de </sp= an>enfermer=C3=ADa, por tratarse</s= pan> de revisiones sistem=C3=A1tic= as, <sp= an class=3D"awspan">por constituir estudios= puramente cl=C3=ADnicos o= por no mostrar resultados. Finalmente, se incluyeron= 10 estudios que = abordan la neumon= =C3=ADa </spa= n>asociada a la</s= pan> ventilaci=C3=B3n mec=C3=A1nica y<spa= n class=3D"awspan" style=3D"letter-spacing:-0.4pt"> refieren pr=C3=A1cticas cl=C3=ADni= cas <s= pan class=3D"awspan">de enfermer=C3=ADa = y <spa= n class=3D"awspan">organizativas dirigidas a <s= pan class=3D"awspan">garantizar la seguridad del <= span class=3D"awspan">paciente. La pertenen= cia <sp= an class=3D"awspan">de los estudios<= span class=3D"awspan" style=3D"letter-spacing:1.4pt"> seleccionados a las bases </span= >de datos en las</sp= an> que se realiz=C3=B3<spa= n class=3D"awspan" style=3D"letter-spacing:0.5pt"> la </spa= n>b=C3=BAsqueda fue la <s= pan class=3D"awspan">siguiente: Scielo (4</= span> estudios), LILACS (2 = <img src=3D"data:image/jpeg;base64,/9j/4AAQSkZJRgABAQEAYABgAAD/2wBDA= AUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8SEhEPERETFhwXExQaFRERGCEYGh0dHx8fExci= JCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4= eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAxoDASIAAhEBAxEB/8QAHAABAQACAwEBAAAAAA= AAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGCQMEAgMAAAECAwQFEQYSByExExQXQVFTVmGSl= OMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0haCsRg4Q2IkwWNzg//EABsBAQEBAQEBAQEAAAAAAAAA= AAABAgMEBQYH/8QANBEBAQACAgIABAIJAwQDAAAAAAECEQMSBFEFITFBE4EUIjI0YXGRsdGhwfA= GMzXhUlPx/9oADAMBAAIRAxEAPwDqXfGR5+77cnfGR5+77cuIf0nUfi91yzkX/P3fblO+L/n7vt= 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(00593) 511262 y 0984058533 = Tel. 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Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" st= yle=3D"text-decoration:none"></a><a href=3D"http://www.anatomiadigi= tal.org" style=3D"text-decoration:none">www.anatomiadigital.org</a> = <a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration= :none"></a><a href=3D"http://www.cienciadigitaleditorial.com" style= =3D"text-decoration:none">www.cienciadi= gitaleditorial.com</a><img src=3D"data:image/png;base64,iVBORw= 0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOx= AAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM= 3xfCue0huWAqFAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qe= npzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKR= aLFItFRkdHicViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk= 0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE= 43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbp= dEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n8= 3NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVA= LLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovP= Fvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSk= ECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/j= tse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIB= KZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJ= r1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd= 9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O1= 8z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcw= S6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqK= T0/sycXcKidnAAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"= margin-left:-1pt; position:absolute" /><img src=3D"data:image/png;bas= e64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAl= wSFlzAAAOxAAADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QT= d9hT5iVCBdFQjiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+= fmJMQa/34+UEikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBK= OQUVY2We59FsNrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8s= MBgMsy0JrPQGOFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM= 7OziiVSnieN4IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EE= KyurgKQz+fJZDJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFa= rUa328V6fX3FcZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/d= kMhmur6/Z2dnBdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8G= vIr8Avmi9N7u7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G= +vrzAQCaK2xLIt4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoR= CoWwpJRsb28TDocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT08= 5Pz9HKTVphgGM1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZp= QtITDagIAvNWqS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNpp= JT/2vNzOCqlqNfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAA= AElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt= ; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoA= AAANSUhEUgAAABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQ= BlSsOGwAAAztJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpC= shMtFl1sSPhFmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6= HQ6CCGIx+OkUikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzM= DIZheOkI13WllJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05= OTigUCrTb7dENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7= MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8= V/HWJaFlJJGo8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32G= wyF3d3cAKK1Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41= t2xweHqLrOv/U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIx= qNsrGxQa/Xo1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQ= OPj4yQSCT/Zo6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HG= xmL8/OEDruvyzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq= 1cIaO3yq5XG5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0= Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg= 3Q6zdraGplMxl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukF= AAAAAElFTkSuQmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" />Revista Anatom= =C3=ADa Digital <spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Ambato =E2= =80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) &#= xa0; Tels. 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(00593) 511262 y 098405= 8533 Tel. 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(00593= ) 511262 y 0984058533 </spa= n>Tel. = Directo (00593) 0998-235-485 = ; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decoratio= n:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"tex= t-decoration:none">www.anatomiadigital.= org</a>&#= xa0; <a href=3D"http://www= .cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><a= href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:n= one">www.cienciadigitaleditorial.com</s= pan></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABM= AAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJRE= FUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICj= UKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5i= miZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGE= YKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3v= D8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgz= kSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz= +H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A= 8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiY= QRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFK= kcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhb= n4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZn= JZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD= 2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRB= w8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kgh= aDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5Q= yMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR= 5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFT= kSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; pos= ition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANS= UhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsO= GwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mju= YGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhhP= i5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQK= NDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61W= o9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKhS= LRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJkc= feARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vql= XA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398J= BAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+Cw= LYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kEs= GKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEwt= TY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+6597= 6cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEol= wdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80G= g0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital</spa= n> = ; Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. 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Los pasos<span= class=3D"awspan" style=3D"letter-spacing:0.25pt"> realizados durante el proceso <= /span>de b=C3=BAsqueda y selecci=C3=B3n de los estudios se muestran en la <a href=3D"#= fig1" style=3D"text-decoration:none"></a><a href=3D"#fig1" style=3D"text-decoration= :none">figura 1</a>.<a id=3D"fig1"></a>Figura 1. <sp= an class=3D"awspan" style=3D"font-size:10pt; font-style:italic">Diagrama de= flujo para la selecci=C3=B3n de los estudiosEn</span= > la= <a href=3D"#tabla1" style=3D"text-decoration:none"></a><a href=3D"#tabla1" = style=3D"text-decoration:none">tabla </s= pan>1</a> por <= /span>su parte, se</= span> describen los estudios</span= > incluidos en la revisi=C3=B3n= sistem=C3=A1tica en cuanto a autores, a=C3= =B1o de publicaci=C3=B3n, t=C3=ADtulos y pa=C3=ADses de procedencia.= <a id=3D"tabla1"></a>Tabla 1. Estudios incluidos en la re= visi=C3=B3n sistem=C3=A1tica (2019-2024) No. <sp= an class=3D"awspan" style=3D"font-size:10pt">T=C3=ADtulo/Pa=C3=ADs</= p>&#= xa0;Autor/A= =C3=B1o Muestra Metodolog=C3=ADa Resultados1Infecciones nosocomiales en adulto mayor. Cuidados de Enfermer=C3=ADa. (Ecuador)Lam-Vivanco et al. (2021) (<a href=3D"#ref3" style=3D"text-= decoration:none"></a><a href=3D"#ref3" style=3D"text-decoration:non= e">3</a>)<spa= n class=3D"awspan" style=3D"font-size:10pt">Historias cl=C3=ADnicas de 25 adultos mayores<spa= n class=3D"awspan" style=3D"font-size:10pt">Cuantitativo. Descriptivo.</spa= n> = No experimental </sp= an>de tipo transver= salEl= </s= pan>16% de las infecciones nosocomiales lo constituyeron neumon=C3=ADas</s= pan>= asociadas al= </= span>ventilador mec=C3=A1ni= co. <img src=3D"data:image/jpeg;base64,/9j/4AAQSkZJRgABAQEAY= ABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8SEhEPERETFhwXExQaFRERGCEY= Gh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4eHh4eHh4eHh4eHh4eHh4eHh4= eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAxoDASIAAhEBAxEB/8QAHAABAQ= ACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGCQMEAgMAAAECAwQFEQYSByExE= xQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0haCsRg4Q2IkwWNzg//EABsBAQEBAQEB= AQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgIABAIJAwQDAAAAAAECEQMSBFEFITFBE4EUIjI= 0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPwDqXfGR5+77cnfGR5+77cuIf0nUfi91yzkX/P= 3fblO+L/n7vty4w1F3XJORf8/d9uU74yPP3fblhKGobrk74v8An7vtyd8ZHn7vty4w1Flrk74v+= fu+3KTkZHn7vtywSV1F3WffOR5+77cnfOR5+77cuMXUZ3XJ3zkefu+3K98ZHn7vty4hNRZaznJy= 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(00593) 511262 y 09840= 58533 Tel. 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(00593) 511= 262 y 0984058533 <sp= an class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Tel. 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(00593) 511262 y 0984058533 &#x= a0; Tel. 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Estudios incluidos en la revisi= =C3=B3n sistem=C3=A1tica (2019-2024) (continuaci=C3=B3n) </span= >No. </= span>T=C3=ADtulo/Pa= =C3=ADs Autor/A=C3=B1o Muestra Metodolog=C3=ADa = Resultados<s= pan class=3D"awspan" style=3D"font-size:10pt">A pesar de no estar prot= ocolizados, fueron realizados los = cuidados de enfer= mer=C3=ADa (cabec= ero elevado, preve= nci=C3=B3n de =C3= =BAlcera g=C3=A1s= trica, evaluaci=C3=B3n de la sedac= i=C3=B3n diaria,= terapia respirat= oria, aspiraci=C3=B3n endotraqueal y fijaci=C3=B3n del tubo endotraqueal).2Aplicaci=C3=B3n del bundle de = prevenci=C3=B3n d= e neumon=C3=ADas = en UCI pedi=C3=A1= trica. (Brasil)Vargas & Souza (2021) = 0; (<a href= =3D"#ref7" style=3D"text-decoration:none"></a><a href=3D"#ref7" st= yle=3D"text-decoration:none">7)</a>= 307 pacientes pedi=C3=A1tricos (28 d=C3=AD= as y 12 a=C3=B1os)Cuantitativo, descriptivo y cuasiexperimentalLa aplicaci=C3=B3n del bundle de prevenci=C3= =B3n (cabecero e= levado, prevenci=C3=B3n de =C3=BAl= cera g=C3=A1strica, higiene bucal, evaluaci=C3=B3n de la sedaci=C3= =B3n diaria) inci= de en<spa= n class=3D"awspan" style=3D"font-size:10pt; letter-spacing:19.85pt"> </span= >la disminuci=C3=B3n de la<= /span>incidencia</s= pan> de neumon=C3=ADas<= /span> y <span= class=3D"awspan" style=3D"font-size:10pt">en el tiempo medio de u= so del ventilador.3Efect= ividad de la hipe= rinsuflaci=C3=B3n manual como t=C3=A9cnica de fisioterapia respiratoria en neumon=C3=ADa nosocomial post ventilaci=C3=B3n mec=C3=A1nica</s= pan>= en pacientes= </sp= an>de 40 a 64 a=C3=B1os en =C3=A1rea de<= /span> UCI <sp= an class=3D"awspan" style=3D"font-size:10pt">del hospital Teodoro Maldonado= Heredia et = al. (2023) (<a href=3D"#ref8" style=3D"text-decoration:none"></a></p= ><a href=3D"#ref8" style=3D"text-decoration:none">8</a>)537 pacientes co= n diagn=C3=B3stico de neumon=C3=ADanosocomial u= sando t=C3=A9cnica de hiperinflaci=C3=B3n manual.Cuantitativo. No experimental. Descriptivo observacional <span= class=3D"awspan" style=3D"font-size:10pt">y transversal.<sp= an class=3D"awspan" style=3D"font-size:10pt">La t=C3=A9cnica de hiperinflaci=C3=B3n es 10% m=C3=A1s efectiva que el = drenaje y acorta l= a estanciahospitalaria.<img src=3D"data:image/jpeg;= base64,/9j/4AAQSkZJRgABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkM= EQ8SEhEPERETFhwXExQaFRERGCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBE= UHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCA= RjAxoDASIAAhEBAxEB/8QAHAABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDC= wgGCQMEAgMAAAECAwQFEQYSByExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0haC= sRg4Q2IkwWNzg//EABsBAQEBAQEBAQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgIABAIJAwQ= DAAAAAAECEQMSBFEFITFBE4EUIjI0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPwDqXfGR5+= 77cnfGR5+77cuIf0nUfi91yzkX/P3fblO+L/n7vty4w1F3XJORf8/d9uU74yPP3fblhKGobrk74= v8An7vtyd8ZHn7vty4w1Flrk74v+fu+3KTkZHn7vtywSV1F3WffOR5+77cnfOR5+77cuMXUZ3XJ= 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(00593) 511262 y 09840= 58533 Tel. 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(00593) 511= 262 y 0984058533 <sp= an class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Tel. 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(00593) 511262 y 0984058533 &#x= a0; Tel. 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Estudios incluidos en la revisi= =C3=B3n sistem=C3=A1tica (2019-2024) (continuaci=C3=B3n) </span= >No. </= span>T=C3=ADtulo/Pa= =C3=ADs Autor/A=C3=B1o Muestra Metodolog=C3=ADa = Resultados<s= pan class=3D"awspan" style=3D"font-size:10pt">Carbo IESS desde el a=C3=B1o 2020 a 202= 2. (Ecuador)= 4<sp= an class=3D"awspan" style=3D"font-size:10pt">Estrategias para disminuir infecciones en</span= >terapia intensiva = pedi=C3=A1trica polivalente. (Argentina)Fortini(2021) (<a href=3D"#ref9" style=3D"text-decoration:none"></a></p= ><a href=3D"#ref9" style=3D"text-decoration:none">9</a>)575 profesionales de la salud</s= pan> = (m=C3=A9dicos, enfer= meros, kinesi=C3=B3logos, radi=C3=B3logos, nutricionistas)<s= pan class=3D"awspan" style=3D"font-size:10pt">ni=C3=B1os con CVC,SV y/o en asiste= ncia respiratoria mec=C3=A1nica (ARM) (de 6</span= > <= /span>meses <spa= n class=3D"awspan" style=3D"font-size:10pt">a 16 a=C3=B1os) durante 2019Cuantitativo. Cuasiexperimental (antes-despu=C3=A9s= ) de intervenci=C3= =B3n con an=C3= =A1lisis de seriestemporales (prospectivo).Las estrategias destinadas a modificarpr=C3=A1cticas y cond= uctas en los</span= > </s= pan>profesionales de= </s= pan>la salud, junto a los procesos = de registros y m= onitoreo, aumentaron la efectividad en la prevenci= =C3=B3n de infec= ciones intrahospitalarias. Post intervenci=C3=B3n, se registra una disminuci=C3=B3n la ta= sa de neumon=C3= =ADas asociadas a= la ventilaci=C3= =B3n mec=C3=A1nica= y de<span= class=3D"awspan" style=3D"font-size:10pt; letter-spacing:0.65pt"> <= span class=3D"awspan" style=3D"font-size:10pt">la utilizaci=C3=B3n de los dispositivos, evitando prolongar su uso innecesario.<s= pan class=3D"awspan" style=3D"font-size:10pt">5Impacto de una intervenci=C3=B3n educativa dirigida al personal de enfermer=C3=ADa sobre sobre los cuidados de higieneoral en la i= ncidencia de neu= mon=C3=ADa asociada a ventiladoren adultos en S=C3=A1nchez et al. (2021) (= <a href=3D"#ref10" style=3D"text-decoration:none"></a><a h= ref=3D"#ref10" style=3D"text-decoration:none">10</a>) = profesionales de = enfermer=C3=ADa (= 40 enfermeros y<= /span> 20 auxiliares</s= pan> de enfermer=C3=ADa= ). Se tomaron</sp= an>= datos <s= pan class=3D"awspan" style=3D"font-size:10pt">de 171 pacientes.Cuantitativo. Cuasiexperimental pre</s= pan> <= /span>y posintervenci=C3=B3= neducativa.<= /span>Se redujo</s= pan> <= /span>la incidencia<= span class=3D"awspan" style=3D"font-size:10pt; letter-spacing:4.3pt"> </spa= n>de NAV en los adultos conectados a ventilador en UCI.<img src=3D"data:image/j= peg;base64,/9j/4AAQSkZJRgABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8L= CwkMEQ8SEhEPERETFhwXExQaFRERGCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4= eFBEUHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wA= ARCARjAxoDASIAAhEBAxEB/8QAHAABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDA= gIDCwgGCQMEAgMAAAECAwQFEQYSByExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy= 0haCsRg4Q2IkwWNzg//EABsBAQEBAQEBAQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgIABAI= JAwQDAAAAAAECEQMSBFEFITFBE4EUIjI0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPwDqXf= GR5+77cnfGR5+77cuIf0nUfi91yzkX/P3fblO+L/n7vty4w1F3XJORf8/d9uU74yPP3fblhKGob= rk74v8An7vtyd8ZHn7vty4w1Flrk74v+fu+3KTkZHn7vtywSV1F3WffOR5+77cnfOR5+77cuMXU= 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(00593) 511262 y 09840= 58533 Tel. 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(00593) 511= 262 y 0984058533 <sp= an class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Tel. 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(00593) 511262 y 0984058533 &#x= a0; Tel. 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wWi4WFCxei0+k4d+4cJ06cwOv1snjxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4= cM0Nzff1E5WVhbTp0/n4sWLNDcHC2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1Y= BhOK/67+/0b36rX/FXvXmzN47GY2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII= =3D" width=3D"77" height=3D"28" alt=3D"" style=3D"margin-left:441.05pt; pos= ition:absolute" />Tabla 1. Estudios incluidos en la revisi= =C3=B3n sistem=C3=A1tica (2019-2024) (continuaci=C3=B3n) </span= >No. </= span>T=C3=ADtulo/Pa= =C3=ADs Autor/A=C3=B1o Muestra Metodolog=C3=ADa = Resultados<s= pan class=3D"awspan" style=3D"font-size:10pt">Unidad de Cuidado Intensivo. (Colombia)6Conocimiento y pr=C3=A1cticas del profesional de enfermer=C3=ADa sobre prevenci=C3=B3n<span= class=3D"awspan" style=3D"font-size:10pt; letter-spacing:8.65pt"> <= span class=3D"awspan" style=3D"font-size:10pt">de neumon=C3=ADa asociada</s= pan> a ventilaci=C3=B3n= mec=C3=A1nica. (Ec= uador)Graniz= o et al.<= span class=3D"awspan" style=3D"font-size:10pt; letter-spacing:13.65pt"> </s= pan>(2020) (<a href= =3D"#ref17" style=3D"text-decoration:none"></a><a href=3D"#ref17" s= tyle=3D"text-decoration:none">17</a>)22 = enfermerosCu= antitativo. No ex= perimental descriptivo y transversal.Se ident= ific=C3=B3 un ad= ecuado conocimiento te=C3=B3rico y = desempe=C3=B1o pr=C3=A1ctico del p= ersonal deen= fermer=C3=ADa en<= /span> la atenci=C3=B3n<= /span> al paciente cr=C3=ADtico ventilado</= span>7<p= class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt; font-size:10pt= ">Neumon=C3=ADa asociada</s= pan>= a la ventilaci=C3=B3n mec=C3=A1nica<= /span> en la Unidad de cuidados intermedios. (<spa= n class=3D"awspan" style=3D"font-size:10pt">Cuba)Montielo et al. (2023) (<a href=3D"#ref18" style=3D"text-decorat= ion:none"></a><a href=3D"#ref18" style=3D"text-decoration:none"><sp= an class=3D"awspan" style=3D"font-size:10pt; text-decoration:underline">18)= </a>73</span= > </s= pan>pacientes <spa= n class=3D"awspan" style=3D"font-size:10pt">que desarrollaron <s= pan class=3D"awspan" style=3D"font-size:10pt">una neumon=C3=ADa<span= class=3D"awspan" style=3D"font-size:10pt; letter-spacing:1.3pt"> <s= pan class=3D"awspan" style=3D"font-size:10pt">asociada a la ventilaci=C3=B3n<s= pan class=3D"awspan" style=3D"font-size:10pt">mec=C3=A1nica.= Cuantitativo. <sp= an class=3D"awspan" style=3D"font-size:10pt">No experimantal.Observacional, descriptivo= , transversalLas neumon=C3= =ADas asociadas a= la ventilaci=C3= =B3n mec=C3=A1nica= fueron m=C3=A1s = frecuentes en pac= ientes masculinos = mayores de<= span class=3D"awspan" style=3D"font-size:10pt; letter-spacing:1.4pt"> </spa= n>60 a=C3=B1os. La mitad de los pacien= tes egresaron fal= lecidos 8</s= pan>Implementaci=C3= =B3n de medidas = preventivas de la= s Infecciones Asoc= iadas a<spa= n class=3D"awspan" style=3D"font-size:10pt; letter-spacing:3.6pt"> <= span class=3D"awspan" style=3D"font-size:10pt">la Atenci=C3=B3n<span= class=3D"awspan" style=3D"font-size:10pt; letter-spacing:16.4pt"> <= span class=3D"awspan" style=3D"font-size:10pt">de Salud (IAAS) en un departamento de cuidados intensivos. (<spa= n class=3D"awspan" style=3D"font-size:10pt">Paraguay)Ozuna et al. (2019) (<a href=3D"#ref19" style=3D"text-decorat= ion:none"></a><a href=3D"#ref19" style=3D"text-decoration:none"><sp= an class=3D"awspan" style=3D"font-size:10pt; text-decoration:underline">19<= /span></a>)Se revisaron 300 historias cl=C3=ADnicasde pacientes pedi=C3=A1tricos.Cuantitativo. No experimental. Descriptivo, observacional, r= etrospectivo de c= orte trasversal concomponente anal=C3=ADticoLas medidas implementadas (elevaci=C3=B3n del cabecero, higiene bucal, higiene de = las manos y= </sp= an>aspiraci=C3=B3n endotraq= ueal) contribuyeron a la disminuci= =C3=B3n de= </s= pan>la neumon=C3=ADa asocia= daal ventila= dor.9= Buenas pr=C3=A1ctic= as en <sp= an class=3D"awspan" style=3D"font-size:10pt">la prevenci=C3=B3n<span= class=3D"awspan" style=3D"font-size:10pt; letter-spacing:-0.55pt"> = de la neumon=C3=ADa asociada <s= pan class=3D"awspan" style=3D"font-size:10pt">a la ventilaci=C3=B3n mec=C3=A1nica.<sp= an class=3D"awspan" style=3D"font-family:Calibri; font-size:10pt"> (= Brasil)<spa= n class=3D"awspan" style=3D"font-size:10pt">Alecrim et al. (2019) (<a href=3D"#ref20" style=3D"text-decoration:none"></a><a h= ref=3D"#ref20" style=3D"text-decoration:none">20</a>)La r= ecolecci=C3=B3n de= datos 92 pac= ientes a trav=C3= =A9s de<sp= an class=3D"awspan" style=3D"font-size:10pt; letter-spacing:0.75pt"> </span= >consulta de archivos.Cuantitativo. No experimental, descriptivo<s= pan class=3D"awspan" style=3D"font-size:10pt; letter-spacing:22.9pt"> </spa= n>de cohorte prospectivo.</= span>A mayor</sp= an> = adhesi=C3=B3n= </s= pan>a las medidas de buenas pr=C3=A1cticas (elevaci=C3=B3n del cabecero, higiene bucal, evaluaci=C3=B3n de la sedaci=C3=B3n diaria y uso de tubos <img src=3D"data:image/jpeg;base= 64,/9j/4AAQSkZJRgABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8S= EhEPERETFhwXExQaFRERGCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4= eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAx= oDASIAAhEBAxEB/8QAHAABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGC= QMEAgMAAAECAwQFEQYSByExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0haCsRg4= Q2IkwWNzg//EABsBAQEBAQEBAQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgIABAIJAwQDAAA= AAAECEQMSBFEFITFBE4EUIjI0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPwDqXfGR5+77cn= fGR5+77cuIf0nUfi91yzkX/P3fblO+L/n7vty4w1F3XJORf8/d9uU74yPP3fblhKGobrk74v8An= 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(00593) 511262 y 0984058= 533 Tel. 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(00593) 511262 y 0984058533 &#x= a0; Tel. 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wWi4WFCxei0+k4d+4cJ06cwOv1snjxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4= cM0Nzff1E5WVhbTp0/n4sWLNDcHC2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1Y= BhOK/67+/0b36rX/FXvXmzN47GY2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII= =3D" width=3D"77" height=3D"28" alt=3D"" style=3D"margin-left:441.05pt; pos= ition:absolute" />Tabla 1. Estudios incluidos en la revisi= =C3=B3n sistem=C3=A1tica (2019-2024) (continuaci=C3=B3n) </span= >No. </= span>T=C3=ADtulo/Pa= =C3=ADs Autor/A=C3=B1o Muestra Metodolog=C3=ADa = Resultados<s= pan class=3D"awspan" style=3D"font-size:10pt">endotraqueales <span= class=3D"awspan" style=3D"font-size:10pt">con bal=C3=B3n manteniendo la adecuada insuflaci=C3=B3n del bal=C3=B3n), menor riesgo de Neumon=C3=ADa Asociada a la Ventilaci=C3=B3n Mec=C3=A1nica.10Buenas pr=C3=A1cticas de enfermer=C3=ADa a pacientes en ventilaci=C3=B3n mec=C3=A1nica invasiva<= span class=3D"awspan" style=3D"font-size:10pt; letter-spacing:19.75pt"> </s= pan>en emergencia hospitala= ria. (Brasil)</span= >dos <spa= n class=3D"awspan" style=3D"font-size:10pt">Santos et al. (2020) (<a href=3D"#ref21" style=3D"text-de= coration:none"></a><a href=3D"#ref21" style=3D"text-decoration:none= ">21</a>)<spa= n class=3D"awspan" style=3D"font-size:10pt">16 enfermeros de la emergencia general de un= = hospital<spa= n class=3D"awspan" style=3D"font-size:10pt; letter-spacing:2pt"> <sp= an class=3D"awspan" style=3D"font-size:10pt">de la regi=C3=B3n Sur de Brasil.<sp= an class=3D"awspan" style=3D"font-size:10pt">Estudio cualitativo y descriptivo.<= span class=3D"awspan" style=3D"font-size:10pt">Los enfermeros consideraron como buenas pr=C3=A1cticas, para pacientes con ventilaci=C3=B3n mec=C3=A1nica invasiva, 13 cuidados, relacionados<span= class=3D"awspan" style=3D"font-size:10pt; letter-spacing:4.3pt"> <s= pan class=3D"awspan" style=3D"font-size:10pt">con el tubo endotraqueal, el ventilador y circuito, la pre= venci=C3=B3n de</= span> la broncoaspiraci= =C3=B3n, el contro= l de<span= class=3D"awspan" style=3D"font-size:10pt; letter-spacing:-0.55pt"> = infecci=C3=B3n <= span class=3D"awspan" style=3D"font-size:10pt">y la sedaci=C3=B3n, la analgesia/el sue=C3=B1o, la vigilia/dolor.3.1. Caracter=C3=ADsticas generales de los estudios<= /span><s= pan class=3D"awspan">De los 10<s= pan class=3D"awspan" style=3D"letter-spacing:-0.55pt"> estudios incluidos, los</sp= an> pa=C3=ADses con mayor</s= pan> representaci=C3=B3n fueron Brasil <= /span>y Ecuador con 3 <sp= an class=3D"awspan">estudios cada uno.</spa= n> Argentina, Cuba, Colombia</span= > y = Paraguay tambi=C3=A9n</span= > estuvieron representados. Respecto<span= class=3D"awspan" style=3D"letter-spacing:0.75pt"> a </spa= n>las muestras, = se <sp= an class=3D"awspan">trabaj=C3=B3 con mues= tras <= span class=3D"awspan">pedi=C3=A1tricas (<a href= =3D"#ref7" style=3D"text-decoration:none"></a><a href=3D"#ref7" style=3D"text-deco= ration:none">7</= span></a>, </s= pan><a href=3D"#ref9" style=3D"text-decoration:none"></a><a href=3D"#ref9" style=3D= "text-decoration:none">9</a><span= class=3D"awspan">, <a href=3D"#ref20" style=3D"text-decoration:none"></a><a href=3D"#ref= 20" style=3D"text-decoration:none">20</a>) y adultas. Dos <= span class=3D"awspan">estudios (<a href=3D"#ref18" s= tyle=3D"text-decoration:none"></a><a href=3D"#ref18" style=3D"text-decoration:none"= >18</a></= p>,</= span> <a href= =3D"#ref22" style=3D"text-decoration:none"></a><a href=3D"#ref22" style=3D"text-dec= oration:none">22= </a>) = indagaron sobre las </span= >buenas pr=C3=A1cticas en <= span class=3D"awspan">la prevenci=C3=B3n NAVM a trav=C3=A9s</sp= an> la percepci=C3=B3n y= el conocimiento del<sp= an class=3D"awspan" style=3D"letter-spacing:-0.3pt"> personal de enfermer=C3=ADa</span= > y= se present=C3=B3 un<= span class=3D"awspan" style=3D"letter-spacing:-0.15pt"> estudio (<a href=3D"#ref10" style=3D"t= ext-decoration:none"></a><a href=3D"#ref10" style=3D"text-decoration:none">10</a>)<spa= n class=3D"awspan" style=3D"letter-spacing:-0.15pt"> en <= /span>el cual el= <spa= n class=3D"awspan">conocimiento mostrado por </span= >los enfermeros y <s= pan class=3D"awspan">la evoluci=C3=B3n de los </spa= n>pacientes permitieron<span= class=3D"awspan" style=3D"letter-spacing:0.35pt"> constatar la efectividad<spa= n class=3D"awspan" style=3D"letter-spacing:0.35pt"> de </s= pan>una intervenci=C3=B3n<sp= an class=3D"awspan" style=3D"letter-spacing:0.35pt"> educativa dirigida al personal</s= pan> de enfermer=C3=ADa. Dicha<= /span> intervenci=C3=B3n se cen= tr=C3=B3 </sp= an>en la incidenci= a <spa= n class=3D"awspan">de los cuidados de hig= iene oral en la prevenci=C3=B3n de NAVM.El </= span>tama=C3=B1o de las </s= pan>muestras fue variable. <= /span>Los estudios cuyas </s= pan>muestras estaban constituidas por profesionales de</spa= n> la= salud, esencialmente<= span class=3D"awspan" style=3D"letter-spacing:0.2pt"> enfermeros, utilizaron tama=C3=B1o= s <span= class=3D"awspan">de muestras variables que van desde 16 ha= sta 575 profesionales. En los estudios dirigidos a pacientes pedi=C3=A1tric= os <sp= an class=3D"awspan">el tama=C3=B1o de</sp= an> las muestras fue<spa= n class=3D"awspan" style=3D"letter-spacing:-0.2pt"> m=C3=A1s homog=C3=A9neo, con</span= > valores de 300 a = 307. Los estudios cen= trados <s= pan class=3D"awspan">en pacientes adultos,</spa= n> por = su parte, mostrar= on los valores muestrales que var= iaron desde 25 hasta 537 pacientes. <img src=3D"data:image/jp= eg;base64,/9j/4AAQSkZJRgABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LC= wkMEQ8SEhEPERETFhwXExQaFRERGCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4e= FBEUHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAA= RCARjAxoDASIAAhEBAxEB/8QAHAABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAg= IDCwgGCQMEAgMAAAECAwQFEQYSByExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0= haCsRg4Q2IkwWNzg//EABsBAQEBAQEBAQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgIABAIJ= AwQDAAAAAAECEQMSBFEFITFBE4EUIjI0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPwDqXfG= R5+77cnfGR5+77cuIf0nUfi91yzkX/P3fblO+L/n7vty4w1F3XJORf8/d9uU74yPP3fblhKGobr= k74v8An7vtyd8ZHn7vty4w1Flrk74v+fu+3KTkZHn7vtywSV1F3WffOR5+77cnfOR5+77cuMXUZ= 3XJ3zkefu+3K98ZHn7vty4hNRZaznJyPP3fbk75yPP3fblxz2hqFtcnfOR5+77cnfOR5+77cuMN= 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(00593) 511262 y 09840= 58533 Tel. 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(00593) 511= 262 y 0984058533 <sp= an class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Tel. 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(00593) 511262 y 0984058533 &#x= a0; Tel. 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dXV03dN5oNBIREYHD4QgRmC6Xi+TkZBRF4dKlS6H8eyMJDw8nLS2Nzs5Ompub0ev1IZqpr6/vJp= oCKbiy5YBgY/nBu++x6sFV5ORMYEhsHIcOHOJ4xXFOnvwavd6AXq9H07TgAkKQmmpjyQ+Xckv2O= ExGI9u3lXLwOoABxMXF8corr1BfX09vby9VVVVMmjQp9Hh/8803OXHixA3dHjNmDKtWreKtt94i= Ozubnp4ePB4Pd999N36/n927d7Nr165Qz3g9KS4uxu/3o6oqW7ZswWQysXr1al566SVOnDhx3R5= ysFwDmuYPUHP2LP/98susWLGCsWPH8pMlP2HOvDk0NjTSdOkidrsdnaLDZrMxLNVGSnIK4eZwXK= 5e/ra5hH2f7MPnvf6JBWlyK8ePHycrK4uamhqKiop49dVXkVJSXV19U4fNZjNjxoxh+fLlOJ1OW= lpamDBhAps2baKtrY2IiAh0Ot1NbUyfPp2dO3dy+vRpuru7mTlzJhaLhby8PKqrq783Uq8BrR+4= pvoLvLjhJebcNoeC2QXExccyJCmByUou/VSJpmlogQDuXhdHv/qKXWW7qK2tveJhfrVIKVFVlai= oKBITEzEYDPz+97/niy++YNy4cVewHdcTIQRHjhwhIyODsLAw9u7dS2RkJK2trXR1deH3+2+6vq= IoFBcXk5+fz8qVK9m3bx/Jyck0NTVRVFRESUnJDUEL0vc3AC04A9zOXnb9fSdHPv+SMWPHMmLkC= GJiYggzGdECAXp6nDRfvMSpU6c4V1t30yvRL5qm0d3dTWtr6+UHPdTW1nLp0iXq6+tDdNGNxOfz= 0dnZycaNG1m7di0Oh4ODBw+ybNky/H4/TU1NvPvuuzf0RVVVli1bxq5duwgEAowaNYq+vj5qa2t= JTU0lMzOTL7/88sawSImorq6WWVlZ37tZIQSKomAwGEKNrMfjwe/3f28OGCwWi4WFCxei0+k4d+= 4cJ06cwOv1snjxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1E5WVhbTp= 0/n4sWLNDcHC2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+/0b36rX/= FXvXmzN47GY2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" width=3D"77= " height=3D"28" alt=3D"" style=3D"margin-left:441.05pt; position:absolute" = />Se observa una = prevalencia de est= udios = cuantitativos, con dise=C3=B1os= no experimentales<sp= an class=3D"awspan" style=3D"letter-spacing:1.05pt"> y fines descriptivos, 6<span= class=3D"awspan" style=3D"letter-spacing:3.8pt"> de </span= >los 10 estudios</sp= an> incluidos. Tres estudios</span= > tuvieron dise=C3=B1os cuasiexperimentales</span= > (<a href=3D"#ref7" style=3D"text-decoration:none"></a></= p><a href=3D= "#ref7" style=3D"text-decoration:none">7</a>, <a href=3D"#ref9" style=3D"text-decoration:non= e"></a><= a href=3D"#ref9" style=3D"text-decoration:none">9</a>, <a href=3D"#ref10" style=3D"text-deco= ration:none"></a><a href=3D"#ref10" style=3D"text-decoration:none">10</a>) y= s=C3=B3lo uno respondi=C3= =B3 <sp= an class=3D"awspan">al enfoque cualitativo<= /span> de investigaci=C3=B3n (<a href=3D"#ref22" style=3D"t= ext-decoration:none"></a><a href=3D"#ref22" style=3D"text-decoration:none">22</a>).</p= >3.2. Buenas pr=C3=A1cticas para prevenir las neumon=C3=ADas asociadas a la ventilaci=C3=B3n mec=C3=A1nica en hospitales de tercer nivel en A= m=C3=A9rica LatinaLa lectura<s= pan class=3D"awspan" style=3D"letter-spacing:2.6pt"> cr=C3=ADtica de los estudios </s= pan>seleccionados permiti=C3=B3</spa= n> identificar las pr=C3=A1cticas<= /span> de enfermer=C3=ADa mayormente concebidas en la = prevenci=C3=B3n de infecciones<spa= n class=3D"awspan" style=3D"letter-spacing:1.55pt"> nosocomiales, en pacientes con</spa= n> ventilaci=C3=B3n mec=C3=A1nica, en <sp= an class=3D"awspan">ucis de hospitales</spa= n> de= tercer nivel de <sp= an class=3D"awspan">Am=C3=A9rica Latina. En la = <a href=3D"#tabla2" style=3D"text-decoration:none"></a><a href=3D"#tabla2" style=3D= "text-decoration:none">tabla <span= class=3D"awspan" style=3D"font-weight:bold; text-decoration:underline">2</= span></a> se <s= pan class=3D"awspan">exponen las pr=C3=A1= cticas </span= >identificadas, en orden </sp= an>de prevalencia, y los estudios que las tuvieron en consideraci=C3=B3n.<a i= d=3D"tabla2"></a>Tabla 2. Evidencia <sp= an class=3D"awspan" style=3D"font-size:10pt; font-style:italic">Cient=C3=AD= fica de las <= span class=3D"awspan" style=3D"font-size:10pt; font-style:italic">buenas</s= pan> pr=C3=A1cticas en </sp= an>la</s= pan> prevenci=C3=B3n de </s= pan>la</= span> neumon=C3=ADa asociada a la ventilaci=C3=B3n mec=C3=A1nica<spa= n class=3D"awspan" style=3D"font-size:10pt">Buenas pr=C3=A1cticas</p= >Estudios <p= class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt; font-size:10pt= ">1Elevar el cabecero de la cama </span= >1, 2,3,5,7,8,9,10<= /span>2<= p class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt; font-size:10p= t">Higiene bucal regular co= n clorhexidina 1,2, 4,5,8,9,103Evalu= aci=C3=B3n de la sedaci=C3=B3n diaria1,2,3,9,104Higiene de las manos1,2,5,8,105Prevenci=C3=B3n de =C3=BAlcera g=C3=A1strica1,2,3,7 6Realizaci=C3=B3n correcta de la aspiraci=C3=B3n= endotraqueal5,7,8,107</= span>Uso de tubos e= ndotraqueales manteniendo laadecuada insuflaci=C3=B3n del bal=C3=B3n <sp= an class=3D"awspan" style=3D"font-size:10pt">2,5,9,108Control constante de par=C3=A1metros del vent= ilador mec=C3=A1nico3,5,109No trasla= dos innecesarios2,710</s= pan>No vol=C3=BAmen= es g=C3=A1stricos excesivos2,511Fija= ci=C3=B3n de tubo endotraqueal3,1012Uso de terapia respiratoria3,613Ca= mbios de circuito del ventilador5,10La elevaci= =C3=B3n </spa= n>del cabecero de<= /span> la cama y la = higiene bucal con<= /span> clorhexidina figuran com= o las = pr=C3=A1cticas de = enfermer=C3=ADa mejor valoradas<= span class=3D"awspan" style=3D"letter-spacing:6.25pt"> en la prevenci=C3=B3n<= span class=3D"awspan" style=3D"letter-spacing:6.25pt"> de infecciones nosocomiales. = Se <sp= an class=3D"awspan">observa un consenso</= span> en que la elevaci=C3=B3n adecuada del<spa= n class=3D"awspan" style=3D"letter-spacing:0.55pt"> cabecero de la cama, para estos pa= cientes, debe ser entre 30 y 45o. En<= span class=3D"awspan" style=3D"letter-spacing:0.5pt"> cuanto al uso de</= span> la clor= hexidina </spa= n>para el mantenimie= nto <sp= an class=3D"awspan">de la higiene<sp= an class=3D"awspan" style=3D"letter-spacing:0.5pt"> bucal, = s=C3=B3lo dos observaciones<= /span> relacionadas con los= niveles de clorhexidina</span= > a = utilizar y = la <spa= n class=3D"awspan">frecuencia de uso. La</spa= n> mayor=C3=ADa de los e= studios <= span class=3D"awspan">que tienen en<span= class=3D"awspan" style=3D"letter-spacing:2pt"> consideraci=C3=B3n esta pr=C3=A1ctica= (<a href=3D"#ref8" style=3D"text-decoration:none"></a><p= class=3D"awdiv" style=3D"margin-right:1pt; margin-left:1pt"><a href=3D"#re= f8" style=3D"text-decoration:none">8</a>, <a href=3D"#ref9" style=3D"text-decoration:none"></a= ><a href= =3D"#ref9" style=3D"text-decoration:none">9,</a> </= span><a href=3D"#ref22" style=3D"text-decoration:none"></a><a href=3D"#ref22" style= =3D"text-decoration:none">22</a><= span class=3D"awspan">) sugieren el uso</= span> del 0.12 %, (<a href=3D"#ref10" style=3D"text-decoration:none"></a><a href=3D"#ref10= " style=3D"text-decoration:none">10</a>, <a href=3D"#ref18" style=3D"text-decoration:none">= </a><a h= ref=3D"#ref18" style=3D"text-decoration:none">18</a>) ofrecen</span= > un rango de = 0.12% = a 0.2%, mientras</= span> que (<a href=3D"#ref7" style=3D"tex= t-decoration:none"></a><a href=3D"#ref7" style=3D"text-decoration:none">7</a>) y (<a href=3D"#ref20" style=3D"text-decoration:none"></a><a href=3D"#ref= 20" style=3D"text-decoration:none">20</a>) no esp= ecifican </s= pan>los niveles a <s= pan class=3D"awspan">usar. Por su</span= > parte s=C3=B3lo (<a= href=3D"#ref21" style=3D"text-decoration:none"></a><a href=3D"#ref21" style=3D"tex= t-decoration:none">21</a>) ofrece recomendaciones de frecuencia de</sp= an> higiene bucal con clorhexidina, en este c= aso <sp= an class=3D"awspan">recomienda tres frecuen= cias diarias.<img src=3D"data:image/jpeg;base64,/9j/4AAQSkZJR= gABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8SEhEPERETFhwXExQa= FRERGCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4eHh4eHh4eHh4eHh4= eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAxoDASIAAhEBAxEB/8= QAHAABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGCQMEAgMAAAECAwQFE= QYSByExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0haCsRg4Q2IkwWNzg//EABsB= AQEBAQEBAQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgIABAIJAwQDAAAAAAECEQMSBFEFITF= BE4EUIjI0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPwDqXfGR5+77cnfGR5+77cuIf0nUfi= 91yzkX/P3fblO+L/n7vty4w1F3XJORf8/d9uU74yPP3fblhKGobrk74v8An7vtyd8ZHn7vty4w1= 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(00593) 511262 y 0984058533</spa= n> = ; Tel. 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(00593) 511262 y 098= 4058533 Tel. 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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= MAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJR= EFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReIC= jUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5= imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoG= EYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3= vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPg= zkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7N= z+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/= A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomi= YQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMF= KkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUh= bn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZ= nJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsU= D2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iR= Bw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kg= haDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5= QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvhe= R5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElF= TkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; po= sition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAAN= SUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSs= OGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mj= uYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhh= Pi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQ= KNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61= Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKh= SLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJk= cfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vq= lXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398= JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+C= wLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kE= sGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEw= tTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+659= 76cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEo= lwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80= Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital</spa= n> = ; Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. (00593) 511262 y 0984058533 &#x= a0; Tel. Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-= decoration:none"></a><a href=3D"http://www.anatomiadigital.org" sty= le=3D"text-decoration:none">www.anatomi= adigital.org</a> <a href=3D"h= ttp://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= /p><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-dec= oration:none">www.cienciadigitaleditori= al.com</a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSU= hEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOG= wAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAq= FAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgB= DQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHic= ViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEg= QqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDab= rKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwx= Dcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4O= HMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1y= eVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185Oemy= uLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpB= MJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJ= SSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5= nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2i= x3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3Pj= mBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPH= nyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW= 1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidn= AAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0K= GgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAA= ADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQ= jiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UE= ikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59Fs= Nrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQG= OFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4= IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZ= DJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3F= cZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dn= BdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u= 7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xL= It4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28T= DocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgG= M1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNW= qS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlq= NfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC= " width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:a= bsolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAA= ABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAzt= JREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhF= mVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkU= ikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13Wl= lJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dE= NQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/= 2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo= 8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1W= i2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/= U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1= KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo= 6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvy= zrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5= UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7+= +/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMx= l8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSu= QmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; positi= on:absolute" />Revista Anatom=C3=ADa</span= > Digital<= /span>&= #xa0; Ambato =E2=80=93 Ecuador (J= ard=C3=ADn Ambate=C3=B1o) = = Tels. (00593) 511262 y 0984058533 = Tel. 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/88sawSImorq6WWVlZ37tZIQSKomAwGEKNrMfjwe/3f28OGCwWi4WFCxei0+k4d+4cJ06cwOv1s= njxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1E5WVhbTp0/n4sWLNDcH= C2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+/0b36rX/FXvXmzN47GY= 2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" width=3D"77" height=3D= "28" alt=3D"" style=3D"margin-left:441.05pt; position:absolute" /><s= pan class=3D"awspan">La higiene de= las manos constituye= una medida clave,<spa= n class=3D"awspan" style=3D"letter-spacing:0.55pt"> del </= span>personal de = enfermer=C3=ADa, en la prevenci=C3=B3n</s= pan> de NAVM. Es una </span= >pr=C3=A1ctica tenida en </span= >consideraci=C3=B3n en el </spa= n>50% de los</span= > estudios. Significar que (</spa= n><a href=3D"#ref7" style=3D"text-decoration:none"></a><a href=3D"#ref7" style=3D"t= ext-decoration:none">7</a>, <a href=3D"#ref9" style=3D"text-decoration:none"></a><a href=3D"#ref9" s= tyle=3D"text-decoration:none">9</a>) especifican que<= /span> debe realizarse en<s= pan class=3D"awspan" style=3D"letter-spacing:0.3pt"> cinco = momentos protocolizados: an= tes <s= pan class=3D"awspan">del contacto con</sp= an> el paciente, antes<s= pan class=3D"awspan" style=3D"letter-spacing:0.55pt"> de <= /span>realizar tarea as=C3=A9ptica, despu=C3=A9s del= contacto con fluidos corporales= , <span= class=3D"awspan">despu=C3=A9s del contacto= con el paciente<sp= an class=3D"awspan" style=3D"letter-spacing:0.5pt"> y </spa= n>despu=C3=A9s del c= ontacto </span= >con el entorno.La<spa= n class=3D"awspan" style=3D"letter-spacing:0.85pt"> realizaci=C3=B3n correcta de</span= > la aspiraci=C3=B3n endotraque= al <sp= an class=3D"awspan">y el uso de </spa= n>tubos endotraqueales, con<= span class=3D"awspan" style=3D"letter-spacing:1.2pt"> una <= /span>adecuada insuflaci=C3=B3n</spa= n> del bal=C3=B3n, constituyen</sp= an> otras pr=C3=A1cticas de= enfermer=C3=ADa que destacan e= n <span= class=3D"awspan">la prevenci=C3=B3n de</sp= an> infecciones nosocomiales. En</= span> relaci=C3=B3n con ellas,</sp= an> s=C3=B3lo hay que destacar</= span> que, como adecuada</sp= an> insuflaci=C3=B3n,= (<a href=3D"#ref9" style=3D"text-decoration:none"></a></= p><a href=3D= "#ref9" style=3D"text-decoration:none">9</a>) considera<span= class=3D"awspan" style=3D"letter-spacing:-0.75pt"> una <= /span>presi=C3=B3n de 20 </s= pan>a 25 cmH</sp= an>2O mientras (<a href=3D"#ref18" style=3D"text-decoration:none">= </a><a h= ref=3D"#ref18" style=3D"text-decoration:none">18</a>, <a href=3D"#ref21" styl= e=3D"text-decoration:none"></a><a href=3D"#ref21" style=3D"text-decoration:none"><s= pan class=3D"awspan" style=3D"text-decoration:underline">21</a><= p style=3D"margin-right:1pt; margin-left:1pt">, </sp= an><a href=3D"#ref22" style=3D"text-decoration:none"></a><a href=3D"#ref22" style= =3D"text-decoration:none">22</a><= span class=3D"awspan">) asumen una presi=C3=B3n de hasta 30 cmH<span= class=3D"awspan" style=3D"font-size:8pt">2O.= <= span class=3D"awspan">Mantener un control= <span= class=3D"awspan">constante de los= par=C3=A1metros del ventilado= r, <sp= an class=3D"awspan">la fijaci=C3=B3n del<= /span> tubo endotraqueal y los</s= pan> cambios de circuito<sp= an class=3D"awspan" style=3D"letter-spacing:3.3pt"> del </s= pan>ventilador son p= r=C3=A1cticas = de enfermer=C3=ADa concebidas= <span= class=3D"awspan">en algunos estudios</sp= an> (<a href=3D"#ref3" style=3D"text-decoration:none"></a>= <a href= =3D"#ref3" style=3D"text-decoration:none">3</a>, <a href=3D"#ref18" style=3D"text-decorat= ion:none"></a><a href=3D"#ref18" style=3D"text-decoration:none">18</a>, <a href=3D"#ref22" style=3D= "text-decoration:none"></a><a href=3D"#ref22" style=3D"text-decoration:none">22</a>).<= span class=3D"awspan" style=3D"letter-spacing:0.45pt"> De igual manera otros </s= pan>autores (<a href=3D"#ref= 8" style=3D"text-decoration:none"></a><a href=3D"#ref8" style=3D"text-decoration:no= ne">8</a>= ,= <a hr= ef=3D"#ref9" style=3D"text-decoration:none"></a><a href=3D"#ref9" style=3D"text-dec= oration:none">9,= </a> <a href=3D"#ref18"= style=3D"text-decoration:none"></a><a href=3D"#ref18" style=3D"text-decoration:non= e">18</a>= ,= <a hr= ef=3D"#ref19" style=3D"text-decoration:none"></a><a href=3D"#ref19" style=3D"text-d= ecoration:none">= 19</a>) consideran importante evitar<= /span> los traslados innecesarios,= los vol=C3=BAmenes g=C3=A1= stricos excesivos y realizar terapia respiratoria. La= <spa= n class=3D"awspan">efectividad de las</= span> intervenciones descritas (<a href=3D"#ref9" style=3D"text-decoration:none"></a><a href=3D"#ref9" s= tyle=3D"text-decoration:none">9</a>, <a href=3D"#ref10" style=3D"text-decoration:none"></a= ><a href= =3D"#ref10" style=3D"text-decoration:none">10</a>, <a href=3D"#ref21" style=3D"text-decora= tion:none"></a><a href=3D"#ref21" style=3D"text-decoration:none">21)</a> constatan que = a mayor adhesi= =C3=B3n, de = los profesionales<sp= an class=3D"awspan" style=3D"letter-spacing:-0.75pt"> de = enfermer=C3=ADa, a<s= pan class=3D"awspan" style=3D"letter-spacing:-0.75pt"> las buenas pr=C3=A1cticas</= span> de prevenci=C3=B3n men= or <s= pan class=3D"awspan">es el riesgo de NA= VM. Desde la perc= epci=C3=B3n = de los pr= ofesionales = de enfermer=C3=ADa<s= pan class=3D"awspan" style=3D"letter-spacing:-0.65pt"> sobre el deber<spa= n class=3D"awspan" style=3D"letter-spacing:-0.65pt"> ser = en la pre= venci=C3=B3n de NAVM, hay que destacar el estudio realizado por (<a = href=3D"#ref22" style=3D"text-decoration:none"></a><a href=3D"#ref22" style=3D"text= -decoration:none">22</a>), con el prop=C3=B3sito de identificar los cuidados </= span>concebidos como<span= class=3D"awspan" style=3D"letter-spacing:-0.25pt"> buenas pr=C3=A1cticas. En= este caso, se consideraron un total<spa= n class=3D"awspan" style=3D"letter-spacing:-0.25pt"> de 13 </= span>cuidados como bue= nas <span= class=3D"awspan">pr=C3=A1cticas, en pacientes<= /span> con ventilaci=C3=B3n mec=C3=A1nic= a invasiva. Constan, entre e= llas, <= span class=3D"awspan">pr=C3=A1cticas relacionadas<sp= an class=3D"awspan" style=3D"letter-spacing:0.2pt"> con </s= pan>el tubo endotraq= ueal, <= span class=3D"awspan">con el ventilador</sp= an> y circuito, con la<sp= an class=3D"awspan" style=3D"letter-spacing:0.25pt"> prevenci=C3=B3n de la<span= class=3D"awspan" style=3D"letter-spacing:0.25pt"> broncoaspiraci=C3=B3n, el control</= span> de infecci=C3=B3n y</span= > la sedaci=C3=B3n, la analgesia/el sue=C3=B1o, = la vigilia/dolor.De manera<spa= n class=3D"awspan" style=3D"letter-spacing:1.7pt"> general,= todos los e= studios </span= >consideran modificables<span= class=3D"awspan" style=3D"letter-spacing:1.7pt"> los </spa= n>factores de riesgo= externos </sp= an>que originan NAVM= y, lo m=C3=A1s<sp= an class=3D"awspan" style=3D"letter-spacing:2.4pt"> importante, prevenibles desde= la= puesta en pr=C3=A1ctica</spa= n> de= protocolos de atenci=C3=B3n espec=C3=ADficos. La= educaci=C3=B3n del personal</sp= an> de enfermer=C3=ADa, en cuant= o <sp= an class=3D"awspan">a la adherencia</sp= an> a buenas pr=C3=A1cticas,= <spa= n class=3D"awspan">y la vigilancia</spa= n> epidemiol=C3=B3gica constituyeron ejes cent= rales en la prevenci=C3=B3n de NAV. 4.Discusi=C3=B3n En<s= pan class=3D"awspan" style=3D"letter-spacing:0.95pt"> los = estudios con muestras = de pacientes pedi=C3=A1tricos <a href=3D"#ref7" style=3D"text-decoration:none"></a><a href=3D"#ref7"= style=3D"text-decoration:none">(7</a>, <a href=3D"#ref9" style=3D"text-decoration:none"></= a><a hre= f=3D"#ref9" style=3D"text-decoration:none">9</a>, <a href=3D"#ref20" style=3D"text-decorat= ion:none"></a><a href=3D"#ref20" style=3D"text-decoration:none">20</a>) la</= span> implementaci=C3=B3n del paquete<spa= n class=3D"awspan" style=3D"letter-spacing:1.6pt"> de </spa= n>medidas incidi=C3=B3 en <= span class=3D"awspan">el descenso significa= tivo <s= pan class=3D"awspan">del n=C3=BAmero de</sp= an> pacientes que desarrollaron = NAVM <= span class=3D"awspan">y en el<span= class=3D"awspan" style=3D"letter-spacing:0.55pt"> tiempo = de hospitalizaci=C3=B3n.</sp= an> En el estudio de </span= >(<a href=3D"#ref7" style=3D"text-decoration:= none"></a><a href=3D"#ref7" style=3D"text-decoration:none">7</a>)<= span class=3D"awspan" style=3D"letter-spacing:0.55pt"> se reporta, <img src=3D"data:ima= ge/jpeg;base64,/9j/4AAQSkZJRgABAQEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcH= Bw8LCwkMEQ8SEhEPERETFhwXExQaFRERGCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4= ICA4eFBEUHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh= 7/wAARCARjAxoDASIAAhEBAxEB/8QAHAABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABA= AEDAgIDCwgGCQMEAgMAAAECAwQFEQYSByExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJy= dKGy0haCsRg4Q2IkwWNzg//EABsBAQEBAQEBAQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgI= ABAIJAwQDAAAAAAECEQMSBFEFITFBE4EUIjI0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPw= 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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= MAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJR= EFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReIC= jUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5= imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoG= EYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3= vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPg= zkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7N= z+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/= A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomi= YQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMF= KkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUh= bn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZ= nJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsU= D2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iR= Bw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kg= haDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5= QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvhe= R5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElF= TkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; po= sition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAAN= SUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSs= OGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mj= uYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhh= Pi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQ= KNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61= Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKh= SLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJk= cfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vq= lXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398= JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+C= wLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kE= sGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEw= tTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+659= 76cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEo= lwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80= Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital</spa= n> = ; Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. (00593) 511262 y 0984058533 &#x= a0; Tel. 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Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" st= yle=3D"text-decoration:none"></a><a href=3D"http://www.anatomiadigi= tal.org" style=3D"text-decoration:none">www.anatomiadigital.org</a> = <a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration= :none"></a><a href=3D"http://www.cienciadigitaleditorial.com" style= =3D"text-decoration:none">www.cienciadi= gitaleditorial.com</a><img src=3D"data:image/png;base64,iVBORw= 0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOx= AAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM= 3xfCue0huWAqFAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qe= npzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKR= aLFItFRkdHicViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk= 0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE= 43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbp= dEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n8= 3NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVA= LLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovP= Fvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSk= ECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/j= tse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIB= KZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJ= r1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd= 9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O1= 8z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcw= S6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqK= T0/sycXcKidnAAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"= margin-left:-1pt; position:absolute" /><img src=3D"data:image/png;bas= e64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAl= wSFlzAAAOxAAADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QT= d9hT5iVCBdFQjiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+= fmJMQa/34+UEikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBK= OQUVY2We59FsNrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8s= MBgMsy0JrPQGOFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM= 7OziiVSnieN4IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EE= KyurgKQz+fJZDJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFa= rUa328V6fX3FcZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/d= kMhmur6/Z2dnBdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8G= vIr8Avmi9N7u7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G= +vrzAQCaK2xLIt4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoR= CoWwpJRsb28TDocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT08= 5Pz9HKTVphgGM1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZp= QtITDagIAvNWqS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNpp= JT/2vNzOCqlqNfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAA= AElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt= ; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoA= AAANSUhEUgAAABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQ= BlSsOGwAAAztJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpC= shMtFl1sSPhFmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6= HQ6CCGIx+OkUikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzM= DIZheOkI13WllJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05= OTigUCrTb7dENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7= MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8= V/HWJaFlJJGo8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32G= wyF3d3cAKK1Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41= t2xweHqLrOv/U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIx= qNsrGxQa/Xo1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQ= OPj4yQSCT/Zo6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HG= xmL8/OEDruvyzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq= 1cIaO3yq5XG5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0= Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg= 3Q6zdraGplMxl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukF= AAAAAElFTkSuQmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" />Revista Anatom= =C3=ADa Digital <spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Ambato =E2= =80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) &#= xa0; Tels. 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(00593) 511262 y 0984058533 = 0; Tel. 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ei0+k4d+4cJ06cwOv1snjxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1= E5WVhbTp0/n4sWLNDcHC2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+= /0b36rX/FXvXmzN47GY2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" wid= th=3D"77" height=3D"28" alt=3D"" style=3D"margin-left:441.05pt; position:ab= solute" />adem=C3=A1s, que</s= pan> desciende el tiempo<sp= an class=3D"awspan" style=3D"letter-spacing:0.4pt"> de </sp= an>ventilaci=C3=B3n mec=C3=A1nica;</= span> el consumo de antibi=C3=B3ticos y de los costos de los servicios de sal= ud. Estos resultados = coinciden </sp= an>con los encontrad= os <spa= n class=3D"awspan">por (<a href=3D"#ref23" style=3D"= text-decoration:none"></a><a href=3D"#ref23" style=3D"text-decoration:none">23</a>),<s= pan class=3D"awspan" style=3D"letter-spacing:1.9pt"> en </s= pan>una exhaustiva r= evisi=C3=B3n, donde se aprecia<sp= an class=3D"awspan" style=3D"letter-spacing:-0.3pt"> que <= /span>el uso de</s= pan> paquetes de cuidados</span= > de enfermer=C3=ADa que= incluyen acciones para el</sp= an> mantenimiento de la<= span class=3D"awspan" style=3D"letter-spacing:5.45pt"> higiene bucal, empleando</spa= n> clorhexidina al 0,12%, acomp= a=C3=B1ado </= span>por la elevac= i=C3=B3n </sp= an>del cabecero = de <sp= an class=3D"awspan">la cama y<span= class=3D"awspan" style=3D"letter-spacing:0.85pt"> buenas = pr=C3=A1cticas en<spa= n class=3D"awspan" style=3D"letter-spacing:0.85pt"> el </s= pan>uso del tubo endotraqueal que favorecen<span= class=3D"awspan" style=3D"letter-spacing:-0.45pt"> la </= span>prevenci=C3=B3n de<spa= n class=3D"awspan" style=3D"letter-spacing:-0.45pt"> infecciones relacionadas con</s= pan> el empleo de respiraci= =C3=B3n </spa= n>asistida. No obs= tante, </span= >los resultados = sugieren </sp= an>la necesidad = de <sp= an class=3D"awspan">incorporar otras acciones inherentes = a buenas pr= =C3=A1cticas <= /span>en los cuidado= s <span= class=3D"awspan">de enfermer=C3=ADa como</= span> el cumplimiento de los</sp= an> protocolos para el<s= pan class=3D"awspan" style=3D"letter-spacing:0.15pt"> aseo= de las man= os <sp= an class=3D"awspan">y las acciones= de capacitaci=C3=B3n del personal de enfermer= =C3=ADa.Entre los = estudios </sp= an>que exponen res= ultados </spa= n>de intervenciones educativas,= (<a href=3D"#ref10" style=3D"text-dec= oration:none"></a><a href=3D"#ref10" style=3D"text-decoration:none">10</a>) = se <sp= an class=3D"awspan">centran en los cuidad= os <sp= an class=3D"awspan">de higiene bucal</spa= n> y reportan que la </span= >adhesi=C3=B3n de = los <s= pan class=3D"awspan">enfermeros a esta pr= =C3=A1ctica <= /span>incide de = manera </span= >positiva en la</s= pan> evoluci=C3=B3n de los</spa= n> pacientes. Los estudios</spa= n> (<a href=3D"#ref21" style=3D"text-decoration:none"></a>= <a href= =3D"#ref21" style=3D"text-decoration:none">21</a>, <a href=3D"#ref22" style=3D"text-decorat= ion:none"></a><a href=3D"#ref22" style=3D"text-decoration:none">22</a>) conciben paquetes m= =C3=A1s completos en cuanto a cuidados de enfermer=C3=ADa. Aunque = ning=C3=BAn estudio<s= pan class=3D"awspan" style=3D"letter-spacing:-0.1pt"> reporta adhesi=C3=B3n total</spa= n> a las intervenciones<= span class=3D"awspan" style=3D"letter-spacing:-0.1pt"> implementadas, en los dirigid= os <sp= an class=3D"awspan">a pacientes adultos</= span> que reciben atenci=C3=B3n= <span= class=3D"awspan">en UCI, se observa = una reducci=C3=B3n<sp= an class=3D"awspan" style=3D"letter-spacing:0.55pt"> de los= d=C3=ADas de estancia </sp= an>hospitalaria (<a href=3D= "#ref8" style=3D"text-decoration:none"></a><a href=3D"#ref8" style=3D"text-decorati= on:none">8,</spa= n></a> <a href=3D"#ref18" style= =3D"text-decoration:none"></a><a href=3D"#ref18" style=3D"text-decoration:none"><sp= an class=3D"awspan" style=3D"text-decoration:underline">18</a><p= style=3D"margin-right:1pt; margin-left:1pt">).</spa= n> El= incremento de la <s= pan class=3D"awspan">adhesi=C3=B3n al conju= nto <sp= an class=3D"awspan">de las buenas pr=C3=A1= cticas </span= >enfermeras implementadas<sp= an class=3D"awspan" style=3D"letter-spacing:0.75pt"> en </= span>la UCI se</sp= an> expres=C3=B3 en una<= span class=3D"awspan" style=3D"letter-spacing:0.75pt"> reducci=C3=B3n del riesgo de<= /span> neumon=C3=ADas, en pacie= ntes <= span class=3D"awspan">con ventilaci=C3=B3n asistida </= span>(<a href=3D"#ref21" style=3D"text-decora= tion:none"></a><a href=3D"#ref21" style=3D"text-decoration:none">21</a>). = Estos = resultados coinciden con<spa= n class=3D"awspan" style=3D"letter-spacing:0.65pt"> los </= span>reportados por (<a href=3D"#ref24" style=3D"text-decoration:none"></a><a href=3D"#ref24= " style=3D"text-decoration:none">24</a>) quienes = encontraron, = en una revi= si=C3=B3n </s= pan>sistem=C3=A1tica, que el= cumplimiento global de= un paquete de enfermer=C3=ADa tiene una incidencia positiva al reportar</spa= n> decrecimiento en el<span= class=3D"awspan" style=3D"letter-spacing:0.1pt"> total </s= pan>de pacientes c= on <spa= n class=3D"awspan">NAV, as=C3=AD como</span= > reducci=C3=B3n en los<sp= an class=3D"awspan" style=3D"letter-spacing:0.1pt"> d=C3=ADas de hospitalizaci=C3=B3n.Tambi=C3=A9n= se reporta eficacia= en= los programas de <s= pan class=3D"awspan">capacitaci=C3=B3n encaminados= a = lograr buenas pr=C3=A1cticas<= /span> de enfermer=C3=ADa (10).</s= pan> Ello coincide con<span= class=3D"awspan" style=3D"letter-spacing:1.3pt"> los </spa= n>resultados de (24)= quienes, como resultado = de <sp= an class=3D"awspan">una revisi=C3=B3n sis= tem=C3=A1tica, reportan que las </spa= n>intervenciones educativas, dirig= idas <s= pan class=3D"awspan">a objetivos espec=C3= =ADficos, </sp= an>pueden disminuir = las <sp= an class=3D"awspan">tasas de neumon=C3=ADa<= /span> asociada al ventilador.De los estudios revisados (<a href=3D"#ref10" style=3D"text-decor= ation:none"></a><a href=3D"#ref10" style=3D"text-decoration:none">10</a>, <a href=3D"#= ref18" style=3D"text-decoration:none"></a><a href=3D"#ref18" style=3D"text-decorati= on:none">18</spa= n></a>, <a href=3D"#ref21" style=3D"text-decoration:none"></a><a href=3D"#ref= 21" style=3D"text-decoration:none">21</a>) coinciden con (<a href=3D"#ref24" s= tyle=3D"text-decoration:none"></a><a href=3D"#ref24" style=3D"text-decoration:none"= >24</a></= p>) e= n la importancia y efectividad de las med= idas <= span class=3D"awspan">de higiene bucal,</= span> elevaci=C3=B3n del cabece= ro <sp= an class=3D"awspan">y la observancia</spa= n> de los protocolos para</span= > la aspiraci=C3=B3n en<= span class=3D"awspan" style=3D"letter-spacing:0.65pt"> pacientes con NAV.<spa= n class=3D"awspan" style=3D"letter-spacing:0.65pt"> Por </= span>su parte los<= /span> estudios en poblaci=C3= =B3n <= span class=3D"awspan">adulto mayor (<a href=3D"#re= f3" style=3D"text-decoration:none"></a><a href=3D"#ref3" style=3D"text-decoration:n= one">3</a= >= , <a = href=3D"#ref19" style=3D"text-decoration:none"></a><a href=3D"#ref19" style=3D"text= -decoration:none">19</a>) evidencian que<s= pan class=3D"awspan" style=3D"letter-spacing:-0.35pt"> junto a la administraci=C3=B3n de medicamentos,<= /span> <span= class=3D"awspan">los cuidados de enfer= mer=C3=ADa potencian el empleo de la terapia respiratoria. 4.1. Limitaciones<span= class=3D"awspan">Constituyen limitaciones de esta revisi=C3=B3n sistem=C3= =A1tica: <img src=3D"data:image/jpeg;base64,/9j/4AAQSkZJRgABA= QEAYABgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8SEhEPERETFhwXExQaFRER= GCEYGh0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4eHh4eHh4eHh4eHh4eHh4= eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAxoDASIAAhEBAxEB/8QAHA= ABAQACAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGCQMEAgMAAAECAwQFEQYSB= yExExQXQVFTVmGSlOMIFSJUcYGT0TI3UnWRsyMzNkJydKGy0haCsRg4Q2IkwWNzg//EABsBAQEB= AQEBAQEAAAAAAAAAAAABAgMEBQYH/8QANBEBAQACAgIABAIJAwQDAAAAAAECEQMSBFEFITFBE4E= UIjI0YXGRsdGhwfAGMzXhUlPx/9oADAMBAAIRAxEAPwDqXfGR5+77cnfGR5+77cuIf0nUfi91yz= kX/P3fblO+L/n7vty4w1F3XJORf8/d9uU74yPP3fblhKGobrk74v8An7vtyd8ZHn7vty4w1Flrk= 74v+fu+3KTkZHn7vtywSV1F3WffOR5+77cnfOR5+77cuMXUZ3XJ3zkefu+3K98ZHn7vty4hNRZa= znJyPP3fbk75yPP3fblxz2hqFtcnfOR5+77cnfOR5+77cuMNRN1yTkZG39fd9uWPfOR5+57csJR= 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(00593) 511262 y 0984058533</spa= n> = ; Tel. 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(00593) 511262 y 098= 4058533 Tel. 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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= MAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJR= EFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReIC= jUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5= imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoG= EYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3= vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPg= zkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7N= z+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/= A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomi= YQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMF= KkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUh= bn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZ= nJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsU= D2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iR= Bw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kg= haDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5= QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvhe= R5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElF= TkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; po= sition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAAN= SUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSs= OGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mj= uYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhh= Pi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQ= KNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61= Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKh= SLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJk= cfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vq= lXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398= JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+C= wLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kE= sGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEw= tTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+659= 76cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEo= lwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80= Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital</spa= n> = ; Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. (00593) 511262 y 0984058533 &#x= a0; Tel. Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-= decoration:none"></a><a href=3D"http://www.anatomiadigital.org" sty= le=3D"text-decoration:none">www.anatomi= adigital.org</a> <a href=3D"h= ttp://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= /p><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-dec= oration:none">www.cienciadigitaleditori= al.com</a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSU= hEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOG= wAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAq= FAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgB= DQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHic= ViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEg= QqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDab= rKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwx= Dcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4O= HMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1y= eVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185Oemy= uLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpB= MJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJ= SSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5= nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2i= x3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3Pj= mBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPH= nyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW= 1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidn= AAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0K= GgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAA= ADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQ= jiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UE= ikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59Fs= Nrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQG= OFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4= IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZ= DJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3F= cZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dn= BdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u= 7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xL= It4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28T= DocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgG= M1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNW= qS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlq= NfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC= " width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:a= bsolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAA= ABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAzt= JREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhF= mVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkU= ikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13Wl= lJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dE= NQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/= 2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo= 8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1W= i2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/= U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1= KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo= 6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvy= zrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5= UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7+= +/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMx= l8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSu= QmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; positi= on:absolute" />Revista Anatom=C3=ADa</span= > Digital<= /span>&= #xa0; Ambato =E2=80=93 Ecuador (J= ard=C3=ADn Ambate=C3=B1o) = = Tels. (00593) 511262 y 0984058533 = Tel. 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/88sawSImorq6WWVlZ37tZIQSKomAwGEKNrMfjwe/3f28OGCwWi4WFCxei0+k4d+4cJ06cwOv1s= njxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1E5WVhbTp0/n4sWLNDcH= C2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+/0b36rX/FXvXmzN47GY= 2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" width=3D"77" height=3D= "28" alt=3D"" style=3D"margin-left:441.05pt; position:absolute" /><s= pan class=3D"awspan">La inclusi=C3=B3n = de <sp= an class=3D"awspan">estudios que describe= n <spa= n class=3D"awspan">intervenciones efectivas, sin </spa= n>dise=C3=B1ar etapas de seguimiento para las mismas.La i= nclusi=C3=B3n </= span>de estudios centrad= os en un solo pro= ceder <sp= an class=3D"awspan">preventivo de NAVM<s= pan class=3D"awspan" style=3D"letter-spacing:1pt"> como </spa= n>la higiene bucal y la terapia respiratoria.= La util= izaci=C3=B3n = de instrumentos autoinformes para conocer<sp= an class=3D"awspan" style=3D"letter-spacing:1.15pt"> el </= span>conocimiento y proceder pr=C3=A1ctico del personal</sp= an> de enfermer=C3=ADa en</span= > la prevenci=C3=B3n de<= span class=3D"awspan" style=3D"letter-spacing:1.35pt"> NAVM en ucis. Este </span= >aspecto puede restar validez y confiabilidad a los = resultados que se exponen.4.2. L=C3=ADneas futuras Se justif= ica <= span class=3D"awspan">realizar otras re= visiones </s= pan>donde la tot= alidad </spa= n>de estudios mu= estren </spa= n>resultados de paquetes<sp= an class=3D"awspan" style=3D"letter-spacing:1.5pt"> de </sp= an>intervenciones y, de <sp= an class=3D"awspan">ser posible, que= consideren una fase<span= class=3D"awspan" style=3D"letter-spacing:1.5pt"> de </span= >seguimiento posterior a las intervenciones.<= /p>Los paquetes de intervenciones, con demostrada<= span class=3D"awspan" style=3D"letter-spacing:0.9pt"> eficacia en la r= educci=C3=B3n = de riesgos d= e NAVM </span= >y dise=C3=B1os = cuasi-experimentales, deben ser<sp= an class=3D"awspan" style=3D"letter-spacing:1.55pt"> promovidos y extrapolados<= span class=3D"awspan" style=3D"letter-spacing:1.55pt"> a= otros contextos.5.Conclusiones=EF=82=B7Lo= s <spa= n class=3D"awspan">paquetes de intervenci= =C3=B3n </spa= n>que se aplican</= span> en las UCI de </span= >Am=C3=A9rica Latina, en </span= >la atenci=C3=B3n de pacientes con neumon=C3=ADa= asociada a la ventilaci=C3=B3n mec=C3=A1nica, co= inciden en </spa= n>incluir como principal= es acciones de cuidados<sp= an class=3D"awspan" style=3D"letter-spacing:1pt"> de <= span class=3D"awspan">enfermer=C3=ADa las med= idas <spa= n class=3D"awspan">de higiene bucal, la</sp= an> elevaci=C3=B3n del cabecero</s= pan> de las camas = y <span= class=3D"awspan">la observancia de<= span class=3D"awspan" style=3D"letter-spacing:1.7pt"> los protocolos para la aspiraci=C3=B3n endotraqueal.=EF=82=B7Aunque no se log= ra <sp= an class=3D"awspan">una adhesi=C3=B3n tot= al, <s= pan class=3D"awspan">las intervenciones = implementadas favorecen la reducci=C3=B3n</= span> de la estancia hospitalaria y la reducc= i=C3=B3n </spa= n>del riesgo de neum= on=C3=ADas en pacientes con ventilaci=C3=B3n asistida. =EF=82=B7Los </span= >resultados sugieren la = necesidad de incor= porar = otras acciones rel= acionadas </s= pan>con buenas pr=C3=A1cticas</span= > de enfermer=C3=ADa, como</spa= n> el cumplimiento de<sp= an class=3D"awspan" style=3D"letter-spacing:0.65pt"> los <= /span>protocolos para el aseo de las manos y capacitaci=C3=B3n del personal de enfermer=C3= =ADa.6.Conf= licto de interesesLos autores<= span class=3D"awspan" style=3D"letter-spacing:2.1pt"> declaran que no e= xiste <= span class=3D"awspan">conflicto de interese= s <span= class=3D"awspan">en relaci=C3=B3n con</spa= n> el= art=C3=ADculo presentado.7.Declaraci=C3=B3n de contribu= ci=C3=B3n de los autoresTodos aut= ores contribuyeron significativamente en la elaboraci=C3=B3n del art=C3=ADc= ulo.<img src=3D"data:image/jpeg;base64,/9j/4AAQSkZJRgABAQEAYA= BgAAD/2wBDAAUDBAQEAwUEBAQFBQUGBwwIBwcHBw8LCwkMEQ8SEhEPERETFhwXExQaFRERGCEYG= h0dHx8fExciJCIeJBweHx7/2wBDAQUFBQcGBw4ICA4eFBEUHh4eHh4eHh4eHh4eHh4eHh4eHh4e= Hh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh4eHh7/wAARCARjAxoDASIAAhEBAxEB/8QAHAABAQA= CAwEBAAAAAAAAAAAAAAECBwMGCAUE/8QATRABAAEDAgIDCwgGCQMEAgMAAAECAwQFEQYSByExEx= 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Directo (00593) 0998-235-485 &= #xa0; <a href=3D"http://www.anatomiadigital.org" s= tyle=3D"text-decoration:none"></a><a href=3D"http://www.anatomiadig= ital.org" style=3D"text-decoration:none">www.anatomiadigital.org</a> </span= ><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoratio= n:none"></a><a href=3D"http://www.cienciadigitaleditorial.com" styl= e=3D"text-decoration:none">www.cienciad= igitaleditorial.com</a><img src=3D"data:image/png;base64,iVBOR= w0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAO= xAAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3L= M3xfCue0huWAqFAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9q= enpzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nK= RaLFItFRkdHicViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9P= k0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fv= E43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIb= pdEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n= 83NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoV= ALLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFov= PFvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHS= kECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/= jtse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cI= BKZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXR= Jr1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wv= d9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O= 18z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJc= wS6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5Stq= KT0/sycXcKidnAAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D= "margin-left:-1pt; position:absolute" /><img src=3D"data:image/png;ba= se64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAA= lwSFlzAAAOxAAADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/Q= Td9hT5iVCBdFQjiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx= +fmJMQa/34+UEikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEB= KOQUVY2We59FsNrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8= sMBgMsy0JrPQGOFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxH= M7OziiVSnieN4IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2E= EKyurgKQz+fJZDJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKF= arUa328V6fX3FcZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/= dkMhmur6/Z2dnBdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8= GvIr8Avmi9N7u7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8= G+vrzAQCaK2xLIt4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUo= RCoWwpJRsb28TDocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT0= 85Pz9HKTVphgGM1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZ= pQtITDagIAvNWqS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNp= pJT/2vNzOCqlqNfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAA= AAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1p= t; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgo= AAAANSUhEUgAAABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADs= QBlSsOGwAAAztJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwp= CshMtFl1sSPhFmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e= 6HQ6CCGIx+OkUikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMz= MDIZheOkI13WllJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF0= 5OTigUCrTb7dENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys= 7MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM= 8V/HWJaFlJJGo8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32= GwyF3d3cAKK1Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn4= 1t2xweHqLrOv/U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbI= xqNsrGxQa/Xo1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZH= QOPj4yQSCT/Zo6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1H= GxmL8/OEDruvyzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0G= q1cIaO3yq5XG5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg= 0Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAM= g3Q6zdraGplMxl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhuk= FAAAAAElFTkSuQmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left= :-1pt; position:absolute" />Revista Anatom= =C3=ADa Digital <spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Ambato =E2= =80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) &#= xa0; Tels. (00593) 511262 y 0984058533 &= #xa0; Tel. 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(00593) 511262 y 0984058533 = Tel. 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(00593) 511262 y 0984058533= = Tel. 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position:absolute" />Revista Anatom=C3=ADa Digital &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) = = Tels. (00593) 511262 y 098= 4058533 Tel. 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(00593) 5112= 62 y 0984058533 <spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Tel. 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(00593= ) 511262 y 0984058533 </spa= n>Tel. = Directo (00593) 0998-235-485 = ; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decoratio= n:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"tex= t-decoration:none">www.anatomiadigital.= org</a>&#= xa0; <a href=3D"http://www= .cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><a= href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:n= one">www.cienciadigitaleditorial.com</s= pan></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABM= AAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJRE= FUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICj= UKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5i= miZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGE= YKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3v= D8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgz= kSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz= +H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A= 8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiY= QRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFK= kcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhb= n4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZn= JZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD= 2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRB= w8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kgh= aDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5Q= yMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR= 5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFT= kSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; pos= ition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANS= UhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsO= GwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mju= YGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhhP= i5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQK= NDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61W= o9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKhS= LRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJkc= feARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vql= XA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398J= BAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+Cw= LYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kEs= GKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEwt= TY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+6597= 6cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEol= wdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80G= g0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital<= span class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt"> &#= xa0; Ambato =E2=80=93 Ecuador (Jard=C3= =ADn Ambate=C3=B1o) </span= >Tels. = (00593) 511262 y 0984058533 = Tel. 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(00593) 511262 y 0984058533 = ; Tel. 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Conocimientos y pr=C3=A1cticas del profesional de enferm= er=C3=ADa sobre la prevenci=C3=B3n de neumon=C3=ADa asociada a ventilaci=C3= =B3n mec=C3=A1nica en la unidad de cuidados intensivos de un hospital nacio= nal de Lima, 2024 [Tesis de Especialidad, Universidad Privada Norbert Wiene= r, Lima, Per=C3=BA] [Internet]. 2024 [citado 05 de enero 2025]. 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position:absolute" /><= span class=3D"awspan" style=3D"font-family:Calibri; font-size:9pt; font-wei= ght:bold; color:#4472c4">Revista Anatom=C3=ADa Digital &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3= =B1o) Tels. 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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= MAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJR= EFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReIC= jUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5= imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoG= EYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3= vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPg= zkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7N= z+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/= A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomi= YQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMF= KkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUh= bn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZ= nJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsU= D2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iR= Bw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kg= haDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5= QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvhe= R5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElF= TkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; po= sition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAAN= SUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSs= OGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mj= uYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhh= Pi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQ= KNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61= Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKh= SLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJk= cfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vq= lXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398= JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+C= wLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kE= sGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEw= tTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+659= 76cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEo= lwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80= Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital</spa= n> = ; Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. (00593) 511262 y 0984058533 &#x= a0; Tel. 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Directo (00593) 0998-235-485 &#= xa0; <a href=3D"http://www.anatomiadigital.org" st= yle=3D"text-decoration:none"></a><a href=3D"http://www.anatomiadigi= tal.org" style=3D"text-decoration:none">www.anatomiadigital.org</a> = <a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration= :none"></a><a href=3D"http://www.cienciadigitaleditorial.com" style= =3D"text-decoration:none">www.cienciadi= gitaleditorial.com</a><img src=3D"data:image/png;base64,iVBORw= 0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOx= AAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM= 3xfCue0huWAqFAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qe= npzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKR= aLFItFRkdHicViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk= 0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE= 43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbp= dEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n8= 3NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVA= LLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovP= Fvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSk= ECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/j= tse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIB= KZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJ= r1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd= 9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O1= 8z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcw= S6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqK= T0/sycXcKidnAAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"= margin-left:-1pt; position:absolute" /><img src=3D"data:image/png;bas= e64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAl= wSFlzAAAOxAAADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QT= d9hT5iVCBdFQjiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+= fmJMQa/34+UEikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBK= OQUVY2We59FsNrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8s= MBgMsy0JrPQGOFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM= 7OziiVSnieN4IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EE= KyurgKQz+fJZDJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFa= rUa328V6fX3FcZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/d= kMhmur6/Z2dnBdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8G= vIr8Avmi9N7u7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G= +vrzAQCaK2xLIt4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoR= CoWwpJRsb28TDocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT08= 5Pz9HKTVphgGM1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZp= QtITDagIAvNWqS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNpp= JT/2vNzOCqlqNfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAA= AElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt= ; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoA= AAANSUhEUgAAABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQ= BlSsOGwAAAztJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpC= shMtFl1sSPhFmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6= HQ6CCGIx+OkUikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzM= DIZheOkI13WllJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05= OTigUCrTb7dENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7= MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8= V/HWJaFlJJGo8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32G= wyF3d3cAKK1Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41= t2xweHqLrOv/U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIx= qNsrGxQa/Xo1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQ= OPj4yQSCT/Zo6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HG= xmL8/OEDruvyzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq= 1cIaO3yq5XG5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0= Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg= 3Q6zdraGplMxl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukF= AAAAAElFTkSuQmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:= -1pt; position:absolute" />Revista Anatom= =C3=ADa Digital <spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt">Ambato =E2= =80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) &#= xa0; Tels. 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(00593) 511262 y 0984058533 = 0; Tel. 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te" />ISSN: <s= pan class=3D"awspan" style=3D"font-weight:bold; color:#ffffff">2697-3391</s= pan>Vol. 8 No. 2, pp. 6 =E2= =80=93 25, abril - junio 2025Revista en ciencias m=C3=A9dicas, salud p=C3= =BAblicaArt=C3=ADculo de revisi=C3=B3n bibliogr=C3=A1fica.<svg font-fa= mily=3D"Times New Roman" font-size=3D"16" height=3D"41.33" version=3D"1.1" = width=3D"209.31" xmlns=3D"http://www.w3.org/2000/svg" style=3D"width:209.31= px; height:41.33px; font-family:'Times New Roman'; font-size:16px" xmlns:xl= ink=3D"http://www.w3.org/1999/xlink"><defs /><g><g><path d=3D"M0,0 L209,0 L= 209,0 L209,41 L209,41 L0,41 Z" fill=3D"#7d7d7d" fill-rule=3D"evenodd" /></g= ></g></svg>www.anatomiadigital.org<spa= n class=3D"awspan" style=3D"font-family:Calibri; font-size:9pt; font-weight= :bold; color:#4472c4">Revista Anatom=C3=ADa Digital = Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1= o) Tels. 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(00593) 511262 y 0984058533</spa= n> = ; Tel. 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(00593) 511262 y 098= 4058533 Tel. 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(0059= 3) 511262 y 0984058533 </sp= an>Tel.= Directo (00593) 0998-235-485 = 0; <a href=3D"http://www.anatomiadigital.org" style=3D"text-decorati= on:none"></a><a href=3D"http://www.anatomiadigital.org" style=3D"te= xt-decoration:none">www.anatomiadigital= .org</a>&= #xa0; <a href=3D"http://ww= w.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a><= a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:= none">www.cienciadigitaleditorial.com</= span></a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAB= MAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJR= EFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReIC= jUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5= imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoG= EYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3= vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPg= zkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7N= z+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/= A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomi= YQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMF= KkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUh= bn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZ= nJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsU= D2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iR= Bw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kg= haDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5= QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvhe= R5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElF= TkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; po= sition:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAAN= SUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSs= OGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6Mj= uYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhh= Pi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQ= KNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61= Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKh= SLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJk= cfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9Vq= lXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398= JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+C= wLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kE= sGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEw= tTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+659= 76cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEo= lwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80= Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width= =3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAA= SCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI= 1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPy= MrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycx= DAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpye= Ojo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKt= Mz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9= Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI= 6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA= 4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26R= O9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQ= Tab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm= 8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3= xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cj= AYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2= B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3= QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" w= idth=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:abso= lute" />Revista Anatom=C3=ADa Digital</spa= n> = ; Ambato =E2=80=93 Ecuador (Jard= =C3=ADn Ambate=C3=B1o) </s= pan>Tel= s. (00593) 511262 y 0984058533 &#x= a0; Tel. 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d+4cJ06cwOv1snjxYkpKSr7XVkJCAikpKdTW1pKbm0tjYyPt7e0UFBQghODw4cM0Nzff1E5WVhb= Tp0/n4sWLNDcHC2BlZSU5OTl4vV6qqqquq1dWVsa8efMQDQ0N8v777/+XNz1YBhOK/67+/0b36r= X/FXvXmzN47GY2nnvuOXJycv4tf//fy/8AgnKjIiDLf+gAAAAASUVORK5CYII=3D" width=3D"= 77" height=3D"28" alt=3D"" style=3D"margin-left:441.05pt; position:absolute= " />Centro [Internet]. 2018 [citado 5 enero 2= 025]; 12(3). 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position:absolute" /><sp= an class=3D"awspan" style=3D"font-family:Calibri; font-size:9pt; font-weigh= t:bold; color:#4472c4">Revista Anatom=C3=ADa Digital = ; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3= =B1o) Tels. 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Direct= o (00593) 0998-235-485 </sp= an><a href=3D"http://www.anatomiadigital.org" style=3D"text-decoration:none= "></a><a href=3D"http://www.anatomiadigital.org" style=3D"text-deco= ration:none">www.anatomiadigital.org</s= pan></a><= span class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt"> &#= xa0; <a href=3D"http://www.cienc= iadigitaleditorial.com" style=3D"text-decoration:none"></a><a href= =3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:none">= www.cienciadigitaleditorial.com<= /a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAA= TCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJREFUOI= 1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICjUKgl= BgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5imiZS= Sj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGEYKgD= P89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3vD8+X= MqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgzkSem= ZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz+H6A= EJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A8j1Q= qxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiYQRrY= ZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFKkcV1= tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhbn4l8= MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZnJZEi= n0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD2qIF= D0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRBw8ek= kql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kghaDQd= PtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5QyMrq= KCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR5KKe= LxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFTkSuQ= mCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; 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position:absolute= " />Revista Anatom=C3=ADa Digital<s= pan class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt"> &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3= =ADn Ambate=C3=B1o) </span= >Tels. = (00593) 511262 y 0984058533 = Tel. Directo (00593) 0998-235-485 = ; <a href=3D"http://www.anatomiadigital.org" style=3D"text-dec= oration:none"></a><a href=3D"http://www.anatomiadigital.org" style= =3D"text-decoration:none">www.anatomiad= igital.org</a> <a href=3D"htt= p://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a></p= ><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decor= ation:none">www.cienciadigitaleditorial= .com</a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUh= EUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGw= AAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqF= AUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBD= Q0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicV= iCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQ= qCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabr= KysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxD= crkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OH= MDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1ye= VuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185Oemyu= LjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBM= JDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJS= SRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5n= MXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix= 3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3Pjm= Bjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHn= yhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1= ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnA= AAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-= 1pt; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0K= GgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAA= ADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQ= jiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UE= ikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59Fs= Nrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQG= OFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4= IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZ= DJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3F= cZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dn= BdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u= 7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xL= It4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28T= DocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgG= M1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNW= qS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlq= NfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC= " width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:a= bsolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgA= AABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAz= tJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPh= FmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+Ok= UikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13W= llJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7d= ENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f= /2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJG= o8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1= Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv= /U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo= 1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Z= o6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruv= yzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG= 5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7= ++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplM= xl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkS= uQmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; posit= ion:absolute" />Revista Anatom=C3=ADa Digi= tal Ambato =E2=80=93 Ecuado= r (Jard=C3=ADn Ambate=C3=B1o) &#x= a0; Tels. (00593) 511262 y 0984058533 &#= xa0; Tel. 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(00593) 511262 y 0984058533 &= #xa0; Tel. 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(00593) 511262 y 0984058533 &#= xa0; Tel. Directo (00593) 0998-235-485= &= #xa0; <a href=3D"http://www.anat= omiadigital.org" style=3D"text-decoration:none"></a><a href=3D"http= ://www.anatomiadigital.org" style=3D"text-decoration:none">www.anatomiadigital.org</a> = ; <a href=3D"http://www.cienciadigitaleditorial.com" sty= le=3D"text-decoration:none"></a><a href=3D"http://www.cienciadigita= leditorial.com" style=3D"text-decoration:none">www.cienciadigitaleditorial.com</a><img src=3D"data:i= mage/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAg= IfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEp= Ng1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZa= fT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlh= dXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyA= MQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1W= o4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL1= 6//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQk= SimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQ= ZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtux= Gs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycA= KAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++T= TKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRA= wCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6f= V6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4= eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2= ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLq= uUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0= HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFTkSuQmCC" width=3D"19" height=3D"= 19" alt=3D"" style=3D"margin-left:-1pt; position:absolute" /><img sr= c=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAA= BHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9= bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8= 887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQS= mHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbW= FqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQ= zM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1y= Ofz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0= Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdx= aLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp35= 4fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz= +fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQ= sdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cY= QzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQT= BYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh= 8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0P= wfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" st= yle=3D"margin-left:-1pt; position:absolute" /><img src=3D"data:image= /png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAh= kiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9= zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89b= wk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKy= LFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH1= 9nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8Ho= CAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUI= p/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8= P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7= jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihP= AfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEY= jGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyD= ubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6V= c/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKS= WhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5= eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTT= aUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" width=3D"18" height=3D"18" alt=3D= "" style=3D"margin-left:-1pt; position:absolute" />Revista Anatom=C3=ADa </spa= n>Digital = 0; Ambato =E2=80=93 Ecuador (Jard=C3=ADn Ambate=C3=B1o) &= #xa0; Tels. (00593) 511262 y 0984058533</span= > = Tel. 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(00593) 511262 y 098405= 8533 Tel. 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(00593) 511262 y 0984058= 533 Tel. 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Direc= to (00593) 0998-235-485 </s= pan><a href=3D"http://www.anatomiadigital.org" style=3D"text-decoration:non= e"></a><a href=3D"http://www.anatomiadigital.org" style=3D"text-dec= oration:none">www.anatomiadigital.org</= span></a>= &= #xa0; <a href=3D"http://www.cien= ciadigitaleditorial.com" style=3D"text-decoration:none"></a><a href= =3D"http://www.cienciadigitaleditorial.com" style=3D"text-decoration:none">= www.cienciadigitaleditorial.com<= /a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABMAAAA= TCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA7BJREFUOI= 1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqFAUBReICjUKgl= BgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBDQ0OMjo5imiZS= Sj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicViCCGuoGEYKgD= P89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQqCgDdv3vD8+X= MqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabrKysnIPgzkSem= ZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxDcrkcc7Nz+H6A= EJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OHMDLdyt/A8j1Q= qxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1yeVuYZomiYQRrY= ZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185OemyuLjA4rMFKkcV1= tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBMJDCTqUhbn4l8= MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJSSRCIRjZnJZEi= n0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5nMXbGxsUD2qIF= D0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix3Qmf/iRBw8ek= kql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3PjmBjdv2kghaDQd= PtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHnyhFwuh5QyMrq= KCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1ujVqvheR5KKe= LxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnAAAAAElFTkSuQ= mCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; positio= n:absolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhE= UgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwA= AAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQjiybK6MjuYGY= VHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UEikllmUhhPi5D= P/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59FsNrm8vKRQKNDp= dBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQGOFXieR61Wo9V= q4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4IppahUKhSLRQ= aDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZDJks9nJkcfeA= RPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3FcZyJH9VqlXA4= zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dnBdV3e398JBAK= 4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u7v6fV6+CwLYw= xSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xLIt4PE4kEsGKR= CKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28TDocnoHEwtTY8= 1WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgGM1lg+65976cd= ojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNWqS3+8nEolwdH= Q0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlqNfrPDw80Gg0+= Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC" width=3D"1= 9" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:absolute" /><= /span><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABIAAAASCAY= AAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAztJREFUOI1VlM= 1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPhFmVg1EPyMrAy= ofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+OkUikmJycxDAMh= xI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13WllJKnpyeOjo4= olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7dENQqCqKtMz0w= TUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f/2KZVkA9Ho9D= g4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJGo8H5+fkI6PX1= lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1Wi2azCUA4HGZ= 1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv/U6/z26RO9bp= d/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo1KpcHFxQTab5= f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Zo6zrOpqm8dTv= 02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruvyzrJ4fX3xmWm= axvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG5UquM4cjAYcH= x8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7++/aRVP2B+FN= k2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplMxl8XQog3QN7c= 7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkSuQmCC" width= =3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; position:absolute= " />Revista Anatom=C3=ADa Digital<s= pan class=3D"awspan" style=3D"font-family:Calibri; font-size:8pt"> &#x= a0; Ambato =E2=80=93 Ecuador (Jard=C3= =ADn Ambate=C3=B1o) </span= >Tels. = (00593) 511262 y 0984058533 = Tel. Directo (00593) 0998-235-485 = ; <a href=3D"http://www.anatomiadigital.org" style=3D"text-dec= oration:none"></a><a href=3D"http://www.anatomiadigital.org" style= =3D"text-decoration:none">www.anatomiad= igital.org</a> <a href=3D"htt= p://www.cienciadigitaleditorial.com" style=3D"text-decoration:none"></a></p= ><a href=3D"http://www.cienciadigitaleditorial.com" style=3D"text-decor= ation:none">www.cienciadigitaleditorial= .com</a><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUh= EUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGw= AAA7BJREFUOI1tlM1PG0cYxn8zu/baXhzWBKfpEpNg1aVNkJAi2VLCsYLSQ3LM3xfCue0huWAqF= AUBReICjUKglBgndWq0/ljbCNbr3clh+UjUvJcZafT+NO/M8zxCKaUAzhcu9qenpzQaDdrtNgBD= Q0OMjo5imiZSSj4vIQRCCKFfNCulCIIAx3HY2dlhdXWVbrfL2dkZAIZhkE6nKRaLFItFRkdHicV= iCCGuoGEYKgDP89jf32dpaYmDgwMGgwFCCDRNAyAMQ8IwRAjB+Pg4s7OzTE9Pk0wmAZBSChEEgQ= qCgDdv3vD8+XMqlQpKKSzLwh4bw8pkkELQ7Xap1Wo4joMKQ7LZLI8fP+b+/fvE43E0TYvGbDabr= KysnIPgzkSemZmH5G7fRkqJ7/skjAQf3r9na2uL16//wnEcXr58ycjICIVCIbpdEEa32tvbIwxD= crkcc7Nz+H6AEJK9vb/Z3t7hzPPw+z5zcz/z/eQkSimOjo7Y3t7m9Ow0gvl9n83NTfr9PnHD4OH= MDLdyt/A8j1QqxbWhIbLXr2MYBlJKLMtibn4e0zQZDAbs7u7SarUimOu6VCoVALLZLPaYTdt1ye= VuYZomiYQRrYZBZiTD4T8HZCyLOxN3ADg+PsZtuxGs1Wrh+z5CCKzhYdrtFovPFvjt9185Oemyu= LjA4rMFKkcV1tfXeLrwlH8/vOdb20Yphed5nJycAKAHQRAJFQhRCAS6pqFLHSkECSPBQPpoQpBM= JDCTqUhbn4l8MBhEsGQyeXnYdTsMpdP8NDuH3++TTKSYn/+FIAiw7TFieox8/jtse4zNjT9BgJS= SRCIRjZnJZEin0wA4jsNxvc7du3dBCHq9HulraRAwCALaboeJ/ARu2+Xdu3cIBKZpXvZL0zSj5n= MXbGxsUD2qIFD0el06nQ7/1et43hlCguu6LC+X6fV6AIyPj2NZVgTTdZ1SqXRJr1arLJfLSE2ix= 3Qmf/iRBw8ekkql0HWNP5bLvH27C4Bpmty7d4/h4eHozaSU5PN5SqUSr169wvd9Dg8PaTQa3Pjm= Bjdv2kghaDQdPtY+0mw2CcMQTdOYmppienqaWCx2ZXSlFPV6nRcvXrC1tXX5O18z+rmpKRQKPHn= yhFwuh5QyMrqKCqUU7XabcrnM+vr6pXY+zyylFLquUywWefToEdls9iLLEEJcwS6q3+9TrVZZW1= ujVqvheR5KKeLxOLZtUyqVKBQKxOPx/4Wj+ILEl0HZ6XTo9XoopS4lcAH5StqKT0/sycXcKidnA= AAAAElFTkSuQmCC" width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-= 1pt; position:absolute" /><img src=3D"data:image/png;base64,iVBORw0K= GgoAAAANSUhEUgAAABMAAAATCAYAAAByUDbMAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAA= ADsQBlSsOGwAAAyxJREFUOI2tlFFLOksYxn+zOn9bLTUDbwKNSLLCJCjoJiI/QTd9hT5iVCBdFQ= jiybK6MjuYGYVHl3TNnJ05Fx492f9cnvdmWXbnN8887zOvMMYYfpQxBqUUnufx+fmJMQa/34+UE= ikllmUhhPi5DP/3F601ruvy8vJCqVSiWq3S6XRQSmHbNvF4nM3NTdbW1lhYWEBKOQUVY2We59Fs= Nrm8vKRQKNDpdBBCMBZujEEIgc/nI5FIcHBwwNbWFqFQaFqZ1prn52dOTk4ol8sMBgMsy0JrPQG= OFXieR61Wo9Vq4TgOuVwO27YBsIwxOI7DxcXFBDQzM0MsFsOyrJF8ISaw8dNxHM7OziiVSnieN4= IppahUKhSLRQaDAbZts7e3x+HhIdls9jeTv1ev1yOfz9NsNkew4XBIsVjEdV2EEKyurgKQz+fJZ= DJks9nJkcfeARPVzWaTSqWC53lYjuPQaDSmdlRK0Wq1aLfbpFIphBCTxd9rHKFarUa328V6fX3F= cZyJH9VqlXA4zPLyMouLi9zd3aG1Rms91dnvQMdxaLfb+IfD4aRbxhi63S739/dkMhmur6/Z2dn= BdV3e398JBAK4rstgMJjKpud5fH194Q8Gg0gpp354fHxkbm6OZDJJvV5nM7vJ8GvIr8Avmi9N7u= 7v6fV6+CwLYwxSSoLBIFY8HicajU55obXm9vaWpz+fiC0s0Ou5dJwOtVqN+dg8G+vrzAQCaK2xL= It4PE4kEsGKRCKsrKz85oVSipubG0p/lLBtm3AkQsdxMMB8bB6fzwdAIBAglUoRCoWwpJRsb28T= DocnoHEwtTY81WpcXV3yV6vF7u4uFoJyuUy/38cYQzKZZGNjY3T5tdbGdV1OT085Pz9HKTVphgG= M1lg+65976cdojfIUAsHs7CzHx8ek02l8Ph9+IQTBYJD9/X36/T6FQoFer4cxZpQtITDagIAvNW= qS3+8nEolwdHQ0AcG3qTHOy9XVFcVikbe3t9FRRh8RQiClJBQKkUgkyOVypNNppJT/2vNzOCqlq= NfrPDw80Gg0+Pj4QGtNIBAgFouxtLTE+vo60Wj0Pwfk/1Z/A9FuujSizfbsAAAAAElFTkSuQmCC= " width=3D"19" height=3D"19" alt=3D"" style=3D"margin-left:-1pt; position:a= bsolute" /><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgA= AABIAAAASCAYAAABWzo5XAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAz= tJREFUOI1VlM1PIkkYxn/VTdMNDUIM4jIxozsBD9zEg5rg6kkTM3sy/pGzyXrwpCshMtFl1sSPh= FmVg1EPyMrAyofY2tBde2C6d3yTSiVV9T71vE89bwk5CgCklLiui2VZ1Ot1Hh4e6HQ6CCGIx+Ok= UikmJycxDAMhxI9DBPgeUkosy6JarVIul7m6usKyLFzXBUBVVUzTJJvNsry8zMzMDIZheOkI13W= llJKnpyeOjo4olUo0m01c10UIAQIEAo81QCKRYH19nYWFBcLhMIqiiICUkpeXF05OTigUCrTb7d= ENQqCqKtMz0wTUALe3t9i2DUCz2WRnZwcpJfl8HoCAlJJarUaxWPRBvFJy8zkys7MM7AFjsRh/f= /2KZVkA9Ho9Dg4OmJqaGgENh0NOT0+p1+s+SCgUIp/P89O7FLZtE9R1MrMZTDPM8V/HWJaFlJJG= o8H5+fkI6PX1lbOzM1+DeDzOysoKoXAYx3GIRCI8P1uoaoD372cIh00+l0r0+32GwyF3d3cAKK1= Wi2azCUA4HGZ1dRVN04hEIqiKyvbv2xT2C1jPFo7jMDExwcePv/ov7cmhdDodn41t2xweHqLrOv= /U6/z26RO9bpd/W00K+3/w3H+i+e0bX76UkVIihPAfwPcRwHA45PHxEV3X2dvbIxqNsrGxQa/Xo= 1KpcHFxQTab5f7+/n//CDFiFIvFUFXVX/Q2pJTEYjGSySSKopBMJt94yTsXDAZHQOPj4yQSCT/Z= o6zrOpqm8dTv02630TSNYDCIUEYm9SIej49KMwyDubk5dnd3/c3BYMjy8i9Eo1HGxmL8/OEDruv= yzrJ4fX3xmWmaxvT09AgoEAiQy+WoVCrUajUcx6Vc/pNIJEqj8cDN7c33RImU0Gq1cIaO3yq5XG= 5UquM4cjAYcHx8zPb2Nt1uF0VRfA28XvNKd10XKSWhUIitrS2WlpbQdV0EhBAEg0Hm5+fp9/vs7= ++/aRVP2B+FNk2Tzc1NFhcX0TRtdMb7jKSU2LbN5eUlxWKRm5sbbNv2vxFFUTAMg3Q6zdraGplM= xl8XQog3QN7c7Xa5vr6mWq3SaDQQQpBKpchkMqTTaUzTfGMVIYT4D2/Tm3grhukFAAAAAElFTkS= uQmCC" width=3D"18" height=3D"18" alt=3D"" style=3D"margin-left:-1pt; posit= ion:absolute" />Revista Anatom=C3=ADa Digi= tal Ambato =E2=80=93 Ecuado= r (Jard=C3=ADn Ambate=C3=B1o) &#x= a0; Tels. (00593) 511262 y 0984058533 &#= xa0; Tel. 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(00593) 511262 y 0984058533 &= #xa0; Tel. 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(00593) 511262 y 0984058533 = ; Tel. 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(00593) 511262 y 0984058533= &= #xa0; Tel. 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