Use of Dexmedetomidine in Total Intravenous Anesthesia (TIVA)
Keywords:
Dexmedetomidine, anesthesia intravenous, receptors adrenergic alpha-2, adrenergic agonists.
Abstract
Dexmedetomidine was used initially for sedation in intensive care units. However, because of its sedative, analgesic and anti-anxiety effects and the fact that it does not alter ventilatory function, its use may be expanded as an intravenous agent in surgery. There are reports in the literature about its effective use in specific surgical populations, although further studies are required in order to support its use in all situations where total intravenous anesthesia (TIVA) is applied. The purpose of this review is to describe the role of dexmedetomidine in this form of anesthesia.
Materials y methods. A literature search was conducted in PubMed, Medline, EMBASE, Cochrane and LILACS. The search was expanded based on the references found in the articles reviewed initially and analyzed by the authors; the search was conducted under the MeSH included as key words below.
References
1. Venegas Saavedra A. Anestésicos intravenosos, anestesia intravenosa, 2 ed., Bogotá (DC): Editorial Médica Panamericana, 2008;5:194-8.
2. Miller RD. Anesthetic pharmacologic, Intravenous Anesthetics. En: Miller's Anesthesia. 7ed. Churchill Livingstone Elsevier, 2009;26.
3. Ramsay MA, Luterman DL. Dexmedetomidine as a total intravenous anesthetic agent. Anesthesiology 2004;101:787-90.
4. Talke Pekka O, Caldwell James E, Richardson Charles A, Kirkegaard-Nielsen H, Stafford M. The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology 2000;93: 382-94.
5. Popat K, Purugganan R, Malik I. Off-Label Uses of Dexmedetomidine, Advances in Anesthesia Vol. 24, 2006:177-92.
6. Khan ZP, Ferguson CN, Jones RM. Alpha-2 and imidazoline receptor agonists: their pharmacology and therapeutic role. Anaesthesia 1999;54:146-65.
7. Kamibayashi T, Maze M. Clinical uses of a2 adrenergic agonists. Anesthesiology 2000;93:1345-9.
8. Tobias JD. Dexmedetomidine: applications in pediatric critical care and pediatric anesthesiology. Pediatr Crit Care Med 2007;8:115-31.
9. Maze M, Tranquilli W. Alpha-2 adrenoceptor agonists: defining the role in clinical anesthesia. Anesthesiology 1991;74:581-605.
10. Bekker A, Jorden VSB. Alpha-2 agonists in neuroanesthesia. Seminars in anesthesia, perioperative medicine and pain 2004;3:181-91.
11. Yazbeck-karam V, Aouad M. Perioperative uses of dexmedetomidine. Middle East Journal of Anesthesiology 2006;6:1043-58.
12. Guo TZ, Jiang JY, Buttermann AE, Maze M. Dexmedetomidine injection into the locus ceruleus produces antinociception. Anesthesiology 1996;84:873-81.
13. Nelson LE, Lu J, Guo T, Saper CB, Franks NP, Maze M. The alpha2-adrenoceptor agonist dexmedetomidine converges on an endogenous sleep-promoting pathway to exert its sedative effects. Anesthesiology 2003;98:428-36.
14. Nacif-Coelho C, Correa-Sales C, Chang LL, Maze M. Perturbation of ion channel conductance alters the hypnotic response to the alpha 2-adrenergic agonist dexmedetomidine in the locus coeruleus of the rat. Anesthesiology 1994;81:1527-34.
15. Venn RM, Bradshaw CJ, Spencer R, Brealey D, Caudwell E, Naughton C, et al. Preliminary UK experience of dexmedetomidine, a novel agent for postoperative sedation in the intensive care unit. Anaesthesia 1999;54:1136-42.
16. Virtanen R, Savola JM, Saano V, Nyman L. Characterization of the selectivity, specificity and potency of medetomidine as an alpha 2-adrenoceptor agonist. Eur J Pharmacol 1988;150:9-14.
17. Venn RM, Karol MD, Grounds RM. Pharmacokinetics of dexmedetomidine infusions for sedation of postoperative patients requiring intensive caret. Br J Anaesth 2002;88:669-75.
18. Dyck JB, Maze M, Haack C, Vuorilehto L, Shafer SL. The pharmacokinetics and hemodynamic effects of intravenous and intramuscular dexmedetomidine hydrochloride in adult human volunteers. Anesthesiology 1993;78:813-20.
19. De Wolf AM, Fragen RJ, Avram MJ, Fitzgerald PC, Rahimi-Danesh F. The pharmacokinetics of dexmedetomidine in volunteers with severe renal impairment. Anesth Analg 2001;93:1205-9.
20. Dyck JB, Maze M, Haack C, Azarnoff DL, Vuorilehto L, Shafer SL. Computer-controlled infusion of intravenous dexmedetomidine hydrochloride in adult human volunteers. Anesthesiology 1993;78:821-8.
21. Engelhard K, Werner C, Kaspar S, Möllenberg O, Blobner M, Bachl M, et al. Effect of the alpha2-agonist dexmedetomidine on cerebral neurotransmitter concentrations during cerebral ischemia in rats. Anesthesiology 2002;96:450-7.
22. Aantaa R, Kallio A, Virtanen R. Dexmedetomidine, a novel a2-adrenergic agonist: a review of its pharmacodynamic characteristics. En: Drugs Future 1993;18:49-56.
23. Frangoulidou E, Kuhlen R, Marenghi C. Sedative agents and respiratory depression: a unique profile of dexmedetomidine. En: Maze M, Morrison P, editors. Redefining Sedation. London (UK): The Royal Society of Medicine Press Ltd.;1998P. 40-50.
24. Riker RR, Fraser GL. Adverse events associated with sedatives, analgesics, and other drugs that provide patient comfort in the intensive care unit. Pharmacotherapy 2005; 25:8S-18S.
25. Lerch C, Park GR. Sedation and analgesia. En: BMJ 1999;55:76-95.
26. Pandharipande P, Pun B, Herr D, Maze M, Girard T, Miller R, et al. Effect of sedation with dexmedetomidine versus lorazepam on acute brain dysfunction in mechanically ventilated patients: the MENDS randomized controlled trial, JAMA 2007;298:2644-64.
27. Willigers HM, Prinzen FW, Roekaerts PM, De Lange S, Durieux ME. Dexmedetomidine decreases perioperative myocardial lactate release in dogs. Anesth Analg 2003;96:657-64.
28. Roekaerts P, Prinzen F, Willingers H. The effect of dexmedetomidine on systemic haemodynamics, regional myocardial function and blood flow during coronary artery stenosis in acute anaesthetized dogs. J Cardiothorac Anesth 1994;8:58.
29. Wallace AW, Galindez D, Salahieh A, Layug EL, Lazo EA, Haratonik KA, et al. Effect of clonidine on cardiovascular morbidity and mortality after noncardiac surgery. Anesthesiology 2004;101:284-93.
30 Aho M, Lehtinen AM, Erkola O, Kallio A, Korttila K. The effect of intravenously administered dexmedetomidine on perioperative hemodynamics and isoflurane requirements in patients undergoing abdominal hysterectomy. Anesthesiology 1991;74:997-1002.
31. Jaakola ML, Ali-Melkkilä T, Kanto J, Kallio A, Scheinin H, Scheinin M. Dexmedetomidine reduces intraocular pressure, intubation responses and anaesthetic requirements in patients undergoing ophthalmic surgery. Br J Anaesth 1992;68:570-5.
32. Scheinin B, Lindgren L, Randell T, Scheinin H, Scheinin M. Dexmedetomidine attenuates sympathoadrenal responses to tracheal intubation and reduces the need for thiopentone and peroperative fentanyl. Br J Anaesth 1992;68:126-31.
33. Aantaa R, Kanto J, Scheinin M, Kallio A, Scheinin H. Dexmedetomidine, an alpha 2-adrenoceptor agonist, reduces anesthetic requirements for patients undergoing minor gynecologic surgery. Anesthesiology 1990;73:230-5.
34. Triltsch AE, Welte M, von Homeyer P, Grosse J, Genähr A, Moshirzadeh M, et al. Bispectral index-guided sedation with dexmedetomidine in intensive care: a prospective, randomized, double blind, placebo-controlled phase II study. Crit Care Med 2002;30:1007-14.
35. Koroglu A, Demirbilek S, Teksan H, Sagir O, But AK, Ersoy MO. Sedative, haemodynamic and respiratory effects of dexmedetomidine in children undergoing magnetic resonance imaging examination: preliminary results. Br J Anaesth 2005;94:821-4.
36. Koroglu Ah, Teksan H, Sagir O, Yucel A, Toprak H, Ersoy O. A comparison of the sedative, hemodynamic, and respiratory effects of dexmedetomidine and propofol in children undergoing magnetic resonance imaging. Anesth Analg 2006;103:63-7.
37. Wijeysundera DN, Naik JS, Beattie WS. Alpha-2 adrenergic agonists to prevent perioperative cardiovascular complications: a meta-analysis. Am J Med 2003;114:742-52.
38. Jalonen J, Hynynen M, Kuitunen A, Heikkilä H, Perttilä J, Salmenperä M, et al. Dexmedetomidine as an anesthetic adjunct in coronary artery bypass grafting. Anesthesiology 1997;86:331-45.
39. But AK, Ozgul U, Erdil F, Gulhas N, Toprak HI, Durmus M, et al. The effects of preoperative dexmedetomidine infusion on hemodynamics in patients with pulmonary hypertension undergoing mitral valve replacement surgery. Acta Anaesthesiol Scand 2006;50:1207-12.
40. Sadhasivam S, Boat A, Mahmoud M. Comparison of patient-controlled analgesia with and without dexmedetomidine following spine surgery in children. Journal of Clinical Anesthesia 2009;21:493-501.
41. Hammer GB, Sam WJ, Chen MI, Golianu B, Drover DR. Determination of the pharmacodynamic interaction of propofol and dexmedetomidine during esophagogastroduodenoscopy in children, Pediatric Anesthesia 2009;19:138-44.
42. Biccard BM, Goga S, de Beurs J. Dexmedetomidine and cardiac protection for non-cardiac surgery: a meta-analysis of randomised controlled trials, Anaesthesia 2008;63:4-14.
43. Ruesch S, Levy J. Treatment of persistent tachycardia with dexmedetomidina during off-pump cardiac surgery. Anesth Analg 2002;95:316-8.
44. Ickeringill M, Shehabi Y, Adamson H, Ruettimann U. Dexmedetomidine infusion without loading dose in surgical patients requiring mechanical ventilation: haemodynamic effects and efficacy. Anaesth Intensive Care 2004;32:741-5.
45. Abulhasan Y, Buu N, Frigon C. Perioperative use of dexmedetomidine in an infant with familial dysautonomia. British Journal of Anaesthesia 2009;103(3):413-5.
46. Bakhamees H. Effects of dexmedetomidine in morbidly obese patients undergoing laparoscopic gastric bypass Middle East Journal of Anesthesiology 2007;19(3).
47. Shukry M, Kennedy K. Dexmedetomidine as a total intravenous anesthetic in infants. Pediatric anesthesia 2007;17:581-3.
48. Bulow NM, Barbosa NV, Rocha JB. Opioid consumption in total intravenous anesthesia is reduced with dexmedetomidine: a comparative study with remifentanil in gynecologic videolaparoscopic surgery. Journal of Clinical Anesthesia 2007;19:280-5. 49. Mani V, Morton NS. Overview of total intravenous anesthesia in children. Pediatric Anesthesia 2010;20:211-22.
50. Arain SR, Ebert TJ. The efficacy, side effects, and recovery characteristics of dexmedetomidine versus propofol when used for intraoperative sedation. Anesth Analg 2002;95:461-6.
51. Turgut N, Turkmen A, Gökkaya S, Altan A, Hatiboglu MA. Dexmedetomidine-based versus fentanyl-based total intravenous anesthesia for lumbar laminectomy, Minerva Anestesiologica 2008;74:469-74.
52. Carollo DS, Nossaman BD, Ramadhyani U. Dexmedetomidine: a review of clinical applications; current opinion. En: Anesthesiology 2008,21:456-61.
53. Aho M, Erkola O, Kallio A, Scheinin H, Korttila K. Comparison of dexmedetomidine and midazolam sedation and antagonism of dexmedetomidine with atipamezole. J Clin Anesth 1993;5:194-203.
54. Reid K, Hayashi Y, Guo TZ, Correa-Sales C, Nacif-Coelho C, Maze M. Chronic administration of an alpha 2 adrenergic agonist desensitizes rats to the anesthetic effects of dexmedetomidine. Pharmacol Biochem Behav 1994;47:171-5.
2. Miller RD. Anesthetic pharmacologic, Intravenous Anesthetics. En: Miller's Anesthesia. 7ed. Churchill Livingstone Elsevier, 2009;26.
3. Ramsay MA, Luterman DL. Dexmedetomidine as a total intravenous anesthetic agent. Anesthesiology 2004;101:787-90.
4. Talke Pekka O, Caldwell James E, Richardson Charles A, Kirkegaard-Nielsen H, Stafford M. The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology 2000;93: 382-94.
5. Popat K, Purugganan R, Malik I. Off-Label Uses of Dexmedetomidine, Advances in Anesthesia Vol. 24, 2006:177-92.
6. Khan ZP, Ferguson CN, Jones RM. Alpha-2 and imidazoline receptor agonists: their pharmacology and therapeutic role. Anaesthesia 1999;54:146-65.
7. Kamibayashi T, Maze M. Clinical uses of a2 adrenergic agonists. Anesthesiology 2000;93:1345-9.
8. Tobias JD. Dexmedetomidine: applications in pediatric critical care and pediatric anesthesiology. Pediatr Crit Care Med 2007;8:115-31.
9. Maze M, Tranquilli W. Alpha-2 adrenoceptor agonists: defining the role in clinical anesthesia. Anesthesiology 1991;74:581-605.
10. Bekker A, Jorden VSB. Alpha-2 agonists in neuroanesthesia. Seminars in anesthesia, perioperative medicine and pain 2004;3:181-91.
11. Yazbeck-karam V, Aouad M. Perioperative uses of dexmedetomidine. Middle East Journal of Anesthesiology 2006;6:1043-58.
12. Guo TZ, Jiang JY, Buttermann AE, Maze M. Dexmedetomidine injection into the locus ceruleus produces antinociception. Anesthesiology 1996;84:873-81.
13. Nelson LE, Lu J, Guo T, Saper CB, Franks NP, Maze M. The alpha2-adrenoceptor agonist dexmedetomidine converges on an endogenous sleep-promoting pathway to exert its sedative effects. Anesthesiology 2003;98:428-36.
14. Nacif-Coelho C, Correa-Sales C, Chang LL, Maze M. Perturbation of ion channel conductance alters the hypnotic response to the alpha 2-adrenergic agonist dexmedetomidine in the locus coeruleus of the rat. Anesthesiology 1994;81:1527-34.
15. Venn RM, Bradshaw CJ, Spencer R, Brealey D, Caudwell E, Naughton C, et al. Preliminary UK experience of dexmedetomidine, a novel agent for postoperative sedation in the intensive care unit. Anaesthesia 1999;54:1136-42.
16. Virtanen R, Savola JM, Saano V, Nyman L. Characterization of the selectivity, specificity and potency of medetomidine as an alpha 2-adrenoceptor agonist. Eur J Pharmacol 1988;150:9-14.
17. Venn RM, Karol MD, Grounds RM. Pharmacokinetics of dexmedetomidine infusions for sedation of postoperative patients requiring intensive caret. Br J Anaesth 2002;88:669-75.
18. Dyck JB, Maze M, Haack C, Vuorilehto L, Shafer SL. The pharmacokinetics and hemodynamic effects of intravenous and intramuscular dexmedetomidine hydrochloride in adult human volunteers. Anesthesiology 1993;78:813-20.
19. De Wolf AM, Fragen RJ, Avram MJ, Fitzgerald PC, Rahimi-Danesh F. The pharmacokinetics of dexmedetomidine in volunteers with severe renal impairment. Anesth Analg 2001;93:1205-9.
20. Dyck JB, Maze M, Haack C, Azarnoff DL, Vuorilehto L, Shafer SL. Computer-controlled infusion of intravenous dexmedetomidine hydrochloride in adult human volunteers. Anesthesiology 1993;78:821-8.
21. Engelhard K, Werner C, Kaspar S, Möllenberg O, Blobner M, Bachl M, et al. Effect of the alpha2-agonist dexmedetomidine on cerebral neurotransmitter concentrations during cerebral ischemia in rats. Anesthesiology 2002;96:450-7.
22. Aantaa R, Kallio A, Virtanen R. Dexmedetomidine, a novel a2-adrenergic agonist: a review of its pharmacodynamic characteristics. En: Drugs Future 1993;18:49-56.
23. Frangoulidou E, Kuhlen R, Marenghi C. Sedative agents and respiratory depression: a unique profile of dexmedetomidine. En: Maze M, Morrison P, editors. Redefining Sedation. London (UK): The Royal Society of Medicine Press Ltd.;1998P. 40-50.
24. Riker RR, Fraser GL. Adverse events associated with sedatives, analgesics, and other drugs that provide patient comfort in the intensive care unit. Pharmacotherapy 2005; 25:8S-18S.
25. Lerch C, Park GR. Sedation and analgesia. En: BMJ 1999;55:76-95.
26. Pandharipande P, Pun B, Herr D, Maze M, Girard T, Miller R, et al. Effect of sedation with dexmedetomidine versus lorazepam on acute brain dysfunction in mechanically ventilated patients: the MENDS randomized controlled trial, JAMA 2007;298:2644-64.
27. Willigers HM, Prinzen FW, Roekaerts PM, De Lange S, Durieux ME. Dexmedetomidine decreases perioperative myocardial lactate release in dogs. Anesth Analg 2003;96:657-64.
28. Roekaerts P, Prinzen F, Willingers H. The effect of dexmedetomidine on systemic haemodynamics, regional myocardial function and blood flow during coronary artery stenosis in acute anaesthetized dogs. J Cardiothorac Anesth 1994;8:58.
29. Wallace AW, Galindez D, Salahieh A, Layug EL, Lazo EA, Haratonik KA, et al. Effect of clonidine on cardiovascular morbidity and mortality after noncardiac surgery. Anesthesiology 2004;101:284-93.
30 Aho M, Lehtinen AM, Erkola O, Kallio A, Korttila K. The effect of intravenously administered dexmedetomidine on perioperative hemodynamics and isoflurane requirements in patients undergoing abdominal hysterectomy. Anesthesiology 1991;74:997-1002.
31. Jaakola ML, Ali-Melkkilä T, Kanto J, Kallio A, Scheinin H, Scheinin M. Dexmedetomidine reduces intraocular pressure, intubation responses and anaesthetic requirements in patients undergoing ophthalmic surgery. Br J Anaesth 1992;68:570-5.
32. Scheinin B, Lindgren L, Randell T, Scheinin H, Scheinin M. Dexmedetomidine attenuates sympathoadrenal responses to tracheal intubation and reduces the need for thiopentone and peroperative fentanyl. Br J Anaesth 1992;68:126-31.
33. Aantaa R, Kanto J, Scheinin M, Kallio A, Scheinin H. Dexmedetomidine, an alpha 2-adrenoceptor agonist, reduces anesthetic requirements for patients undergoing minor gynecologic surgery. Anesthesiology 1990;73:230-5.
34. Triltsch AE, Welte M, von Homeyer P, Grosse J, Genähr A, Moshirzadeh M, et al. Bispectral index-guided sedation with dexmedetomidine in intensive care: a prospective, randomized, double blind, placebo-controlled phase II study. Crit Care Med 2002;30:1007-14.
35. Koroglu A, Demirbilek S, Teksan H, Sagir O, But AK, Ersoy MO. Sedative, haemodynamic and respiratory effects of dexmedetomidine in children undergoing magnetic resonance imaging examination: preliminary results. Br J Anaesth 2005;94:821-4.
36. Koroglu Ah, Teksan H, Sagir O, Yucel A, Toprak H, Ersoy O. A comparison of the sedative, hemodynamic, and respiratory effects of dexmedetomidine and propofol in children undergoing magnetic resonance imaging. Anesth Analg 2006;103:63-7.
37. Wijeysundera DN, Naik JS, Beattie WS. Alpha-2 adrenergic agonists to prevent perioperative cardiovascular complications: a meta-analysis. Am J Med 2003;114:742-52.
38. Jalonen J, Hynynen M, Kuitunen A, Heikkilä H, Perttilä J, Salmenperä M, et al. Dexmedetomidine as an anesthetic adjunct in coronary artery bypass grafting. Anesthesiology 1997;86:331-45.
39. But AK, Ozgul U, Erdil F, Gulhas N, Toprak HI, Durmus M, et al. The effects of preoperative dexmedetomidine infusion on hemodynamics in patients with pulmonary hypertension undergoing mitral valve replacement surgery. Acta Anaesthesiol Scand 2006;50:1207-12.
40. Sadhasivam S, Boat A, Mahmoud M. Comparison of patient-controlled analgesia with and without dexmedetomidine following spine surgery in children. Journal of Clinical Anesthesia 2009;21:493-501.
41. Hammer GB, Sam WJ, Chen MI, Golianu B, Drover DR. Determination of the pharmacodynamic interaction of propofol and dexmedetomidine during esophagogastroduodenoscopy in children, Pediatric Anesthesia 2009;19:138-44.
42. Biccard BM, Goga S, de Beurs J. Dexmedetomidine and cardiac protection for non-cardiac surgery: a meta-analysis of randomised controlled trials, Anaesthesia 2008;63:4-14.
43. Ruesch S, Levy J. Treatment of persistent tachycardia with dexmedetomidina during off-pump cardiac surgery. Anesth Analg 2002;95:316-8.
44. Ickeringill M, Shehabi Y, Adamson H, Ruettimann U. Dexmedetomidine infusion without loading dose in surgical patients requiring mechanical ventilation: haemodynamic effects and efficacy. Anaesth Intensive Care 2004;32:741-5.
45. Abulhasan Y, Buu N, Frigon C. Perioperative use of dexmedetomidine in an infant with familial dysautonomia. British Journal of Anaesthesia 2009;103(3):413-5.
46. Bakhamees H. Effects of dexmedetomidine in morbidly obese patients undergoing laparoscopic gastric bypass Middle East Journal of Anesthesiology 2007;19(3).
47. Shukry M, Kennedy K. Dexmedetomidine as a total intravenous anesthetic in infants. Pediatric anesthesia 2007;17:581-3.
48. Bulow NM, Barbosa NV, Rocha JB. Opioid consumption in total intravenous anesthesia is reduced with dexmedetomidine: a comparative study with remifentanil in gynecologic videolaparoscopic surgery. Journal of Clinical Anesthesia 2007;19:280-5. 49. Mani V, Morton NS. Overview of total intravenous anesthesia in children. Pediatric Anesthesia 2010;20:211-22.
50. Arain SR, Ebert TJ. The efficacy, side effects, and recovery characteristics of dexmedetomidine versus propofol when used for intraoperative sedation. Anesth Analg 2002;95:461-6.
51. Turgut N, Turkmen A, Gökkaya S, Altan A, Hatiboglu MA. Dexmedetomidine-based versus fentanyl-based total intravenous anesthesia for lumbar laminectomy, Minerva Anestesiologica 2008;74:469-74.
52. Carollo DS, Nossaman BD, Ramadhyani U. Dexmedetomidine: a review of clinical applications; current opinion. En: Anesthesiology 2008,21:456-61.
53. Aho M, Erkola O, Kallio A, Scheinin H, Korttila K. Comparison of dexmedetomidine and midazolam sedation and antagonism of dexmedetomidine with atipamezole. J Clin Anesth 1993;5:194-203.
54. Reid K, Hayashi Y, Guo TZ, Correa-Sales C, Nacif-Coelho C, Maze M. Chronic administration of an alpha 2 adrenergic agonist desensitizes rats to the anesthetic effects of dexmedetomidine. Pharmacol Biochem Behav 1994;47:171-5.
How to Cite
1.
García Botero A, Rodríguez L, Salazar Pérez FA, Venegas Saavedra A. Use of Dexmedetomidine in Total Intravenous Anesthesia (TIVA). Colomb. J. Anesthesiol. [Internet]. 2011 Oct. 1 [cited 2024 Apr. 26];39(4):514-26. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/678
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2011-10-01
How to Cite
1.
García Botero A, Rodríguez L, Salazar Pérez FA, Venegas Saavedra A. Use of Dexmedetomidine in Total Intravenous Anesthesia (TIVA). Colomb. J. Anesthesiol. [Internet]. 2011 Oct. 1 [cited 2024 Apr. 26];39(4):514-26. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/678
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