<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0484-7903</journal-id>
<journal-title><![CDATA[Revista mexicana de anestesiología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. mex. anestesiol.]]></abbrev-journal-title>
<issn>0484-7903</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Anestesiología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0484-79032025000100028</article-id>
<article-id pub-id-type="doi">10.35366/118364</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Implementación de cuidados paliativos en Terapia Intensiva: experiencia de un hospital de referencia en Puebla]]></article-title>
<article-title xml:lang="en"><![CDATA[Implementation of palliative care in Intensive Care: experience of a reference hospital in Puebla]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López-Altamirano]]></surname>
<given-names><![CDATA[Karla Fabiola]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A1"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rascón-Martínez]]></surname>
<given-names><![CDATA[Dulce María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guevara-López]]></surname>
<given-names><![CDATA[Uría]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Terrazas-Luna]]></surname>
<given-names><![CDATA[Víctor Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguilar-Cózatl,]]></surname>
<given-names><![CDATA[Israel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Zamudio-Jaramillo]]></surname>
<given-names><![CDATA[Rosa Elena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cruz-Martínez]]></surname>
<given-names><![CDATA[Jesús]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Daniel-Zacarías]]></surname>
<given-names><![CDATA[Georgina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tomax-Deolarte]]></surname>
<given-names><![CDATA[Daniel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villalobos-Villegas]]></surname>
<given-names><![CDATA[Leonardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Hospital General de Zona 20 ]]></institution>
<addr-line><![CDATA[Puebla Puebla]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Hospital General de Zona 20 ]]></institution>
<addr-line><![CDATA[Puebla Puebla]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Centro Médico Nacional Siglo XXI  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad Autónoma «Benito Juárez» de Oaxaca Facultad de Medicina y Cirugía Observatorio Nacional de Cuidados Paliativos]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Hospital Regional de Alta Especialidad de Oaxaca (HAEO)  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Instituto Mexicano del Seguro Social  ]]></institution>
<addr-line><![CDATA[Puebla Puebla]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,Instituto Mexicano del Seguro Social  ]]></institution>
<addr-line><![CDATA[Puebla Puebla]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af8">
<institution><![CDATA[,Instituto Mexicano del Seguro Social  ]]></institution>
<addr-line><![CDATA[Puebla Puebla]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af9">
<institution><![CDATA[,Hospital General de Zona 1  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2025</year>
</pub-date>
<volume>48</volume>
<numero>1</numero>
<fpage>28</fpage>
<lpage>32</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0484-79032025000100028&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0484-79032025000100028&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0484-79032025000100028&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  en Terapia Intensiva (TI) se aplica sedoanalgesia, pero no es dirigida a un desenlace clínico final digno y sin sufrimiento, considerado un derecho humano básico fundamental.  Objetivo:  evaluar el grado de sedoanalgesia paliativa aplicada a los pacientes en Terapia Intensiva en el Hospital General de Zona (HGZ) 20 del IMSS Puebla.  Material y métodos:  estudio longitudinal, cuasiexperimental, prospectivo y analítico. Fueron analizados enfermos con necesidad de cuidados paliativos en Terapia Intensiva. En total fueron incluidos 14 pacientes con soporte ventilatorio no recuperables de acuerdo a la escala SOFA. Sedación paliativa: midazolam y/o propofol según grado de sedación evaluado mediante la Richmond Agitation Sedation Scale (RASS) y la Analgesia, Behavioral Pain Scale (BPS); administramos fentanilo. Sedoanalgesia de rescate estandarizada. Protocolo SPIKES para la red de apoyo psicológico y/o religioso a los familiares.  Resultados:  dos pacientes (14.2%) estaban fuera de los rangos de meta antes del inicio de la sedación paliativa, posteriormente alcanzaron metas. Todos los pacientes con fentanilo no requirieron rescate de analgesia a comparación de buprenorfina, estadísticamente significativo p = 0.047.  Conclusión:  se registraron adecuados efectos sedantes y analgésicos paliativos de los fármacos utilizados como sedoanalgesia paliativa en pacientes en fase agónica, ya que brindan control hemodinámico, analgésico y sedación adecuado.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  in Intensive Care (IT), sedoanalgesia is applied, but it is not directed to a final clinical outcome that is dignified and without suffering, considered a fundamental basic human right.  Objective:  to evaluate the degree of palliative sedoanalgesia applied to patients in Intensive Care at the Hospital General de Zona (HGZ) 20 IMSS Puebla.  Material and methods:  longitudinal, quasi-experimental, prospective, analytical study. Patients requiring palliative care in intensive care were analyzed. A total of 14 patients with ventilatory support who were not recovering according to the SOFA scale were included. Palliative sedation: midazolam and/or propofol according to the degree of sedation assessed by the Richmond Agitation Sedation Scale (RASS) and the Analgesia, Behavioral Pain Scale (BPS); we administered fentanyl. Standardized rescue sedation and analgesia. SPIKES protocol for the psychological and/or religious support network for family members.  Results:  two patients (14.2%) were outside the goal ranges before the start of palliative sedation, they later reached goals. All patients with Fentanyl did not require rescue analgesia compared to buprenorphine, statistically significant p = 0.047.  Conclusion:  sedative and palliative analgesic effects of the drugs used, palliative sedoanalgesia, in patients in the agonic phase, provides hemodynamic control, analgesic and adequate sedation.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[sedoanalgesia paliativa]]></kwd>
<kwd lng="es"><![CDATA[midazolam]]></kwd>
<kwd lng="es"><![CDATA[propofol]]></kwd>
<kwd lng="es"><![CDATA[fentanilo]]></kwd>
<kwd lng="en"><![CDATA[palliative sedoanalgesia]]></kwd>
<kwd lng="en"><![CDATA[midazolam]]></kwd>
<kwd lng="en"><![CDATA[propofol]]></kwd>
<kwd lng="en"><![CDATA[fentanyl]]></kwd>
</kwd-group>
</article-meta>
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