Buscar

Lesão Renal Aguda - SBCM I

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes
Você viu 3, do total de 9 páginas

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes
Você viu 6, do total de 9 páginas

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes
Você viu 9, do total de 9 páginas

Prévia do material em texto

,168),&,Ç1&,$�5(1$/�$*8'$�� ,1752'8d­2
'(),1,d­2
3HUGD�GD�IXQomR�UHQDO��GH�PDQHLUD�V~ELWD��LQGHSHQGHQWH�GD�HWLRORJLD�RX�PHFDQLVPRV��
SURYRFDQGR�DF~PXOR�GH�VXEVWkQFLDV�QLWURJHQDGDV��XUpLD�H�FUHDWLQLQD���DFRPSDQKDGD�RX�QmR�
GD�GLPLQXLomR�GD�GLXUHVH��
,QGHSHQGHQWH�GD�HWLRORJLD��RFRUUH�XPD�TXHGD�GD�ILOWUDomR�JORPHUXODU��HP�IXQomR�GLVVR�
Ki�SHUGD�GD�IXQomR�H[FUHWRUD�GRV�ULQV��R�TXH�SHUPLWH�R�DF~PXOR�GDV�VXEVWkQFLDV�
QLWURJUHQDGDV��R�TXH�FKDPDPRV�GH�D]RWHPLD��
ͻ
)81d®(6�5(1$,6
$OWHUDo}HV�GH�IXQo}HV�H�PDQLIHVWDo}HV�
3HUGD�GD�IXQomR�H[FUHWRUD� !�UHGXomR�GD�ILOWUDomR� !�DF~PXOR�GH�VXEVWkQFLDV�
QLWURJHQDGDV��iFLGR�~ULFR�H�PHWDEROLWRV�
ͻ
3HUGD�GR�EDODQoR�GH�HOHWUyOLWRV� !�KLSHUIRVIDWHPLD��KLSHUPDJQHVHPLD��KLSHUFDOHPLD��
KLSRFDOFHPLD�
ͻ
$OWHUDomR�GR�HTXLOtEULR�iFLGR�EDVH� !�DFLGRVH�PHWDEyOLFD�ͻ
$�SHUGD�GD�IXQomR�HQGyFULQD�QmR�p�HYLGHQFLDGD�QD�OHVmR�DJXGD��SRLV�DV�PDQLIHVWDo}HV�
HQGyFULQDV�VmR�WDUGLDV��PXLWR�YLVWDV�QD�'5&�H�VHUYLQGR�DWp�SDUD�GLIHUHQFLDomR�GH�
TXDGURV�DJXGR�H�FU{QLFR�DJXGL]DGR�
ͻ
,168),&,Ç1&,$�5(1$/�&5Ð1,&$�� 5(/(0%5$1'2���
$�GRHQoD�UHQDO�FU{QLFD��HP�XP�GDGR�HVWiJLR��HQWUD�HP�XP�HVWDGR�GH�LQVXILFLrQFLD�ͻ
'LIHUHQWH�GD�LQVXILFLrQFLD�DJXGD��RFRUUH�SHUGD�GD�IXQomR�UHQDO�GH�IRUPD�SURJUHVVLYD��
LQVLGLRVD�H�LQH[RUiYHO��H�FDUDFWHULVWLFDPHQWH�LUUHYHUVtYHO�
ͻ
,5&�;�,5$�� ',)(5(1d$6����
1D�,5$��D�KLVWyULD�GR�SDFLHQWH�QRV�WUD]�XP�IDWRU�GHVHQFDGHDQWH�SDUD�D�GRHQoD��SRU�
H[HPSOR��H[SRVLomR�DR�FRQWUDVWH��KLSRYROHPLD��XVR�GH�GURJDV�QHIURWy[LFDV��H[SRVLomR�j�
SHoRQKDV����
ͻ
1D�,5$�WHPRV�D�HOHYDomR�V~ELWD�GD�FUHDWLQLQD�SODVPiWLFD��H�LVVR�p�XP�FULWpULR�
LPSRUWDQWH��EHP�PDLV�GR�TXH�D�7)*�
ͻ
1D�PDLRULD�GDV�YH]HV��D�,5$�VH�PDQLIHVWD�FRP�XPD�UHGXomR�DEUXSWD�GR�GpELWR�XULQiULR�ͻ
ƚĞƌĕĂͲĨĞŝƌĂ͕�ϭϳ�ĚĞ�ŶŽǀĞŵďƌŽ�ĚĞ�ϮϬϮϬ�����ϭϲ͗ϱϲ
/HVmR�5HQDO�$JXGD
1D�,5&�D�IDOWD�GDV�IXQo}HV�HQGyFULQDV�QRV�Gi�FDUDFWHUtVWLFDV�PXLWR�VLJQLILFDQWHV�
$QHPLD�� SRU�GHILFLrQFLD�GH�(32ż
+LSHUSDUDWLUHRLGLVPR�VHFXQGiULR�� SRU�DOWHUDo}HV�QR�&iOFLR�H�QR�)yVIRURż
ͻ
2�H[DPH�GH�LPDJHP�QD�,5&�p�DOWHUDGR��RV�ULQV�QD�86�DSDUHFHP�UHGX]LGRV�GH�WDPDQKR��
DWURILDGRV��FRP�D�VXSHUItFLH�OREXODGD��(QTXDQWR�QD�,5$�R�ULP�SHUPDQHFH�
PRUIRORJLFDPHQWH�LJXDO��
ͻ
$�,5&�QmR�VH�UHYHUWH��HPERUD�R�DYDQoR�SRVVD�VHU�UHWDUGDGR��p�XPD�GRHQoD��
SUHGRPLQDQWHPHQWH�GH�LGRVRV�H�FDPLQKD�SDUD�R�HVWiJLR�WHUPLQDO�H�WUDQVSODQWH�
ͻ
$�,5$�PXLWDV�YH]HV�p�WRWDOPHQWH�UHYHUVtYHO��SRUpP�SRGH�RFRUUHU�XPD�HYROXomR�SDUD�
,5&��
ͻ
&21&(,726�
$]RWHPLD� p�R�DXPHQWR�SODVPiWLFR�GDV��HVFyULDV�QLWURJHQDGDV���GHWHFWDGR�HP�H[DPHV�SHOR�
DXPHQWR�GD�XUHLD�H�FUHDWLQLQD�
+i�D�HOHYDomR�GH�GLYHUVDV�RXWUDV�VXEVWkQFLDV�QLWURJHQDGDV��SRUpP�HVWDV�QmR�VmR�
KDELWXDOPHQWH�GRViYHLV�
ͻ
$�D]RWHPLD�HP�JHUDO�Vy�RFRUUH�FRP�7)*������P/�PLQ��R�TXH�FRUUHVSRQGH�D�FHUFD�GH�
����GR�QRUPDO��� UHJUD�
ͻ
8UHPLD� p�XP�WHUPR�VLQGU{PLFR��FRUUHVSRQGH�j�VtQGURPH�XUrPLFD��H�ID]�UHIHUrQFLD�DR�
DFKDGRV�GRV�VLQDLV�H�VLQWRPDV�TXH�UHVXOWDP�GD�LQVXILFLrQFLD�UHQDO�JUDYH��VHMD�HOD�DJXGD�RX�
FU{QLFD�
1mR�GHYH�VHU�XVDGR�SDUD�LQGLFDU�DSHVDU�R�DXPHQWR�SODVPiWLFR�GRV�QtYHLV�GH�XUHLD�ͻ
$�XUHPLD�FRVWXPD�RFRUUHU�FRP�7)*���������P/�PLQ��ͻ
2OLJ~ULD� GLXUHVH�������P/���K�
(P�DOJXQV�OXJDUHV�FRQVLGHUD�VH�ROLJ~ULD�D�GLXUHVH�������P/���K�ͻ
$Q~ULD� GLXUHVH������P/���K�
(P�DOJXQV�OXJDUHV�FRQVLGHUD�VH�DQ~ULD�D�GLXUHVH�������P/����ͻ
9$/25(6�'(�5()(5Ç1&,$
7)*������ ����P/�PLQͻ
8UHLD������ ���PJ�G/ͻ
&UHDWLQLQD��YDULD�FRP�D�UDoD��R�VH[R��D�LGDGH��D�PDVVD�PXVFXODU�H�R�SHVR
+RPHP�������PJ�G/ż
0XOKHU�������PJ�G/ż
ͻ
6,1$,6�(�6,1720$6�'$�85(0,$�$*8'$
+LSHUWHQVmRͻ
(GHPD�SXOPRQDU��6$5$�� FRQJHVWmRͻ
'LVW~UELR�GD�KHPRVWDVLD�FRP�VDQJUDPHQWRV�
$�XUHLD�PXLWR�HOHYDGD�YDL�LQLELU�R�)Y:ż
ͻ
(QFHIDORSDWLD��FULVH�FRQYXOVLYD��FRPDͻ
6tQGURPH�GDV�SHUQDV�LQTXLHWDV��QHXURSDWLD�SHULIpULFDͻ
'LVW~UELRV�HOHWUROtWLFRV�H�iFLGR�EiVLFRVͻ
1iXVHDV��Y{PLWRV�H�GLDUUpLD
6ROXoRV�WDPEpP��VmR�FRPXPHQWH�DV�SULPHLUDV�PDQLIHVWDo}HV�ż
ͻ
3HULFDUGLWH�H�WDPSRQDPHQWR�FDUGtDFR
$�XUHLD�VH�GHSRVLWD�QDV�VHURVDVż
ͻ
',$*1Ï67,&2�'$�,5$�
1RUPDOPHQWH�p�IHLWR�D�SDUWLU�GH�XPD�GDV�VHJXLQWHV�VLWXDo}HV�FOtQLFDV��
5HGXomR�DEUXSWD�GR�GpELWR�XULQiULRż
6LQDLV�H�VLQWRPDV�GD�VtQGURPH�XUrPLFDż
$]RWHPLD�DVVLQWRPiWLFDż
ͻ
$�,5$�QmR�FRVWXPD�DFDUUHWDU�VLQWRPDV��D�QmR�VHU�TXH�D�UHWHQomR�GH�HVFyULDV�VHMD�
DFHQWXDGD��
ͻ
e�FRPXP�HQFRQWUDUPRV�HOHYDo}HV�GD�XUpLD�H�FUHDWLQLQD�SODVPiWLFD�HP�XP�SDFLHQWH�FRP�
VLQDLV�H�VLQWRPDV�SURYHQLHQWHV�QmR�GD�,5$�HP�VL��PDV�GD�SDWRORJLD�TXH�D�HVWi�
GHWHUPLQDQGR��H[��VHSVH��KLSRYROHPLD����
ͻ
'HILQLomR�GD�,5$�HP�SDFLHQWHV�DVVLQWRPiWLFRV�
$XPHQWR�GD�FUHDWLQLQD�VpULFD� �����PJ�G/�GHQWUR�GH����KRUDV��RXͻ
$XPHQWR�GD�FUHDWLQLQD�VpULD� ����[�R�YDORU�EDVDO��FRQKHFLGR�RX�SUHVXPLGR��TXH�WHQKD�
RFRUULGR�GHQWUR�GH����GLDV��RX
ͻ
9ROXPH�XULQiULR����P/�NJ�K�SRU�XP�SHUtRGR�GH���K��ͻ
$1$01(6(�
'DGRV�PtQLPRV�TXH�SUHFLVDP�HVWDU�SUHVHQWHV�QD�DQDPQHVH�
2EWHU�GDGRV�SUpYLRV�GH�IXQomR�UHQDO�ͻ
'HWHUPLQDU�LQtFLR�H�SURJUHVVmR�GD�SHUGD�GH�IXQomR�UHQDO�ͻ
&RQWURODU�YROXPH�GH�GLXUHVH�ͻ
$QWHFHGHQWHV�GH�IiUPDFRV�QHIURWy[LFRV��XVR�GH�FRQWUDVWH��FRQWDWR�FRP�SHoRQKDV�ͻ
*UDQGHV�WUDXPDV��SHUGD�GH�PDVVD�PXVFXODU�� UDEGRPLyOLVH�ͻ
(;$0(6�&203/(0(17$5(6
6DQJXH�
&UHDWLQLQDͻ
8UHLDͻ
ÈFLGR�~ULFRͻ
(OHWUyOLWRV
6yGLR��3RWiVVLR��&iOFLR��)yVIRURż
ͻ
+HPRJUDPDͻ
&RDJXODomRͻ
37+���2+���9LW�'
,PSRUWDQWH�SDUD�DYDOLDU�VH�R�TXDGUR�p�DJXGR�RX�FU{QLFR�DJXGL]DGRż
ͻ
$OEXPLQD�ͻ
*DVRPHWULDͻ
8ULQD�
9ROXPHͻ
3URWHLQ~ULDͻ
6yGLR�XULQiULRͻ
&UHDWLQLQDͻ
8UHLDͻ
2VPRODULGDGHͻ
6HGLPHQWR
$YDOLDomR�GD�SUHVHQoD�GH�FpOXODV��FULVWDLV��KHPiFLDV��FLOLQGURV���ż
&LOLQGURV�+LDOLQRV��VmR�ILVLROyJLFRV��FRPXP�HP�LQGLYtGXRV�VDXGiYHLV
$V�FpOXODV�GRV�W~EXORV�UHQDLV�SURGX]HP�XPD�JOLFRSURWHtQD��7DPP�+RUVIDOO�RX�
8URPRGXOLQD��D�TXDO�p�VHFUHWDGD�SDUD�D�OX]�WXEXODU�
�
1D�OX]�WXEXODU�HVVD�*3�SRGH�VRIUHU�XPD�FRQGHQVDomR��LVVR�RFRUUH�VH�D�
FRQFHQWUDomR�XULQiULD�HVWLYHU�PXLWR�DOWD�
�
(QWmR�WRGD�YH]�TXH�D�XULQD�VH�FRQFHQWUD�PDLV��HVVD�*3�VH�VROLGLILFD�H�DSDUHFH�
QD�XULQD�FRP�R�IRUPDWR�GR�WXER��RX�VHMD��VHPHOKDQWH�D�XP�FLOLQGUR�� FLLOLQGURV�
KLDOLQRV
�
ż
1D�,5$��SRGHP�DSDUHFHU�&LOLQGURV�*UDQXORVRV�
+DYHQGR�OHVmR�QHFURVH�WXEXODU��DV�FpOXODV�GR�HSLWpOLR�GHVFDPDP�H�IRUPDP�
SOXJV FHOXODUHV�QD�OX]�WXEXODU��LPSUHJQDQGR�DV�*3�TXH�VmR�HOLPLQDGDV�FRP�XP�
DVSHFWR�JUDQXORVH�
�
6mR�PDUFDGRUHV�GH�OHVmR�WXEXODU���
ż
2XWURV�WLSRV�GH�FLOLQGURV��
+HPiWLFRV� !�JORPHUXORQHIULWH��PLRJORELQ~ULD�����
/HXFRFLWiULRV�
ż
ͻ
([DPHV�GH�,PDJHP�
86�GH�DSDUHOKR�XULQiULRͻ
2XWURV��GRSSOHU��7&��50�H�ELySVLDͻ
2EV��SDFLHQWHV�GLDEpWLFRV�SRGHP�SRVVXLU�ULP�PRUIRORJLFDPHQWH�QRUPDO�QD�86�H�PHVPR�
DVVLP�VHU�SRUWDGRU�GH�'5&
ͻ
Ë1',&(6�85,1È5,26
&OHDUDQFH�GH�&UHDWLQLQD� QR�JHUDO�GHWHUPLQD�D�7)*��PDV�QD�,5$�p�XVDGR�SDUD�FiOFXOR�GD�
IUDomR�H[FUHWRUD�GH�1D��H�8UHLD��
2�FiOFXOR�GD�IUDomR�H[FUHWRUD��TXH�p�IHLWR�DWUDYpV�GR�FOHDUDQFH��p�LPSRUWDQWH�QR�
GLDJQyVWLFR�GLIHUHQFLDO�SDUD�GHWHUPLQDU�VH�p�XPD�,5$�SUp�UHQDO�RX�XPD�QHFURVH�WXEXODU�
DJXGD��SRU�H[HPSOR�
ͻ
)UDomR�([FUHWRUD�GD�1D���p�D�SRUFHQWDJHP�GH�VyGLR�TXH�HVWi�VHQGR�H[FUHWDGD�QD�XULQD�
HP�UHODomR�DR�TXH�IRL�ILOWUDGR��
1RUPDOPHQWH�R�VyGLR�p�ILOWUDGR��UHDEVRUYLGR�H�H[FUHWDGR��QmR�VRIUH�VHFUHomR��ͻ
'R�WRWDO�ILOWUDGR��H[FUHWDPRV�HP�WRUQR�GH����� UHDEVRUomR�GH������ͻ
)UDomR�([FUHWRUD�GH�8UHLD� p�D�SRUFHQWDJHP�GH�XUHLD�TXH�HVWi�VHQGR�H[FUHWDGD�QD�XULQD��
(P�FRQGLo}HV�ILVLROyJLFDV��HP�WRUQR�GH��������GD�XUHLD�ILOWUDGD�p�H[FUHWDGD��H��������
p�UHDEVRUYLGD��
ͻ
4XDQGR�R�SDFLHQWH�HVWi�ID]HQGR�XVR�GH�GLXUpWLFRV��LQLEHP�D�UHDEVRUomR�GH�1D����Ki�XP�ͻ
DXPHQWR�QR�YDORU�GD�)H1D���LVVR�SRGH�FRQIXQGLU�R�GLDJQyVWLFR��1HVWHV�SDFLHQWHV�YDPRV�
FRQVLGHUDU�D�)H�GD�8UHLD�
&/$66,),&$d­2�'$�,5$
'H�DFRUGR�FRP�R�YROXPH�XULQiULR�
2OLJ~ULFD��SLRU�SURJQyVWLFR�ͻ
1mR�ROLJ~ULFD��WHP�HYROXomR�PHOKRU�ͻ
'H�DFRUGR�FRP�R�SURFHVVR�ILVLRSDWROyJLFR�
3Up�UHQDO����������� p�GHWHUPLQDGD�SRU�XPD�UHGXomR�GD�SHUIXVmR�UHQDO�ͻ
5HQDO�RX�,QWUtQVHFD����������� p�GHWHUPLQDGD�SRU�XP�GDQR�GR�SDUrQTXLPD�UHQDO�ͻ
3yV�UHQDO���������� p�GHWHUPLQDGD�SRU�XP�SURFHVVR�REVWUXWLYR�GDV�YLDV�XULQiULDVͻ
,168),&,Ç1&,$�28�$=27(0,$�35e�5(1$/
e�D�HOHYDomR�GDV�HVFyULDV�QLWURJHQDGDV�FDXVDGDV�GLUHWDPHQWH�SHOD�UHGXomR�GR�IOX[R�
VDQJXtQHR�UHQDO�
ͻ
e�R�WLSR�PDLV�FRPXP�GH�,5$��ͻ
&DUDFWHUL]D�VH�FOtQLFDPHQWH�SHOD�UHYHUVLELOLGDGH��XPD�YH]�UHVWDXUDGR�R�IOX[R�UHQDO�ͻ$�IXQomR�LQWUtQVHFD�GR�ULP�HVWi�LQWDFWD�H�D�FDSDFLGDGH�GR�ULP�IXQFLRQDU�DGHTXDGDPHQWH�
HVWi�FRPSURPHWLGD�HP�GHFRUUrQFLD�GD�KLSRSHUIXVmR��
ͻ
6H�QmR�WUDWDGD��D�FRQGLomR�DYDQoD�SDUD�XPD�IDOKD�UHQDO�LQWUtQVHFD�ͻ
35,1&,3$,6�&$86$6
+LSRYROHPLD��UHGXomR�GH�YROXPH�VDQJXtQHR��
&KRTXHV��Pi�GLVWULEXLomR�GH�YROXPH�VDQJXtQHR�� KLSRSHUIXVmR�H�KLSRWHQVmR��
,QVXILFLrQFLD�FDUGtDFD��UHSUHVDPHQWR�GH�VDQJXH�QR�VLVWHPD�YHQRVR��
&LUURVH�KHSiWLFD�FRP�DVFLWH��UHSUHVDPHQWR�GR�VDQJXH�QR�WHUULWyULR�HVSOkQFQLFR��
$,1(V��LQLEHP�DV�SURVWDJODQGLQDV��TXH�VmR�VXEVWkQFLDV�YDVRGLODWDGRUDV��
,QLELGRUHV�GD�(&$�H�%5$��VmR�QHIURSURWHWRUHV��PDV�HP�SDFLHQWHV�FRP�EDL[D�SHUIXVmR�
UHQDO�Ki�OLEHUDomR�GH�DQJLRWHQVLQD��D�TXDO�SURPRYH�YDVRFRQVWULomR�GD�DUWHUtROD�HIHUHQWH�
DXPHQWDQGR�D�SUHVVmR�LQWUDJORPHUXODU�SDUD�PDQWHU�D�ILOWUDomR�� LQLELQGR�D�DomR�GD�
��
DQJLRWHQVLQD�YDPRV�UHGX]LU�D�7)*��SRGHQGR�OHYDU�j�,5$


(QWmR�GH���D���RFRUUH�UHGXomR�GR�YROXPH�FLUFXODQWH�HIHWLYR��H�FRP���H���RFRUUH�
SUHFLSLWDomR�GH�D]RWHPLD�GLDQWH�GH�EDL[R�IOX[R�VDQJXtQHR�UHQDO�
),6,23$72/2*,$
'LDQWH�GH�XPD�KLSRYROHPLD��RX�TXDOTXHU�RXWUD�FDXVD�GH�UHGXomR�GH�IOX[R�VDQJXtQHR�
UHQDO���WHPRV�TXHGD�GD�3$�H�HVWLPXODomR�GH�EDURUUHFHSWRUHV��
ͻ
&RQVHTXHQWHPHQWH��Ki�DWLYDomR�GR�61�VLPSiWLFR�H�GR�65$$��FRP�OLEHUDomR�GH�
QRUHSLQHIULQD�H�DQJLRWHQVLQD�,,�
ͻ
'HSHQGHQGR�GR�JUDX�GH�KLSRYROHPLD�RFRUUH�WDPEpP�D�OLEHUDomR�GH�YDVRSUHVVLQD��$93���
TXH�YDL�DWXDU�SURPRYHQGR�D�UHWHQomR�GH�iJXD�OLYUH��
ͻ
$�QRUHSLQHIULQD��D�DQJLRWHQVLQD�,,�H�D�$93�DWXDP�HVWLPXODQGR�D�YDVRFRQVWULomR�H�D�
UHWHQomR�UHQDO�GH�VDO�H�iJXD�� EORTXHLR�GH�PHFDQLVPRV�QDWULXUpWULFRV�H�DWLYDomR�GH�
PHFDQLVPRV�DQWL�QDWULXUpWLFRV�
ͻ
&$5$&7(5Ë67,&$6�'$�85,1$�
9ROXPH�GLPLQXtGR�� GLPLQXL�ILOWUDomR�H�LQWHQVLILFD�D�UHDEVRUomR�� ROLJ~ULD�RX�DQ~ULD�ͻ
2VPRODULGDGH�HOHYDGD�� DXPHQWR�GD�FRQFHQWUDomR�SRUTXH�Ki�SRXFD�iJXD�QD�XULQD�ͻ
%DL[D�FRQFHQWUDomR�GH�6yGLR�� )H1D��������SRUTXH�D�UHDEVRUomR�p�DXPHQWDGD�ͻ
,5$�325�/(6­2�,175Ë16(&$�28�$=27(0,$�5(1$/�,175Ë16(&$
e�D�GLVIXQomR�UHQDO�DJXGD�FDXVDGD�SRU�OHVmR�GR�SUySULR�SDUrQTXLPD�ͻ
5HVSRQViYHO�SRU��������GRV�FDVRV�GH�,5$�ͻ
3RGH�FXUVDU�FRP�
2OLJ~ULD�� QHFURVH�WXEXODU�DJXGD�LVTXrPLFD�ż
$Q~ULD�� QHFURVH�FRUWLFDO�DJXGD�H�DOJXPDV�JORPHUXORQHIULWHV�ż
1mR�ROLJ~ULD�SROLXULD�� QHFURVH�WXEXODU�SRU�DPLQRJOLFRVtGHRV�ż
ͻ
(7,2/2*,$
9DVFXODU��PLFURHPEROLDV��FRO$HVWHURO���YDVFXOLWHV��&,9'ͻ
*ORPHUXODU�RX�0HVDQJLDO��JORPHUXORQHIULWHV�DJXGDVͻ
,QWHUVWLFLDO��LQIHFFLRVDV�H�KLSHUVHQVLELOLGDGHͻ
7XEXODU��QHFURVH�WXEXODU�DJXGD��17$��ͻ
6LVWHPD�&ROHWRU��GHSyVLWR�WXEXODU�H�GXFWRV�FROHWRUHV�GH�FULVWDLV�ͻ
,5$�,175Ë16(&$�78%8/$5��
&RQKHFLGD�FRPR�QHFURVH�WXEXODU�DJXGD��17$�ͻ
(WLRORJLDV�&OiVVLFDV�
17$�,VTXrPLFD��p�D�PDLV�FRPXP��JHUDOPHQWH�WHP�UHODomR�FRP�D�SHUVLVWrQFLD�GD�
LVTXHPLD�QD�,5$�SUp�UHQDO�
ͻ
17$�1HIURWy[LFD��QHFURVH�GH�FpOXODV�WXEXODUHV�SHOD�H[SRVLomR�j�VXEVWkQFLDV�QHIURWy[LFDV�
H[yJHQDV�RX�HQGyJHQDV�
([yJHQDV��GURJDV��PHGLFDo}HV�H�WR[LQDV�� GRVH�GHSHQGHQWH
&RQWUDVWH��$PLQRJOLFRVLGHRV��$,1(6��SHoRQKDV�
ż
(QGyJHQDV��SLJPHQWRV��ELOLUUXELQD��PLRJORELQD�H�SURWHtQDVż
ͻ
)LVLRSDWRORJLD��
3HOD�SHUVLVWrQFLD�GD�LVTXHPLD�RX�SRU�XPD�OHVmR�FHOXODU�SRU�VXEVWkQFLD�QHIURWy[LFD��R�
HSLWpOLR�YDL�VH�GHJHQHUDU�� SHUGD�GD�ERUGD�HP�HVFRYD��HVIROLDomR�H�REVWUXomR�WXEXODU�
SHOD�IRUPDomR�GH�SOXJV FHOXODUHV��
ͻ
(VVH�PHFDQLVPR�QmR�VH�SHUSHWXD��SRLV�ORJR�FRPHoDP�D�PLJUDU�PDFUyIDJRV�H�OHXFyFLWRV�
SDUD�D�UHJLmR�OHVLRQDGD�H�FRPHoDP�D�UHJHQHUDU�R�HSLWpOLR��
ͻ
'HQWUR�GH�FHUFD�GH����GLDV�Ki�D�UHJHQHUDomR�FRPSOHWD�GR�HSLWpOLR��RX�QmR�ͻ
1RV�FDVRV�HP�TXH�QmR�RFRUUH�D�UHFRQVWLWXLomR�GR�HSLWpOLR��YDL�KDYHU�IRUPDomR�GH�
ILEURVH��OHYDQGR�DR�GHVHQYROYLPHQWR�GH�XP�TXDGUR�FU{QLFR�
ͻ
(P�TXDOTXHU�SURFHVVR�RQGH�Ki�H[FHVVR�GH�6yGLR�FKHJDQGR�DR�W~EXOR�GLVWDO��Ki�XPD�
UHDomR�GR�QpIURQ�SDUD�FRQWHU�D�SHUGD�GHVVH�6yGLR�� D�SHUFHSomR�GR�H[FHVVR�GH�6yGLR�VH�
Gi�SRU�DomR�GR�$SDUHOKR�-XVWDJORPHUXODU�
2�RUJDQLVPR�HQWHQGH�TXH�R�SURFHVVR�GH�ILOWUDomR�HVWi�PXLWR�UiSLGR��HQWmR�RV�
PHFDQLVPRV�GH�UHDEVRUomR�QmR�HVWmR�FRQVHJXLQGR�UHWHU�R�6yGLR�
ż
(QWmR�R�QpIURQ�OLEHUD�XPD�VXEVWkQFLD�SDUiFULQD��DGHQRVLQD��TXH�SURPRYH�
YDVRFRQVWULomR�GD�DUWHUtROD�DIHUHQWH��LVVR�SDUD�GLPLQXLU�D�WD[D�GH�ILOWUDomR��
ż
5HGX]LQGR�D�WD[D�GH�ILOWUDomR��R�REMHWLYR�p�TXH�RV�PHFDQLVPR�GH�UHDEVRUomR�
WHQKDP�WHPSR�R�VXILFLHQWH�SDUD�HIHWLYDU�D�UHDEVRUomR�GR�6yGLR��
ż
ͻ
+DYHQGR�XPD�OHVmR�WXEXODU��R�TXH�YDL�RFRUUHU"
5HGXomR�GD�UHDEVRUomR�WXEXODU�GH�1D��ż
$XPHQWR�GD�FRQFHQWUDomR�RIHUWD�GH�1D��QRV�W~EXORV�GLVWDLVż
&RQWUDomR�GD�DUWHUtROD�DIHUHQWHż
5HGX]�7)*����
(QWmR�QD�17$�D�7)*�WDPEpP�p�UHGX]LGD��H�LVVR�RFRUUH�FRPR�UHVSRVWD�DR�
DXPHQWR�GD�RIHUWD�GH�1D��QR�W~EXOR�GLVWDO�
�
6H�R�PHFDQLVPR�HQYROYLGR�p�D�LVTXHPLD��D�7)*�Mi�HVWDYD�GLPLQXtGD�H�YDL�
GLPLQXLU�PDLV�DLQGD�SHOD�FRQWUDomR�GD�DUWHUtROD�DIHUHQWH��LVVR�MXVWLILFD�D�
SRVVLELOLGDGH�GH�HYROXomR�SDUD�DQ~ULD�
�
ż
ͻ
&$5$&7(5Ë67,&$6�'$�85,1$
2�YROXPH�GD�XULQD�GHSHQGH�GH�XP�EDODQoR�GH�IRUoDV��UHGXomR�GD�ILOWUDomR�;�UHGXomR�GD�
UHDEVRUomR�� SRU�H[HPSOR��TXDQGR�D�ILOWUDomR�UHGX]�PXLWR�H�D�UHDEVRUomR�UHGX]�SRXFR��R�
YROXPH�XULQiULR�SRGH�VHU�DWp�DXPHQWDGR�
3RGH�YDULDU�GH�SROL~ULD�D�DQ~ULD�ż
ͻ
2VPRODULGDGH�GLPLQXtGD�� D�XULQD�p�GLOXtGD��SRLV�D�iJXD�QmR�HVWi�VHQGR�UHDEVRUYLGD�ͻ
)D1D��!����� DXPHQWR�GD�H[FUHomR�GH�6yGLR�QD�XULQD�SRU�GLPLQXLomR�GD�UHDEVRUomR�ͻ
',)(5(1d$6�(175(�,5$�35e�5(1$/�(�17$����
+LVWyULD�H�H[DPH�ItVLFR��
7HPSR�H�LQWHQVLGDGH�GD�KLSRWHQVmR�VmR�LPSRUWDQWHV�QD�,5$�SUp�UHQDO��ż
4XDQWR�PDLRU�R�SHUtRGR�GH�KLSRWHQVmR��PDLRU�R�ULVFR�GH�HYROXomR�SDUD�17$�ż
ͻ
7UDWDPHQWR�GH�SURYD�
$�,5$�SUp�UHQDO�p�UHVROYLGD�FRP�R�UHHVWDEHOHFLPHQWR�GD�SHUIXVmR�ż
(QWmR�VH�R�SDFLHQWH�HVWi�HP�TXDGUR�GH�,5$�H�PHOKRUD�FRP�R�UHHVWDEHOHFLPHQWR�GD�
SHUIXVmR��D�JHQWH�IHFKD�GLDJQyVWLFR�GH�,5$�SUp�UHQDO�
ż
6H�QmR�Ki�PHOKRUD�FRP�R�WUDWDPHQWR��p�SURYiYHO�TXH�R�SDFLHQWH�WHQKD�HYROXtGR�
SDUD�XP�TXDGUR�GH�17$�
ż
ͻ
)H1D���Vy�XP�YDORU�FRQVLGHUDGR�SDUD�GLDJQyVWLFR�FDVR�R�SDFLHQWH�QmR�WHQKD�IHLWR�XVR�
GH�GLXUpWLFRV��GR�FRQWUiULR�XWLOL]DGRV�D�IUDomR�H[FUHWDGD�GD�XUHLD�
e������QD�,5$�SUp�UHQDO��ż
e�!����QD�17$�ż
ͻ
$OWHUDo}HV�QD�8ULQD�ͻ
$=27(0,$�3Ï6�5(1$/�28�,5$�3Ï6�5(1$/
e�XPD�GLVIXQomR�UHQDO�FDXVDGD�SRU�REVWUXomR�DJXGD�GR�VLVWHPD�XUR�H[FUHWRU�ͻ
e�UHVSRQViYHO�SRU�DSHQDV����GRV�FDVRV�GH�,5$�ͻ
0DLV�FRPXP�HP�LGRVRV��SHOD�UHODomR�FRP�D�KLSHUSODVLD�SURVWiWLFD�ͻ
6y�LUD�VH�GHVHQYROYHU�QDV�REVWUXo}HV�FRP�UHSHUFXVVmR�UHQDO�ELODWHUDO � REVWUXomR�
XUHWHUDO��GR�FROR�YHVLFDO��XUHWHUDO�ELODWHUDO�RX�XUHWHUDO�HP�ULP�~QLFR�TXDQGR�R�SDFLHQWH�
SRVVXLU�HVVH�~QLFR�ULP�IXQFLRQDQWH�
ͻ
8PD�REVWUXomR�UHQDO�XQLODWHUDO��PHVPR�TXH�FRPSOHWD��QmR�FDXVD�D]RWHPLD��SRLV�R�ULP�
FRQWUDODWHUDO�p�FDSD]�GH�VXSULU�D�IDOWD�GR�RXWUR�
ͻ
(7,2/2*,$
2EVWUXomR�GD�VDtGD�GD�XULQD�
&iOFXORV��XUHWUDO��YHVLFDO�RX�XUHWHUDO�ͻ
3URVWDWLVPRͻ
1HRSODVLDVͻ
'LYHUWtFXORVͻ
)LEURVH�ͻ
1HRSODVLD�GH�FROR�XWHULQR�HP�PXOKHUHVͻ
+LSHUSODVLD�GH�SUyVWDWD�HP�KRPHQV�LGRVRVͻ
),6,23$72/2*,$
$�ILOWUDomR�D�SULQFtSLR�p�QRUPDO��H�FRQIRUPH�HOD�YDL�DFRQWHFHQGR�D�XULQD�YDL�VH�IRUPDQGR�
H�VHQGR�HQFDPLQKDGD�SDUD�D�H[FUHomR�
ͻ
2FRUUH�TXH�QDV�YLDV�H[FUHWRUDV�HQFRQWUD�VH�D�REVWUXomR��R�TXH�LPSHGH�D�SDVVDJHP�GD�
XULQD��TXH�FRPHoD�D�VH�DFXPXODU�SRU�WRGD�D�YLD�XULQiULD��JHUDQGR�XPD�GLVWHQVmR�
JUDGXDO�GRV�XUHWHUHV��GD�SHOYH�H�GRV�FiOLFHV�
ͻ
&KHJD�XP�PRPHQWR�TXH�R�DF~PXOR�GH�OtTXLGR�p�WmR�JUDQGH�TXH�Ki�XP�DXPHQWR�GD�
SUHVVmR�LQWUDOXPLQDO��LVVR�DOWHUD�D�SUHVVmR�QD�&iSVXOD�GH�%RZPDQ��LQWHUURPSHQGR�D�
ILOWUDomR�� TXHGD�GD�7)*�
ͻ
&RQIRUPH�D�SUHVVmR�QD�FiSVXOD�DXPHQWD��D�WD[D�GH�ILOWUDomR�GLPLQXL�ͻ
&$5$&7(5Ë67,&$6�'$�85,1$
'LPLQXtGD�RX�DXVHQWHͻ
3RGH�KDYHU�KHPDW~ULD�ͻ
&21'87$
'LDQWH�GH�XP�TXDGUR�GH�,5$��R�TXH�ID]HU"
2�SULPHLUR�SRQWR�p�LGHQWLILFDU�TXDO�R�WLSR�GH�D]RWHPLD��SUp�UHQDO"�UHQDO"�SyV�UHQDO"�ͻ
$�DERUGDJHP�p�GLIHUHQWH�HP�FDGD�FDVR�
1D�,5$�SUp�UHQDO��GHYHPRV�LQVWLWXLU�XPD�WHUDSLD�SDUD�QRUPDOL]DU�R�IOX[R�VDQJXtQHRż
1D�,5$�SyV�UHQDO��GHYHPRV�GHVREVWUXLU�DV�YLDV�XULQiULDV�R�PDLV�UiSLGR�SRVVtYHOż
ͻ

Continue navegando