Acta Colombiana de Cuidado Intensivo最新文献

Manejo rápido y escalonado en la tormenta arrítmica: reporte de un caso 心律失常风暴中的快速和分步管理：一份病例报告

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.04.001

Alvaro Andrés Montenegro Apraez , Marcela Rivera Portilla , Alejandro Bejarano Zuleta , Eduardo Echeverry , Juan Pablo Garaicoa Garzon

{"title":"Manejo rápido y escalonado en la tormenta arrítmica: reporte de un caso","authors":"Alvaro Andrés Montenegro Apraez , Marcela Rivera Portilla , Alejandro Bejarano Zuleta , Eduardo Echeverry , Juan Pablo Garaicoa Garzon","doi":"10.1016/j.acci.2024.04.001","DOIUrl":"10.1016/j.acci.2024.04.001","url":null,"abstract":"<div><div>Arrhythmic storm is usually defined as the presentation of 3 or more episodes of ventricular arrhythmias within 24hours. It is widely accepted that this entity is a medical emergency due to the potential for adverse events such as death in up to 54% of cases, probably because the reduction in cardiac chamber filling time significantly reduces cardiac output, leading to cardiogenic shock, multiple organ failure, and death.</div><div>The present case describes a patient with arrhythmic storm secondary to viral myocarditis, due to the recurrence of arrhythmic events despite initial management with antiarrhythmic drugs required a stepwise therapeutic approach guided by a multidisciplinary team and early use of extracorporeal membrane oxygenation (ECMO), which allowed maintaining adequate systemic perfusion while implementing therapeutic measures to control arrhythmic events; The patient was discharged early at 14 days, with no recurrence of arrhythmic events. At 6 months outpatient follow-up, the patient did not require cardiac transplantation, with no recurrence of arrhythmic events, with adequate NYHA functional class I and no left ventricular systolic dysfunction; clinical outcomes are attributed to timely decision making, guided by a multidisciplinary team and early use of early mechanical circulatory support, preventing hypoperfusion, multiple organ failure, and death.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"24 4","pages":"Pages 432-436"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Presión inspiratoria máxima y presión espiratoria máxima en pacientes de 2 unidades de Cuidados Intensivos en Antioquia, Colombia 哥伦比亚安蒂奥基亚省两家重症监护室病人的吸气峰压和呼气峰压。

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.07.001

Mónica Alejandra Mondragón Barrera, Natalia Tabares Echeverri, Susana María Álvarez Montoya, Nicolás Eugenio Gómez Suárez

{"title":"Presión inspiratoria máxima y presión espiratoria máxima en pacientes de 2 unidades de Cuidados Intensivos en Antioquia, Colombia","authors":"Mónica Alejandra Mondragón Barrera, Natalia Tabares Echeverri, Susana María Álvarez Montoya, Nicolás Eugenio Gómez Suárez","doi":"10.1016/j.acci.2024.07.001","DOIUrl":"10.1016/j.acci.2024.07.001","url":null,"abstract":"<div><h3>Background</h3><div>Muscle weakness is a common problem in the Intensive Care Unit (ICU), which becomes more critical when it affects the respiratory muscles, as they are essential for maintaining proper ventilation. To assess respiratory muscle strength, measurements of Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP) are used, with values related to age, sex, anthropometric measures (height, weight, body mass index), presence of diseases, their chronicity, functionality, among various aspects. In Colombia, the results of measurements in a healthy population differ from those found in North America and European countries, suggesting that there may also be differences in populations with morbidity, such as in the intensive care setting.</div></div><div><h3>Objective</h3><div>To describe MIP and MEP values based on some sociodemographic, anthropometric, functional, and clinical characteristics in patients from 2ICUs in Antioquia, Colombia.</div></div><div><h3>Methods</h3><div>Observational, descriptive study with an analytical intention, cross-sectional design. MIP and MEP were measured, and sociodemographic, anthropometric, functional, clinical, and smoking habit variables were obtained in patients from 2ICUs in Antioquia.</div></div><div><h3>Results</h3><div>43 people participated, with most showing muscle weakness compared to the normal limit value. Correlation was found between MIP/MEP and age, sex, height, smoking habit, underlying respiratory disease, having received mechanical ventilation, and handgrip strength weakness.</div></div><div><h3>Conclusions</h3><div>Values in the studied population allow for a more objective functional assessment and individualized approach.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"24 4","pages":"Pages 360-369"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Síndrome de distrés respiratorio agudo por Plasmodium vivax con coinfección de tuberculosis pulmonar en época de pandemia por covid-19. Reporte de caso Covid-19大流行期间合并肺结核感染的间日疟原虫急性呼吸窘迫综合征。病例报告

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.05.004

Ronald Medina , Daniel Molano , Andrés Villa , Cristian Duran , Víctor Gerardino , Said Sánchez

引用次数: 0

Correlación del índice resistivo renal y presión de perfusión renal con la severidad de la lesión renal aguda 肾阻力指数和肾灌注压与急性肾损伤严重程度的相关性

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.04.002

Felipe Hernández Silvano, Edgar Bravo Santibañez, Carlos Jiménez Correa, Luis Pedro González Carrillo

{"title":"Correlación del índice resistivo renal y presión de perfusión renal con la severidad de la lesión renal aguda","authors":"Felipe Hernández Silvano, Edgar Bravo Santibañez, Carlos Jiménez Correa, Luis Pedro González Carrillo","doi":"10.1016/j.acci.2024.04.002","DOIUrl":"10.1016/j.acci.2024.04.002","url":null,"abstract":"<div><h3>Background</h3><div>Acute kidney injury is a frequent complication in the intensive care unit (ICU) leading to prolonged stay and increased mortality; severity staging requires markers such as creatinine which is late and with multiple factors that bias its measurement and interpretation. Renal ultrasound has increased its use, mainly the resistive index, in addition, the evaluation of renal perfusion in post-surgical patients has been described, however, its relationship with severity in acute kidney injury has not been demonstrated.</div></div><div><h3>Objective</h3><div>To establish the correlation of the resistive index and renal perfusion pressure with the severity of acute kidney injury in the Intensive Care Unit.</div></div><div><h3>Material and methods</h3><div>Cross-sectional study in the Intensive Care Unit; patients with acute kidney injury were included and severity was staged according to KDIGO criteria, and renal vascular ultrasonographic measurements were obtained. Statistical analysis was with Kendal's Tau-b test and linear regression analysis.</div></div><div><h3>Results</h3><div>Final population of 81 patients, the variable that correlated with severity was renal perfusion pressure (r=0.62, p≤0.001) and diastolic velocity (r=0.30, p=0.007), however, the resistive index had no correlation (r=0.135, p=0.314). Similarly, renal perfusion pressure correlated with changes in creatinine (r=−0.554), BUN (r=−0.480) and bicarbonate (r=0.331).</div></div><div><h3>Conclusion</h3><div>No statistically significant results were found in relation to the resistive index, however, we found that the decrease in renal perfusion pressure correlates with greater severity of acute kidney injury in the intensive care unit.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"24 4","pages":"Pages 337-343"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ecografía en dengue: 10 hallazgos claves 登革热超声波：10 项主要发现

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.05.011

Juan Diego Galindo Dávila , Derly Mileidy Gomez Sandoval , Iván José Ardila Gómez , Doris Martha Salgado García

引用次数: 0

Post-COVID-19 syndrome: When an acute infection causes a chronic illness 后COVID-19综合征：急性感染导致慢性疾病

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.05.001

Olga Helena Hernández Ortiz , Andrés Felipe Naranjo Ramírez , Andrea Sierra Ramírez , Mariana Restrepo Arias , Natalia Betancourt Rodriguez , Francisco José Molina Saldarriaga , Fabian A. Jaimes B. , Jorge E. Osorio , Juan Pablo Hernández Ortiz

{"title":"Post-COVID-19 syndrome: When an acute infection causes a chronic illness","authors":"Olga Helena Hernández Ortiz , Andrés Felipe Naranjo Ramírez , Andrea Sierra Ramírez , Mariana Restrepo Arias , Natalia Betancourt Rodriguez , Francisco José Molina Saldarriaga , Fabian A. Jaimes B. , Jorge E. Osorio , Juan Pablo Hernández Ortiz","doi":"10.1016/j.acci.2024.05.001","DOIUrl":"10.1016/j.acci.2024.05.001","url":null,"abstract":"<div><div>We are currently contending with a significant consequence of the SARS-CoV-2 virus pandemic, termed post-COVID syndrome, which has escalated into another global crisis. Conservative estimates suggest that at least 76 million individuals worldwide are grappling with this condition, based on a projected 10% incidence rate among those previously infected. Daily, the tally of cases associated with this syndrome continues to mount. The emergence of long COVID has spurred intensified research endeavors, yet the current volume of ongoing studies falls short, and patient prognosis remains largely unchanged. Consequently, there is an urgent need for enhanced research methodologies to tackle this emerging condition effectively and to mount a robust response to the crisis. Management of post-COVID syndrome primarily revolves around symptomatic relief and rehabilitation strategies aimed at ameliorating the most prevalent symptoms that profoundly impact patients’ quality of life, such as fatigue, dyspnea, and loss of taste and smell. Despite sustained investigative efforts, specific treatments, including steroid therapies, have thus far failed to yield clinically significant outcomes. In this review, we delve into the multifaceted nature of post-COVID syndrome, exploring its impact, current management strategies, and the imperative for advancing research to better understand and address this pressing global health challenge.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"24 4","pages":"Pages 387-397"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Paciente joven con angina de Ludwig, mediastinitis necrosante descendente y shock séptico en relación con absceso odontogénico. Reporte de caso en Colombia 与牙源性脓肿有关的年轻路德维希心绞痛、下行性坏死性纵隔炎和脓毒性休克患者。哥伦比亚病例报告

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.05.012

Carlos Rebolledo Maldonado , Ricardo Luis Romero Figueroa , Evasandrid Romero Jiménez , Iván Alberto Salas Pinzón , Claudia Pacheco Escorcia , Jorge Salazar Amaris

{"title":"Paciente joven con angina de Ludwig, mediastinitis necrosante descendente y shock séptico en relación con absceso odontogénico. Reporte de caso en Colombia","authors":"Carlos Rebolledo Maldonado , Ricardo Luis Romero Figueroa , Evasandrid Romero Jiménez , Iván Alberto Salas Pinzón , Claudia Pacheco Escorcia , Jorge Salazar Amaris","doi":"10.1016/j.acci.2024.05.012","DOIUrl":"10.1016/j.acci.2024.05.012","url":null,"abstract":"<div><div>Mediastinitis is a potentially fatal infection, and due to its low incidence, little epidemiological information is available. Complicated odontogenic infections, such as Ludwig's angina, are a rare cause of descending necrotizing mediastinitis but cause 90% of necrotizing infections. We present the case of a 34-year-old male patient with periodontal disease who develops Ludwig's angina. He progresses to descending necrotizing mediastinitis and septic shock, requiring emergency surgical management, ICU stay, invasive mechanical ventilation and broad-spectrum antibiotic management, with multiple complications associated with mediastinal involvement. Key aspects of the case such as epidemiology, physiopathology, diagnosis, and treatment of descending necrotizing mediastinitis secondary to odontogenic infections are analyzed. Ludwig's angina with descending necrotizing mediastinitis is a serious but preventable complication of this type of infections. Its management requires a timely multidisciplinary approach to reduce morbidity and mortality.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"24 4","pages":"Pages 460-465"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Utilidad del PCR múltiplex de hemocultivo para el diagnóstico microbiológico de infecciones nosocomiales del sistema nervioso central en pacientes críticos 血液培养多重 PCR 在重症患者中枢神经系统院内感染的微生物学诊断中的实用性。

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.08.002

Sofía Mauro , Federico Verga , Antonio Galiana , Mariela Vieytes , Marcelo Barbato

{"title":"Utilidad del PCR múltiplex de hemocultivo para el diagnóstico microbiológico de infecciones nosocomiales del sistema nervioso central en pacientes críticos","authors":"Sofía Mauro , Federico Verga , Antonio Galiana , Mariela Vieytes , Marcelo Barbato","doi":"10.1016/j.acci.2024.08.002","DOIUrl":"10.1016/j.acci.2024.08.002","url":null,"abstract":"<div><h3>Background and objective</h3><div>To determine the usefulness of a molecular biology technique for nucleic acid amplification using real-time polymerase chain reaction (PCR) originally designed for microbiological diagnosis in blood cultures, when applied to cerebrospinal fluid (CSF) samples.</div></div><div><h3>Materials and methods</h3><div>Retrospective, observational, single-center study, carried out between January 2017 and February 2024 in a 28-bed multipurpose critical care unit. All patients with suspected postneurosurgical infection and CSF cytochemical alterations were included. In addition to the microbiological study of the CSF by traditional methods, the BioFire® Blood Culture Identification2 (BCID) panel was applied directly to CSF samples. Traditional culture methods were considered as the reference standard for microbiological identification. The main variable of interest was the percentage of concordance of microbial identification between traditional cultures and BCID.</div></div><div><h3>Results</h3><div>29 patients were included. The diagnosis of central nervous system infection was confirmed in 14 cases (48.2%), 7 post-neurosurgical meningitis, 6 infections associated with ventriculostomy and 1subdural empyema. The most frequently found microorganisms were <em>Acinetobacter baumannii</em> and <em>Klebsiella pneumoniae</em>. No discordances were found between PCR and cultures, so both the positive (14/14) and negative identification concordance (15/15) were 100% between both methods.</div></div><div><h3>Conclusions</h3><div>In patients with suspected post-neurosurgical infection and compatible CSF alterations, multiplex PCR blood cultures applied directly to CSF samples could be considered a useful and accurate tool for rapid microbiological diagnosis in infections of the central nervous system.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"24 4","pages":"Pages 379-386"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Desnutrición carencial al ingreso en pacientes intervenidos quirúrgicamente sobre el tubo digestivo 胃肠道手术患者的入院缺乏性营养不良

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.03.002

Yordanys Paez Candelaria , Lázaro Ibrahim Romero García , Karima Maricel Gondres Legró , Pedro Alexei Bacardí Zapata

{"title":"Desnutrición carencial al ingreso en pacientes intervenidos quirúrgicamente sobre el tubo digestivo","authors":"Yordanys Paez Candelaria , Lázaro Ibrahim Romero García , Karima Maricel Gondres Legró , Pedro Alexei Bacardí Zapata","doi":"10.1016/j.acci.2024.03.002","DOIUrl":"10.1016/j.acci.2024.03.002","url":null,"abstract":"<div><h3>Objectives</h3><div>To characterize the population of critically ill patients, surgically operated on digestive tract, according to selected epidemiological, clinical and nutritional variables, as well as to determine the predictive load of the nutritional status on admission on unfavorable clinical evolution.</div></div><div><h3>Design</h3><div>Frame of reference and patients: An applied, explanatory, analytical cohort research was carried out from January 2023 to December 2023 in critically ill patients surgically operated on digestive tract, who were admitted to the Intensive and Intermediate Care Service of the “Saturnino Lora” Provincial Hospital in Santiago de Cuba.</div></div><div><h3>Measurements</h3><div>A nutritional profile was carried out, which included anthropometric, biochemical, and immunological indicators, which allowed the classification of the patients as malnourished and nourished.</div></div><div><h3>Results</h3><div>There was a predominance of males (51.85%), albumin was altered in 35.15% and 32.99% at admission and discharge, respectively. Acute hemorrhagic abdomen accounted for 39.51% of the total. Malnutrition was 44.44% at admission and 59.25% at discharge. The logistic regression model estimated that malnutrition at the patient's admission is a significant causal factor (p=0.000) of unfavorable evolution in the population of patients exposed to this risk [OR=6.95; I.C 95%: 2,55; 18,91]</div></div><div><h3>Conclusions</h3><div>Deficiency malnutrition on admission has a high incidence in patients surgically operated on digestive tract in the intensive care unit, who have a high probability of suffering complications during their stay, evolving unfavorably during the postoperative period.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"24 4","pages":"Pages 330-336"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140774156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Parálisis hipopotasémica familiar: reporte de caso 家族性低钾性麻痹：病例报告

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.03.004

Deivi Barrios Andradez , Edgardo Gonzalez Puche , Rafael Orozco Marun , Johana Criado Urzola , Daniela Páez Jiménez

引用次数: 0