Acta Colombiana de Cuidado Intensivo最新文献

{"title":"Hipotermia terapéutica y su papel en la neuroprotección del paciente crítico pediátrico","authors":"Gerardo Guzmán de la Rosa ,&nbsp;Mauricio Fernández Laverde ,&nbsp;Juan Diego Ciro Quintero","doi":"10.1016/j.acci.2023.03.001","DOIUrl":"https://doi.org/10.1016/j.acci.2023.03.001","url":null,"abstract":"<div><p>Therapeutic hypothermia has been defined as an induced and controlled drop in core body temperature below 36<!--> <!-->°C. The main potential benefit of therapeutic hypothermia is neuroprotection, decreasing neuronal damage and optimizing patient outcomes. It is a strategy that has been used with good results in neonates and there is evidence for some clinical conditions in adults, however, the evidence in the pediatric population has not been conclusive and even though studies have been carried out on this type of therapy, it still exists doubts about its benefits and possible complications, as well as about its effectiveness. In this article, an updated review of the subject is carried out, evaluating the pediatric evidence, with special emphasis on its usefulness in severe traumatic brain injury, post cardiac arrest syndrome and status epilepticus, entities for which therapeutic hypothermia has been used as a possible management strategy.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 3","pages":"Pages 286-292"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49713404","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}

{"title":"Comportamiento del virus COVID-19 en una unidad de cuidados intensivos","authors":"Gilberto García-Zuluaga ,&nbsp;David Gil-Murillo ,&nbsp;Olga Alicia Nieto-Cárdenas","doi":"10.1016/j.acci.2022.12.005","DOIUrl":"https://doi.org/10.1016/j.acci.2022.12.005","url":null,"abstract":"<div><h3>Introduction</h3><p>The COVID-19 pandemic affected public health.</p></div><div><h3>Objective</h3><p>To describe the behavior of COVID-19 virus in patients with a confirmed diagnosis in the ICU of the San Juan de Dios University Hospital in Armenia between April and June 2020.</p></div><div><h3>Materials and methods</h3><p>Descriptive cross-sectional study. Variables are described in mean, standard deviation and confidence intervals. A comparative analysis is made by sex and outcome, analysis of variance and Chi square were performed and statistical difference was considered when the <em>p</em> value was less than 0.05.</p></div><div><h3>Results</h3><p>Sixty patients were included, 38% female and 62% male, with a significant difference by gender (<em>p</em> value = .003). The average age was 57 ± 1 years. Symptoms were dyspnea in 98.3%, dyspnea and cough in 38%, dyspnea and fever in 32%, and dyspnea, cough and fever in 12%. The comorbidities were arterial hypertension 33%, diabetes mellitus 21% and obesity 25%.</p><p>Dimer D (763 ng/ml), ferritin (1253 ng/ml) and LDH (426 U/l) were elevated. The oxygenation index was decreased (114 mm/Hg). Chest X-rays showed pneumonia in 78% and infiltrates in all four quadrants in 7%, and chest CT showed a ground glass image in 47% and multifocal pneumonia in 20%. The average stay in the ICU was 13.55 days, with a range between 0 and 41 days.</p></div><div><h3>Conclusions</h3><p>The patients presented a moderate to severe oxygenation disorder, which is why they required mechanical ventilation and prone position and 45% died.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 3","pages":"Pages 231-239"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49728845","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}

{"title":"Echocardiographic detection of transpulmonary bubble transit during coronavirus-2019 disease (COVID-19)","authors":"Indalecio Carboni Bisso ,&nbsp;Victoria Ruiz ,&nbsp;Mariano Falconi ,&nbsp;Marina Baglioni ,&nbsp;Eugenia Villanueva ,&nbsp;Iván Huespe ,&nbsp;Sabrina Di Stefano ,&nbsp;Marcos Las Heras ,&nbsp;Jorge Sinner","doi":"10.1016/j.acci.2023.02.001","DOIUrl":"https://doi.org/10.1016/j.acci.2023.02.001","url":null,"abstract":"<div><h3>Background</h3><p>Transpulmonary bubble transit (TPBT) detected with contrast echocardiography is reported as a sign of intrapulmonary arteriovenous shunt. However, its pathological meaning is not clear during coronavirus-2019 disease (COVID-19) related acute respiratory distress syndrome (ARDS). Our aim was to determine the prevalence and clinical significance of TPBT detection during COVID-19 related ARDS.</p></div><div><h3>Methods</h3><p>We carried out a prospective observational study performed in a high complexity intensive care unit from Argentina. Patients with COVID-19 related ARDS underwent transthoracic echocardiography with saline contrast. Moderate-to-large TPBT was defined as right-to-left passage of at least twelve bubbles to left chambers after at least three cardiac cycles and complete opacification of the right atrium.</p></div><div><h3>Results</h3><p>We analyzed the results of 28 patients (24 men and 4 women). Seventy-five percent of the patients received invasive mechanical ventilation. Moderate-to-large TPBT was detected in 1 patient (3.5%). Among the 27 patients without significant TPBT, 23 had no TPBT and 4 had a minor TPBT. TPBT was not associated with invasive mechanical ventilation requirement (<em>p</em> <!-->=<!--> <!-->0.5737) nor in-hospital mortality (<em>p</em> <!-->=<!--> <!-->1).</p></div><div><h3>Conclusions</h3><p>TPBT was not associated with severe hypoxemia or invasive mechanical ventilation requirement, although more studies are needed to further clarify its contributing role in COVID-19 hypoxemia.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 3","pages":"Pages 240-246"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49728847","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}

{"title":"The double gut point: A case report of a novel sonographic sign of localized pneumoperitoneum","authors":"Yale Tung-Chen ,&nbsp;Tomás Villén-Villegas ,&nbsp;Elmo Pereira-Junior","doi":"10.1016/j.acci.2023.02.002","DOIUrl":"https://doi.org/10.1016/j.acci.2023.02.002","url":null,"abstract":"<div><p>Pneumoperitoneum is a life-threatening condition, caused by hollow organ perforation. The diagnosis is often difficult, and Point-of-care ultrasound can be useful to distinguish from different conditions, and early set the indication of urgent surgery. We report on a critically ill patient, who presented to the Emergency Department with sudden increase in upper abdominal pain and distension with a diagnosis of small bowel obstruction on ultrasound using a curvilinear probe. After repeating the ultrasound using a linear probe, two dynamic points at mesogastrium very similar to the “double lung point” seen in thoracic ultrasound was detected. This “double gut point” due to bowel ischemia and perforation was confirmed on a computed tomography scan. In this case, the finding of an abdominal “double gut point” allowed us to diagnose localized pneumoperitoneum, being a novel sign, that could aid to diagnose small amounts of free air in the peritoneal cavity.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 2","pages":"Pages 160-163"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49731725","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}

{"title":"Use of tocilizumab in COVID-19 pneumonia hospitalized patients. Cohort study","authors":"Cynthia Anci ,&nbsp;Vanina Solavallone ,&nbsp;Romina Cardone ,&nbsp;Juan Manuel Orlando","doi":"10.1016/j.acci.2022.10.004","DOIUrl":"https://doi.org/10.1016/j.acci.2022.10.004","url":null,"abstract":"<div><h3>Introduction</h3><p>In COVID 19, an aggressive inflammatory response called cytokine release storm has been described. It is mainly mediated by the activation of Interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α), mainly observed in critically ill patients. Among the multiple treatments proposed throughout these two years of pandemic, we highlight the use of Tocilizumab (TCZ).</p></div><div><h3>Objectives</h3><p>To evaluate in-hospital mortality, transfer to critical care unit (CCU), invasive mechanical ventilation requirement (IMV), and hospital stay in patients treated with TCZ versus conventional treatments (CT).</p></div><div><h3>Methods</h3><p>Retrospective, descriptive, and analytical cohort study. Hospitalized patients, May to July 2021. Branches: treated with TCZ versus CT. Statistical analysis: Epi Info 7.2.</p></div><div><h3>Results</h3><p>Ninety patients, 51 TCZ branch and 39 CT branch. Age 48.2 years (± 11.7), males 74 (82.2%). Comorbidities 66 (73.3%): High blood pressure (HBP) 32 (35.6%), Diabetes mellitus 13 (14.4%), BMI<!--> <!-->&gt;<!--> <!-->30, 51 (56.7%). Medical Clinic Admission (MC) 85 (94.4%). Days post-symptom onset 7.9 (± 2.6). Severity of COVID 19: severe 61 (67.8%), critical 26 (28.9%). CCU admission 26 (29.9%). IMV 16 (17.8%). Deaths 7 (7.9%). Hospital stay 12.9 (± 6.6) days. Comparative analysis TCZ versus CT: MC admission 50 (98%) versus 35 (89.7%) <em>p</em> .08. CCU admission 12 (23.5%) versus 14 (38.9%) <em>p</em> .1. IMV 4 (7.8%) versus 12 (30.8%) <em>p</em> .005. Death 1 (2.0%) versus 6 (15.8%) <em>p</em> .02. Mortality in univariate analysis (<em>p</em> <!-->&lt;<!--> <!-->.05): APACHE II, BMI<!--> <!-->&gt;<!--> <!-->30, TCZ, IMV, and CCU admission. TCZ was a protective factor against RR of death .86 (.74–.99). The IMV requirement was a RR factor for death 2.0 (1.23–3.42). Cox logistic regression, independent survival factors: use of TCZ, absence of obesity, and no IMV, <em>p</em> .0000.</p></div><div><h3>Conclusions</h3><p>IMV was found to be a risk factor for mortality. TCZ did not show a decrease in CCU requirement, but it did prove to be a protective factor against mortality. However, this is a non-randomized study so it should be interpreted with caution.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 2","pages":"Pages 105-112"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49731771","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}

{"title":"Consenso colombiano de calidad en cuidados intensivos: task force de la Asociación Colombiana de Medicina Crítica y Cuidados Intensivos (AMCI®)","authors":"Camilo Ernesto Pizarro Gómez ,&nbsp;Julio César Durán ,&nbsp;Víctor Hugo Nieto Estrada ,&nbsp;Bladimir Alejandro Gil Valencia ,&nbsp;Leopoldo Ferrer Zaccaro ,&nbsp;Carmelo Dueñas Castell ,&nbsp;Carmen Chica Meza ,&nbsp;Yulieth Zabaleta Polo ,&nbsp;Fabio Varón Vega ,&nbsp;Manuel Garay Fernández ,&nbsp;Ronald Medina Lombo ,&nbsp;Juan Luis Echeverri Ospina ,&nbsp;Maria Cristina Florián ,&nbsp;César Orlando Enciso ,&nbsp;Mario Gómez Duque ,&nbsp;Agamenon Quintero Villareal ,&nbsp;José Antonio Rojas Suárez ,&nbsp;Byron Piñeres ,&nbsp;Guillermo Ortiz ,&nbsp;Liliana Paola Correa ,&nbsp;Albert Valencia Moreno","doi":"10.1016/j.acci.2023.04.007","DOIUrl":"https://doi.org/10.1016/j.acci.2023.04.007","url":null,"abstract":"<div><p>For Colombia, it is important to adopt a standardized and structured quality management system for the continuous improvement of health care in intensive care units (ICU). The Colombian Association of Critical Medicine and Intensive Care (AMCI) developed this consensus document to offer recommendations on the different pillars of health quality that are necessary for practice within the units. It was built with a comprehensive approach, taking into account the accumulated experience of the actors who practice the discipline of critical medicine together with the analysis of the best available scientific evidence, but contextualized to the national perspective. This consensus seeks to guarantee and prioritize safety and quality conditions for critically ill patients in the units. In response to the variability in processes, systems, structure, and complexity in ICU throughout the national territory, the AMCI convened a multidisciplinary team of experts in critical medicine, clinicians, and methodologists to make a scientific statement using the consensus methodology. formally, mainly through the DELPHI method, about the quality standards necessary to guarantee efficiency and quality in intensive care services and that can be reflected in patient outcomes. It is intended to have a positive impact on the different levels of the health system, providers, administrators and insurers. It is also intended to establish work channels with the national government and its regulatory bodies, to provide arguments from the scientific society that can facilitate the formulation of policies in control and audit regulations. The consensus invites all intensive care units in the country to carry out a self-assessment of their specific conditions, taking into account the contents of this consensus, clarifying that it was developed in a scientific, academic and non-commercial context, focused on the continuous search for benefit for patients, but also for the human talent that works in the units. Each health institution must be a guarantor, through the leadership of the care coordination of the ICU, of having the best conditions to be able to develop the practice of critical medicine. This consensus document constitutes a source for improvement processes. This document has a national scope and its content is expected to be updated in no more than 4 years.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 2","pages":"Pages 164-201"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49715024","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}

{"title":"Consenso colombiano de criterios de ingreso a cuidados intensivos: Task force de la Asociación Colombiana de Medicina Crítica y Cuidados Intensivos (AMCI®)","authors":"Camilo Ernesto Pizarro Gómez ,&nbsp;Carmelo Dueñas Castell ,&nbsp;Víctor Hugo Nieto Estrada ,&nbsp;Bladimir Alejandro Gil Valencia ,&nbsp;Julio César Durán Pérez ,&nbsp;Leopoldo Ferrer Zaccaro ,&nbsp;Fabio Andrés Varón Vega ,&nbsp;Manuel Andrés Garay Fernández ,&nbsp;Ronald Antonio Medina Lombo ,&nbsp;Guillermo Ortiz Ruíz ,&nbsp;Manuel Andrés Garay Fernández ,&nbsp;Rubén Darío Camargo Rubio ,&nbsp;Mario Gómez Duque ,&nbsp;Leopoldo Ferrer Zaccaro ,&nbsp;Carmelo Dueñas Castell ,&nbsp;Ronald Medina Lombo ,&nbsp;Daniel Molano Franco ,&nbsp;Mónica Vargas Ordoñez ,&nbsp;Marcela Granados Sánchez ,&nbsp;María Victoria Alzate Atehortúa ,&nbsp;Paula Velazquez Trujillo","doi":"10.1016/j.acci.2023.04.008","DOIUrl":"https://doi.org/10.1016/j.acci.2023.04.008","url":null,"abstract":"<div><p>It is important to standardize the admission processes to the Intensive Care Units (ICU), and the practices established by consensus determine quality interventions that can enhance specific contexts. ICU are finite, high-cost services that require policies to ensure rational use and to provide quality care to patients. In response to the variability of ICU admission criteria in the country, the Colombian Association of Critical Medicine and Intensive Care (AMCI) convened a multidisciplinary team of experts in critical medicine to establish a scientific statement using the formal consensus methodology, mainly by the Delphi method, about the recommendations and practices that allow to homogenize the criteria for admission to ICU in Colombia. As part of the mission of the AMCI, it is intended to have a positive impact on the different levels of the health system — providers, administrators, insurers and government — and that in the end it will be reflected in benefits for critically ill or at-risk patients. The consensus invites all ICU in the country to select their own criteria taking into account the list of recommendations it contains; it is clarified that the contents are generated in a scientific, academic and non-commercial context. Each health institution must be a guarantor, through the care coordination of the ICUs, of the responsible use of these criteria both for the safe and quality care of patients and to use them for the different commercial relationships established with the administrators of the regimens of health. This document has a national scope and its content is expected to be updated in no more than 4<!--> <!-->years.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 2","pages":"Pages 202-228"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49715037","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}

{"title":"Bioética en cirugía cardiovascular. Teorías éticas aplicadas","authors":"Rubén Darío Camargo Rubio","doi":"10.1016/j.acci.2022.12.003","DOIUrl":"https://doi.org/10.1016/j.acci.2022.12.003","url":null,"abstract":"<div><p>Valve surgery, myocardial revascularization or heart transplant programs, are directly related to the recognition of the dignity of the person and their fundamental rights to health and life. Allowing the patient, the benefit of the intervention will improve their health and quality of life. Bioethics is related to health, life and human behavior and examines actions and decisions through normative ethics that studies moral values through ethical theories. Utilitarianism, Consequentialism, Ethics, Virtue Ethics, Principialism, Casuistry and Proceduralism, helping to better understand moral and ethical decision-making in the face of the dilemma, risks and possible complications, as well as their benefits. The ethical reflection that should be associated with each medical-surgical activity is sometimes taken for granted and the particular ethical analysis of each procedure is taken for granted. The purpose of this reflection is to know that every medical act that is performed in a cardiovascular surgery program is related to ethical theories and the autonomy of the medical professional in their self-regulation, ethics, rationality and scientific evidence. The objective of this article is to argue about bioethics in cardiovascular surgery through normative ethics with applied ethical theories.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 2","pages":"Pages 118-125"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49731773","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}

{"title":"Craniectomía descompresiva y compliance intracraneal en el traumatismo craneoencefálico grave pediátrico","authors":"Angel Jesús Lacerda Gallardo,&nbsp;Daysi Abreu Pérez","doi":"10.1016/j.acci.2022.12.004","DOIUrl":"https://doi.org/10.1016/j.acci.2022.12.004","url":null,"abstract":"<div><h3>Objective</h3><p>To show the effect of primary decompressive craniectomy on ICP, CPP, and intracranial compliance in a group of pediatric patients who suffered from severe head trauma.</p></div><div><h3>Design</h3><p>Descriptive study.</p></div><div><h3>Framework</h3><p>Pediatric intensive care.</p></div><div><h3>Patients</h3><p>Pediatric patients who underwent primary decompressive craniectomy due to severe head trauma, admitted to the pediatric intensive care unit of the “Roberto Rodríguez Fernandez” general teaching hospital in Morón, Ciego de Avila, Cuba between January 2003 and December 2017.</p></div><div><h3>Results</h3><p>Diffuse brain injury Grade IV, was the most frequent tomographic diagnosis at admission 18 (60%), with a predominance of shifts greater than 6<!--> <!-->mm in 24 cases (80%) and absent cisterns 15 (50%). Eighteen cases (60%) had normal ICP for their age after craniectomy, 20 (66.7%) cases showed normal cerebral perfusion pressure. There was a correlation between normal ICP and normal intracranial compliances. The pulse wave amplitude was used as a neuromonitoring method and qualitative representation of compliances. Twenty-two cases survived (73.3%), 18 (60%) of them without sequelae. Eight cases died (26.7%).</p></div><div><h3>Conclusions</h3><p>Primary DC was useful for the control of ICP and maintenance of CPP in the management of pediatric patients with severe TBI in the present study. The favorable effect of the procedure for the increase of intracranial compliance has been verified.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 2","pages":"Pages 126-135"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49731774","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}

{"title":"Fracción de acortamiento como predictor de mortalidad en pacientes con choque séptico","authors":"Josafat Jesús Gutiérrez de la Cruz ,&nbsp;Felipe de Jesús Montelongo ,&nbsp;Jonathan Galindo Ayala ,&nbsp;Nancy Verónica Alva Arroyo ,&nbsp;Luis Eduardo Segura Medina","doi":"10.1016/j.acci.2022.12.002","DOIUrl":"https://doi.org/10.1016/j.acci.2022.12.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Sepsis is a highly prevalent pathology in the intensive care unit, with a significant incidence of complications, so the search for markers as predictors of mortality, with simple and easily available tools, is of the utmost importance.</p></div><div><h3>Objective</h3><p>Determine the shortening fraction in the first 48<!--> <!-->hours of admission to the Intensive Care Unit as a predictive factor for mortality at 21<!--> <!-->days in patients with sepsis.</p></div><div><h3>Methodology</h3><p>A prospective, observational, longitudinal, comparative and descriptive study was carried out in patients from the Intensive Care Unit of the General Hospital of Ecatepec Las Américas, with septic shock. A transthoracic echocardiogram with shortening fraction and appreciable ejection fraction was performed on admission, 24 and 48<!--> <!-->hours later, after 21<!--> <!-->days. Mortality was evaluated.</p></div><div><h3>Results</h3><p>62 patients who met the selection criteria and to whom the design methodology was applied were analyzed, after which a correlation was observed between the shortening fraction and death at 21 days with a significant statistical value (<em>P</em> <!-->&lt;<!--> <!-->.0001).</p></div><div><h3>Conclusions</h3><p>Fractional shortening is a predictor of mortality in patients with septic shock.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 2","pages":"Pages 113-117"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49731772","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}