Acta Colombiana de Cuidado Intensivo最新文献_第2页

Possible immunological events and their pivotal role in disease progression during sepsis: A review 脓毒症期间可能发生的免疫事件及其在疾病进展中的关键作用：综述

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.05.010

Awanindra Dwivedi , Prateek Kumar Singh , Zari Anjum , Awadhesh Kumar Yadav , Ravi Ranjan , Vijayananth Pavadai , Vinay Kumar Garg , Atul Goel

{"title":"Possible immunological events and their pivotal role in disease progression during sepsis: A review","authors":"Awanindra Dwivedi , Prateek Kumar Singh , Zari Anjum , Awadhesh Kumar Yadav , Ravi Ranjan , Vijayananth Pavadai , Vinay Kumar Garg , Atul Goel","doi":"10.1016/j.acci.2024.05.010","DOIUrl":"10.1016/j.acci.2024.05.010","url":null,"abstract":"<div><div>Study of possible physiological events leading to progression of sepsis, i.e., inflammation, coagulation–anticoagulation balance and immunosuppression which have been addressed by new therapeutic targets for these metabolic pathways and thereby, evolution of drugs has better therapeutic potential than the traditional ones. Online database and printed material were searched using relevant keywords. Collected literature was scrutinized for related information with special reference to the objective. These drug molecules have either been approved for treatment of human subjects or these are under evaluation for therapeutic potential on human subjects or animal models. Surviving Sepsis Campaign guidelines include recommendations for recognition and early care, source diagnosis and treatment of infection, hemodynamic care, ventilation and additional therapeutic treatment recommendations. Advancements in these treatment strategies have reduced the mortality yet there is need for implementation of genomic and proteomic<span> analysis techniques for better results. Smaller molecules should be preferred as therapeutic agents because of having less immunogenicity; smaller size is suitable for better tissue penetration.</span></div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"24 4","pages":"Pages 398-403"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659190","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

Infarto de miocardio recurrente por disección espontánea de arterias coronarias en el puerperio. Revisión de caso 产褥期自发性冠状动脉夹层导致的复发性心肌梗死。病例回顾

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.05.002

Liliana Correa-Perez , Ana Alexis Olaya Alturo , Paula Alejandra González Quintero , Nathaly Botero González , Itsabel Juliana Sepulveda Gómez

{"title":"Infarto de miocardio recurrente por disección espontánea de arterias coronarias en el puerperio. Revisión de caso","authors":"Liliana Correa-Perez , Ana Alexis Olaya Alturo , Paula Alejandra González Quintero , Nathaly Botero González , Itsabel Juliana Sepulveda Gómez","doi":"10.1016/j.acci.2024.05.002","DOIUrl":"10.1016/j.acci.2024.05.002","url":null,"abstract":"<div><div>Acute myocardial infarction (AMI) related to pregnancy, or the puerperium is a rare entity, being predominant causes of non-atherosclerotic origin, such as spontaneous coronary dissection; its etiology is associated with physiological cardiovascular changes during pregnancy, as well as hemodynamic stressors, which may include complications for example hemorrhage and hypertensive disorders. Its diagnosis is based on a correct assessment of the patient supported by the use of cardiac biomarkers and electrocardiogram; however, the low frequency of this pathology may go unnoticed within the spectrum of causes of chest pain during pregnancy, a situation that becomes a diagnostic challenge. Arteriography is the gold standard, particularly when there is no access to other diagnostic aids such as intravascular ultrasound, cardiac MRI, or optical coherence tomography. The medical treatment and reperfusion strategy should be individualized according to the conditions and requirements of each patient. In this article, we describe the case of a 43-year-old patient who during the puerperium presented 2episodes of acute myocardial infarction documented by angiography, confirming recurrent spontaneous coronary artery dissection that benefited from 2percutaneous coronary interventions as a diagnostic strategy and early reperfusion. This publication arises from the need to recognize AMI as a cause of chest pain during pregnancy or pospartum, to broaden the knowledge of the clinical course and differential diagnosis, as well as the current management of acute coronary syndrome in obstetrics, with a particular focus on coronary dissection as a cause.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"24 4","pages":"Pages 437-444"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141391126","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

Neumonía nosocomial y neumonía asociada a la ventilación mecánica 非典型肺炎和呼吸机相关肺炎

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.08.004

Francisco José Molina , Antoni Torres

引用次数: 0

Reacción de hipersensibilidad tardía asociada a la picadura de medusa 与水母蜇伤有关的迟发性超敏反应

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.05.003

Diana Paola Socha Herrera , Sebastián Pérez Muñoz , Diana Alexandra Garzón Alfaro

引用次数: 0

Posición semisentada permanente en UCI: ¿el inclinómetro como herramienta efectiva para la prevención de NAV? Experiencia en una unidad de Cuidados Intensivos de Bogotá 重症监护室的固定半坐体位：倾角仪是预防 VAP 的有效工具？波哥大一家重症监护室的经验。

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.05.008

José Antonio Rojas Gambásica , Andrés Ramírez Maussa , Wilder Enrique Sandoval Forero , Sofia Muñoz Medina , Víctor Hugo Nieto Estrada

{"title":"Posición semisentada permanente en UCI: ¿el inclinómetro como herramienta efectiva para la prevención de NAV? Experiencia en una unidad de Cuidados Intensivos de Bogotá","authors":"José Antonio Rojas Gambásica , Andrés Ramírez Maussa , Wilder Enrique Sandoval Forero , Sofia Muñoz Medina , Víctor Hugo Nieto Estrada","doi":"10.1016/j.acci.2024.05.008","DOIUrl":"10.1016/j.acci.2024.05.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Ventilator-associated pneumonia (VAP) is a common complication in intensive care units (ICUs), increasing the risk of mortality. The pathophysiology of VAP involves colonization of the orotracheal tube and microaspiration from the digestive tract, which is why various prevention strategies such as the permanent semi-Fowler position (30° to 45°) focus on reducing this phenomenon.</div></div><div><h3>Objective</h3><div>To describe the experience of implementing an inclinometer at the head of beds in the ICU and its impact on the frequency of VAP and tracheobronchitis.</div></div><div><h3>Methodology</h3><div>Descriptive study using a case series of 24 patients in the ICU with the use of an external inclinometer. Adults with mechanical ventilation were included, excluding those with contraindications to head elevation. The frecuency of VAP and tracheobronchitis was determined.</div></div><div><h3>Results</h3><div>The device was implemented in 3 beds of the ICU, collecting 24 patients, the median age of 58 years (IQR: 36.5-70). The median tilt with the device was 35°, and the time with tilt greater than 30° was 87.5% per day. The incidence of VAP and tracheobronchitis in one year was 8.33% (95% CI: 1.02%-26.99%) and 12.5% (95% CI: 2.65%-32.36%).</div></div><div><h3>Conclusions</h3><div>The use of the inclinometer offered a novel and safe way to monitor the semi-seated position of at least 30° in this series of patients and could potentially prevent ventilator-associated infections, although further research is needed to allow the generalization of the results.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"24 4","pages":"Pages 354-359"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141395702","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

Cambios longitudinales en el índice de ROX y el puntaje de HACOR en pacientes críticos con insuficiencia respiratoria aguda por COVID-19 que requirieron cánula nasal de alto flujo: estudio de cohorte retrospectivo 需要使用高流量鼻插管的 COVID-19 急性呼吸衰竭重症患者 ROX 指数和 HACOR 评分的纵向变化：一项回顾性队列研究。

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.08.001

Izeth Sallas Rodríguez , Helman Diaz Ramírez , José Santacruz Arias , Javier Polo Díaz , Miguel Aguilar Schotborgh , Amilkar Almanza Hurtado , Nestor Lora Villamil , Diana Borré Naranjo , Wilfrido Coronell Rodríguez , José Rojas Suárez , Carmelo Dueñas Castell

{"title":"Cambios longitudinales en el índice de ROX y el puntaje de HACOR en pacientes críticos con insuficiencia respiratoria aguda por COVID-19 que requirieron cánula nasal de alto flujo: estudio de cohorte retrospectivo","authors":"Izeth Sallas Rodríguez , Helman Diaz Ramírez , José Santacruz Arias , Javier Polo Díaz , Miguel Aguilar Schotborgh , Amilkar Almanza Hurtado , Nestor Lora Villamil , Diana Borré Naranjo , Wilfrido Coronell Rodríguez , José Rojas Suárez , Carmelo Dueñas Castell","doi":"10.1016/j.acci.2024.08.001","DOIUrl":"10.1016/j.acci.2024.08.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Validate the IROX and HACOR scores, including their deltas, in determining their success, defined as survival and the need for intubation.</div></div><div><h3>Design</h3><div>Retrospective cohort study involving 115 patients admitted to intensive care for acute hypoxemic respiratory failure (AHRF) and treated with high-flow nasal cannula (HFNC).</div></div><div><h3>Materials and methods</h3><div>IROX and HACOR scores were evaluated at the initiation of HFNC use and at 24hours (delta).</div></div><div><h3>Background</h3><div>In patients with AHRF due to SARS-CoV-2, the study aimed to determine the success of HFNC by evaluating this index and score and their respective deltas at 24hours.</div></div><div><h3>Results</h3><div>At 24hours, the IROX was higher in the success group (6.53 [4.80-10.44] vs. 4.76 [4.11-5.90]) and the HACOR was lower (4 [2-6] vs. 6 [5-6.75]), both results being significant (p=<0.001). The D-ROX was positively associated with survival (47.37 [-1.89-136.11] vs. 5.06 [-16.85-34.25]; p=0.002), contrary to the D-HACOR (-25 [-66.67-0] vs. 0 [-16.67-16.67]; p=<0.001). Multivariate analysis of D-IROX (HR=0.99, 95%CI [0.99-1], p=0.001) and D-HACOR (HR=1.01, 95%CI [1-1.01], p=0.001) indicated that both are valid predictors of survival and failure.</div></div><div><h3>Conclusion</h3><div>The IROX and HACOR scores at 24hours, along with their deltas, are good predictors of success.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"24 4","pages":"Pages 370-378"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659187","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

Hacia una práctica médica consciente: la neurobioética y la prevención de la obstinación terapéutica en pacientes neurocríticos 实现有意识的医疗实践：神经生物伦理学与预防神经重症患者的治疗顽固性

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.07.002

Carlos Andres Bustamante

引用次数: 0

Recomendación sobre los donantes de órganos en asistolia controlada y los donantes de órganos después de la eutanasia 关于器官捐献者在昏迷控制状态下和安乐死后器官捐献者的建议

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.05.009

Rubén Darío Camargo Rubio

引用次数: 0

Asociación de antidepresivos y la reducción de intubación orotraqueal o muerte en los pacientes con COVID-19 抗抑郁药与减少 COVID-19 患者气管插管或死亡的关系

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.04.003

Alvaro Montenegro , Juan Sanjuan , David Cruz , Juan Serna , Marcela Rendon

{"title":"Asociación de antidepresivos y la reducción de intubación orotraqueal o muerte en los pacientes con COVID-19","authors":"Alvaro Montenegro , Juan Sanjuan , David Cruz , Juan Serna , Marcela Rendon","doi":"10.1016/j.acci.2024.04.003","DOIUrl":"10.1016/j.acci.2024.04.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Studies suggest that antidepressant use may prevent clinical deterioration in patients with COVID-19; however, there is insufficient information in patients with hypoxemic respiratory failure.</div></div><div><h3>Objective</h3><div>To associate the composite outcome of orotracheal intubation or in-hospital mortality with the use of antidepressants in patients admitted to the intensive care unit (ICU) with hypoxemic respiratory failure due to COVID-19.</div></div><div><h3>Methodology</h3><div>A retrospective cohort study, of patients admitted to the ICU with a diagnosis of hypoxemic respiratory failure due to COVID-19 and who in turn required non-invasive airway management in their first 48 hours; the sample was collected by convenience, differences in outcomes were analyzed according to antidepressant exposure (no exposure, receiving less than 3 doses, receiving 3 or more doses) by bivariate and multivariate analysis.</div></div><div><h3>Results</h3><div>201 records were reviewed, the primary outcome of orotracheal intubation or in-hospital mortality was lower in patients receiving 3 or more doses of antidepressants compared to the other 2 comparison groups (15.2 vs. 66.7 vs. 51.6%; <em>P</em><.001); this result was mainly influenced by the lower proportion requiring orotracheal intubation in patients receiving 3 doses or more of antidepressants (13.9 vs. 66.7 vs. 51.6%; <em>P</em><.001), these associations were also found in the multivariate analysis.</div></div><div><h3>Conclusions</h3><div>This study suggests an association in decreased risk of orotracheal intubation in patients with hypoxemic respiratory failure due to COVID-19 when ingesting antidepressants for at least 3 continuous doses.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"24 4","pages":"Pages 344-353"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141143421","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

Point of care ultrasound (PoCUS) y el enfoque de hiponatremia: una serie de casos 护理点超声（PoCUS）和低钠血症方法：病例系列

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-10-01 DOI: 10.1016/j.acci.2024.06.003

Luisa Fernanda Martínez , Daniel Martin Arsanios , Luis David Medina , Gina Sofia Montaño Padilla , Maria C. Restrepo-Guarnizo

{"title":"Point of care ultrasound (PoCUS) y el enfoque de hiponatremia: una serie de casos","authors":"Luisa Fernanda Martínez , Daniel Martin Arsanios , Luis David Medina , Gina Sofia Montaño Padilla , Maria C. Restrepo-Guarnizo","doi":"10.1016/j.acci.2024.06.003","DOIUrl":"10.1016/j.acci.2024.06.003","url":null,"abstract":"<div><div>Hyponatremia is a common condition in clinical practice characterized by low blood sodium levels (<135 mmol/L), which can have severe neurological consequences and increase the risk of mortality. Its management requires identifying the underlying cause, for which the use of various tools has been described. In this case, the use of Point-of-Care Ultrasound (PoCUS) to estimate extracellular volume and determine the etiology of the condition is highlighted. Five clinical cases documenting the presence of hyponatremia are presented, with ultrasound findings guiding the etiology in each case.</div><div>Currently, non-invasive methods are proposed, such as PoCUS, which, along with clinical findings and paraclinical tests, allow for characterizing patients’ volume status and determining the type of hyponatremia. Estimating extracellular volume can lead to estimating the cause. Despite limitations in its use and scant literature in this area, its implementation emerges as an innovative strategy to enhance early identification and management of hyponatremia.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"24 4","pages":"Pages 466-471"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141713561","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