Acta Colombiana de Cuidado Intensivo最新文献

{"title":"Combinación del cociente diferencia veno-arterial de dióxido de carbono / diferencia arteriovenosa de oxígeno (Pv-aCO2/Ca-VO2) y lactato como predictor de mortalidad en pacientes con choque séptico","authors":"Javier Hernán Lasso Estupiñán ,&nbsp;Daniela Alejandra Getial Mora ,&nbsp;Diego Luis Lagos Caicedo ,&nbsp;Gloria María Sierra Hincapié","doi":"10.1016/j.acci.2025.08.009","DOIUrl":"10.1016/j.acci.2025.08.009","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the association between the veno-arterial carbon dioxide difference / arterio-venous oxygen difference ratio (Pv-aCO2/Ca-VO2) and lactate as a predictor of mortality in patients with septic shock admitted to the intensive care unit (ICU).</div></div><div><h3>Design</h3><div>Prospective cohort study conducted between June 2017 and October 2020.</div></div><div><h3>Setting</h3><div>Intensive care.</div></div><div><h3>Patients</h3><div>Adults with septic shock admitted to the ICU were included. Pregnant patients, patients with chronic kidney failure on hemodialysis, liver cirrhosis, or chronic obstructive pulmonary disease were excluded.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main variables of interest</h3><div>Lactate, venous-arterial carbon dioxide difference (Pv-aCO2), venous oxygen saturation (ScVO2), Pv-aCO2/Ca-VO2 ratio and mortality. The exposed group were those patients with Pv-aCO2/Ca-VO2<!--> <!-->&gt;<!--> <!-->=<!--> <!-->1,4 and lactate<!--> <!-->&gt;<!--> <!-->=<!--> <!-->2 mmol/L.</div></div><div><h3>Results</h3><div>137 patients were analyzed. Median age was 68 years. 59% of the patients died. The variables reported by the model were: Pv-aCO2/Ca-VO2<!--> <!-->&gt;<!--> <!-->=<!--> <!-->1,4 and lactate<!--> <!-->&gt;<!--> <!-->=<!--> <!-->2 mmol/L RR_adjust 2,29 95% CI (1,57–3,32), oncological diagnosis RR_adjust 1,55 95% CI (1,03-2,26), SOFA RR_adjust 1,30 95% CI (1,13-1,50) and days of stay in ICU RR_adjust 0,92 95% CI (0,85-0,99), all of them with p<!--> <!-->&lt;<!--> <!-->0.05 and a model prediction capacity of 88.1% reported by the area under the ROC curve.</div></div><div><h3>Conclusions</h3><div>According to the predictive model, patients with septic shock who present a Pv-aCO2/Ca-VO2 ratio ≥ 1.4 and lactate levels ≥ 2 mmol/L have a 29% increased risk of mortality.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 1","pages":"Article 100568"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418809","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":"Relación entre la carga laboral de enfermería en las unidades de cuidado intensivo de un hospital de alta complejidad y la ocurrencia de eventos adversos","authors":"Andrés Guzmán Gutiérrez ,&nbsp;Efraín Alonso Gómez López","doi":"10.1016/j.acci.2025.09.001","DOIUrl":"10.1016/j.acci.2025.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the nursing workload and analyze its relationship with the occurrence of adverse events in two high-complexity intensive care units in Bogotá.</div></div><div><h3>Design</h3><div>Observational, analytical, cross-sectional study.</div></div><div><h3>Patients</h3><div>Unit of analysis: shift. Unit of observation: Nursing Activity Score (NAS) measurements and adverse event reports for each shift.</div></div><div><h3>Materials and methods</h3><div>NAS measurements were collected for 158 shifts, along with the number of adverse events and nursing professionals per shift. Logistic regression was applied to explore associations, using a significance level of 0.05.</div></div><div><h3>Results</h3><div>The average workload was 66.4% (range: 26-126%), being higher in the afternoon shift. The nurse/patient ratio averaged 2.6 patients per nurse in the night shift. Logistic regression showed that workload (β=0.074; <em>P</em>=.005; OR<!--> <!-->=<!--> <!-->1.08) and nurse-to-patient ratio (β=1.53; <em>P</em>=.029; OR<!--> <!-->=<!--> <!-->4.63) were significantly associated with the occurrence of adverse events. The type of unit had a marginal effect (<em>P</em>=.062). Other variables, such as mean age, number of patients, and number of professionals, showed no significant association (<em>P</em>&gt;.1). The model had a McFadden pseudo-R² of 0.131, explaining approximately 13% of the variability in the occurrence of events.</div></div><div><h3>Conclusions</h3><div>High workload and nurse-to-patient ratio are associated with a higher occurrence of adverse events, highlighting the need to optimize the allocation of nursing staff in intensive care units as a patient safety strategy.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 1","pages":"Article 100571"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418808","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":"Falla gastrointestinal en pacientes con ventilación mecánica: prevalencia y factores asociados","authors":"Sandra Paola Avila Villalobos ,&nbsp;Jessica Garduño López ,&nbsp;Marcos Antonio Amezcua Gutiérrez ,&nbsp;Fernando Gabriel Delgado Mejía ,&nbsp;Freud Piaget Hernández Bielma ,&nbsp;Hugo Armando Vélez Dávila ,&nbsp;Francisco Javier Ramírez Almaraz ,&nbsp;Juan Ángel Morales Ferrer ,&nbsp;Javier Vázquez Falconi Justiniani ,&nbsp;Ricardo Daniel Estrada Moreno","doi":"10.1016/j.acci.2025.100582","DOIUrl":"10.1016/j.acci.2025.100582","url":null,"abstract":"<div><h3>Background</h3><div>Enteral nutrition intolerance occurs in approximately 30% of patients undergoing invasive mechanical ventilation (IMV) for more than 72<!--> <!-->hours and is associated with worse clinical outcomes. Gastrointestinal dysfunction includes the digestive symptoms frequently observed in this context, while gastrointestinal failure (GIF) represents its most severe form. The aim of this study was to determine the prevalence of GIF in patients receiving IMV and to analyze its relationship with hemodynamic, pharmacological, and ventilatory factors.</div></div><div><h3>Materials and methods</h3><div>This was a prospective, single-center cohort study conducted over six months in an intensive care unit (ICU). Patients admitted for medical or surgical causes with an intact gastrointestinal tract on admission and receiving enteral nutrition via feeding tube were included. GIF was classified according to standardized clinical criteria, and associated hemodynamic, ventilatory, and pharmacological variables were evaluated.</div></div><div><h3>Results</h3><div>A total of 77 patients were included; 22 developed GIF, corresponding to a prevalence of 28.5%. Among these, 63.6% (n<!--> <!-->=<!--> <!-->14) presented grade II GIF, 22.7% (n<!--> <!-->=<!--> <!-->5) grade III, and 13.6% (n<!--> <!-->=<!--> <!-->3) grade IV. No significant differences were found in vasopressor use, lactate levels, or opioid administration between GIF severity groups. Body mass index (BMI), PEEP, and intra-abdominal pressure were associated with greater severity in the bivariate analysis.</div></div><div><h3>Conclusions</h3><div>The prevalence of gastrointestinal failure is a relatively frequent complication in critically ill patients receiving enteral nutrition. Body mass index, PEEP levels, and intra-abdominal pressure were associated with greater severity, highlighting the importance of these parameters in the assessment and monitoring of patients at risk of gastrointestinal failure. The findings in this study suggest the need for further research into factors associated with the progression of gastrointestinal failure to optimize clinical management in the ICU.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 1","pages":"Article 100582"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418806","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":"Pathogenicity of sepsis and its effects on cell physiology","authors":"Qurban Ali ,&nbsp;Mohammad Arshad Javed ,&nbsp;Mohd Amir ,&nbsp;Ajaz Ahmad","doi":"10.1016/j.acci.2025.08.010","DOIUrl":"10.1016/j.acci.2025.08.010","url":null,"abstract":"<div><div>Sepsis is a serious medical condition with a high mortality rate where patients experience a severe infection. In a normal operation, the immune and physiological systems work together to eliminate dangerous infections. On the other hand, sepsis occurs when the body cannot control these normal physiological reactions. In an ideal situation, the first interaction between the immune system and a pathogen would result in the total elimination of the infection and a quick return to balance in the host's body. Increased macrophage and neutrophil activity can accelerate the septic response. Sepsis happens because of many things, such as more cell and tissue damage, faster lymphocyte cell death, longer neutrophil cell death, and too many lymphocytes costimulatory molecules being made. Various interactions between the coagulation system and the inflammatory response result in an imbalanced reaction from both systems. Identifying patients who could potentially benefit from immunomodulatory therapy and assisting in diagnosing sepsis are important applications of biomarkers.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 1","pages":"Article 100569"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418810","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":"Retiro de la ventilación mecánica guiado por ecografía en el paciente sarcopénico críticamente enfermo","authors":"Juan Santiago Serna-Trejos ,&nbsp;Yhonnatan Daniel-Cárdenas ,&nbsp;Stefanya Geraldine Bermúdez-Moyano ,&nbsp;Kevin Aníbal Lloreda-Aranzazu ,&nbsp;Carolina Bustamante-Jaimes ,&nbsp;Álvaro Andrés Montenegro-Apraez ,&nbsp;Carlos Andrés Castro-Galvis ,&nbsp;Luis Alfonso Bustamante-Cristancho","doi":"10.1016/j.acci.2025.09.004","DOIUrl":"10.1016/j.acci.2025.09.004","url":null,"abstract":"<div><div>Sarcopenia is a clinical syndrome characterized by progressive and generalized loss of skeletal muscle mass, increasing the risk of adverse outcomes, including physical disability, risk of falls, and increased likelihood of death. Sarcopenia in the critically ill patient is a heterogeneous and multifactorial clinical syndrome. This entity is considered an independent risk factor related to worse outcomes in the intensive care unit, including complications associated with ventilation such as respiratory muscle atrophy due to cessation of contractile activity, facilitated by the administration of sedatives and muscle relaxants for ventilatory support. Diaphragm inactivity leads to passive shortening of muscle fibers and lower energy consumption of the respiratory muscles. This favors diaphragmatic dysfunction, which is associated with longer mechanical ventilation time, ventilatory weaning failure, increased risk of infection and increased risk of death. It is necessary to use diagnostic tools such as muscle and diaphragmatic ultrasound which is a very useful tool. The measurement of diaphragmatic excursion and diaphragmatic thickening can contribute to the ventilatory weaning process and ensure a successful extubation.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 1","pages":"Article 100574"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418740","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":"Doppler transcraneal y desenlace funcional en los pacientes neurocríticos: asociación con la escala de Rankin modificada al egreso de la unidad de cuidados intensivos","authors":"Hugo Armando Vélez-Dávila ,&nbsp;Marcos Antonio Amezcua Gutiérrez ,&nbsp;José Carlos Gasca-Aldama ,&nbsp;Fernando Gabriel Delgado-Mejía ,&nbsp;Juan Ángel Morales-Ferrer ,&nbsp;Javier Vázquez-Falconi-Justiniani ,&nbsp;Sandra Paola Ávila-Villalobos ,&nbsp;Freud Piaget Hernández-Bielma ,&nbsp;Francisco Javier Ramírez-Almaraz ,&nbsp;Jessica Garduño López","doi":"10.1016/j.acci.2025.10.003","DOIUrl":"10.1016/j.acci.2025.10.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Some neurological pathologies require admission to the intensive care unit (ICU) due to their risk of complications and the need for close monitoring. Transcranial Doppler (TCD), a non-invasive and accessible tool, allows for the evaluation of cerebral hemodynamics and can guide interventions, providing valuable prognostic information. This study assessed its utility and its relationship with functional outcomes according to the Rankin Scale (mRS) at ICU discharge and at 28 days.</div></div><div><h3>Materials and methods</h3><div>A prospective, descriptive, observational study was conducted in patients with central nervous system pathologies. Middle cerebral artery measurements were recorded using transcranial Doppler at admission, 24 and 48 hours, and at ICU discharge, with follow-up at 28 days using the mRS.</div></div><div><h3>Results</h3><div>Diastolic velocity of the middle cerebral artery was significantly associated with functional prognosis according to the mRS at ICU discharge and at 28 days. Likewise, Glasgow, SOFA, and APACHE II scores at admission were significantly associated with 28-day outcomes (<em>P</em>&lt;.001). The mRS at discharge and at 28 days showed a significant association with mortality (<em>P</em>=.001 and <em>P</em>&lt;.001, respectively)</div></div><div><h3>Conclusions</h3><div>Low diastolic velocities and cerebral perfusion pressure, as well as high pulsatility indices and intracranial pressure were associated with greater functional disability and mortality, reflecting clinical severity o the patients. Additionally, Glasgow, SOFA, and APACHE II scores at admission demonstrated prognostic value, correlating with 28-day outcomes.</div></div><div><h3>Conclusions</h3><div>Cerebral blood flow measurements at ICU discharge, particularly low velocities and high pulsatility indices, were associated with greater functional disability, which in turn was linked to increased mortality, reflecting clinical severity and the risk of adverse outcomes.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 1","pages":"Article 100577"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418701","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":"Sedación inhalatoria y su impacto en el uso de opioides en pacientes adultos críticamente enfermos sometidos a ventilación mecánica invasiva","authors":"Daniel Molano Franco ,&nbsp;Mario Gómez ,&nbsp;Edgar Beltran ,&nbsp;Víctor Nieto ,&nbsp;David Andrade Fonseca ,&nbsp;Carmen Quiñonez ,&nbsp;Isabella Ruiz ,&nbsp;Ana Rocio Morales ,&nbsp;Fernando Soler ,&nbsp;Carola Gimenez-Esparza","doi":"10.1016/j.acci.2025.09.003","DOIUrl":"10.1016/j.acci.2025.09.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Invasive mechanical ventilation (IMV) often requires intravenous (IV) sedation, although inhaled sedation (IS) with isoflurane has pharmacological properties that may provide additional benefits in the ICU.</div></div><div><h3>Objective</h3><div>To determine the difference in opioid consumption between adult patients under IMV with IV sedation vs. IS with isoflurane at Hospital San José, Bogotá, between January and April 2023.</div></div><div><h3>Methods</h3><div>Analytical observational cohort study in adult patients undergoing IMV, comparing IV sedation vs. IS plus IV analgesia. Exclusion criteria included severe pulmonary disease, cardiac surgery, myocardial infarction, and pregnancy. Clinical data and midazolam, propofol, and fentanyl doses were collected; statistical analysis performed using STATA 17. Non-parametric tests (Mann-Whitney U, χ²); p &lt;<!--> <!-->0.05.</div></div><div><h3>Results</h3><div>Final sample included 156 patients (median age 66.0 years, 57.7% women; 19.3% under IS). Median IMV duration was 3.0 days (IQR 1.0–6.0). Midazolam, propofol, and fentanyl (total and daily doses) were lower in the IS group when IMV exceeded 48<!--> <!-->hours; significant difference for midazolam (p &lt;<!--> <!-->0.001). In patients with IMV<!--> <!-->&gt;48<!--> <!-->h, daily fentanyl dose was also lower in IS group, though not statistically significant (p<!--> <!-->=<!--> <!-->0.385).</div></div><div><h3>Conclusions</h3><div>Inhaled sedation with isoflurane in adult patients undergoing prolonged IMV (&gt;48<!--> <!-->h) is associated with reduced use of opioids, especially fentanyl. This may result in cost savings, lower risk of complications, and reduced events associated to drug dependence. Further studies with larger samples are needed to confirm these findings.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 1","pages":"Article 100573"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418811","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":"Presión de conducción: un peldaño hacia la ventilación mecánica centrada en el paciente","authors":"Carmelo Dueñas-Castell ,&nbsp;Miguel Aguilar-Schotborgh ,&nbsp;Amilkar Almanza-Hurtado ,&nbsp;Nathalia Montaño-Argote","doi":"10.1016/j.acci.2025.10.001","DOIUrl":"10.1016/j.acci.2025.10.001","url":null,"abstract":"","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 1","pages":"Article 100575"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418812","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":"El rol del ventrículo derecho en la reanimación hídrica: una revisión narrativa","authors":"Jorge Fernando Miño-Bernal ,&nbsp;Juan Santiago Serna-Trejos ,&nbsp;Stefanya Geraldine Bermúdez-Moyano ,&nbsp;Carlos Andrés Castro-Galvis","doi":"10.1016/j.acci.2025.09.002","DOIUrl":"10.1016/j.acci.2025.09.002","url":null,"abstract":"<div><div>The right ventricle (RV), historically underestimated in cardiovascular pathophysiology, has emerged as a key determinant in the evolution of critically ill patients. Its anatomical and functional design, adapted to the low-resistance pulmonary circulation, makes it highly efficient under physiological conditions but extremely vulnerable to increases in afterload. RV dysfunction results from mechanisms such as hypertrophy, fibrosis, ischemia, inflammation, and ventriculo-arterial uncoupling, leading to systemic complications driven by hypoperfusion and congestion that affect the liver, kidneys, intestines, musculoskeletal system, nervous system, and immune response. In acute respiratory distress syndrome (ARDS), heart–lung interactions markedly increase RV load and are associated with higher mortality. Fluid resuscitation, while potentially improving cardiac output in hypovolemia, may also trigger RV overdistension, tricuspid regurgitation, and impaired left ventricular output. The integration of echocardiography, point-of-care ultrasound, inotropes, and pulmonary vascular resistance modulators represents the cornerstone of management. This scenario highlights the need for a multidisciplinary and translational approach to develop individualized strategies aimed at improving patient outcomes.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 1","pages":"Article 100572"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418704","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":"Factores de riesgo para fibrilación auricular en pacientes en el postoperatorio de cirugía cardiovascular en Caldas, Colombia","authors":"Yeny Leandra Uribe Sánchez ,&nbsp;Alejandra Valencia Cardona ,&nbsp;Néstor Caicedo Buitrago ,&nbsp;Fernando Arango Gómez","doi":"10.1016/j.acci.2025.100581","DOIUrl":"10.1016/j.acci.2025.100581","url":null,"abstract":"<div><h3>Introduction</h3><div>Postoperative atrial fibrillation (POAF) is the most frequent arrhythmia following cardiovascular surgery, with an incidence ranging from 20 to 50%. It is associated with prolonged hospital stay, stroke, myocardial infarction, heart failure, and increased mortality. In Colombia, regional characterization of this condition remains limited.</div></div><div><h3>Objective</h3><div>To identify risk factors associated with the development of atrial fibrillation in patients undergoing cardiovascular surgery in three tertiary care institutions in the department of Caldas.</div></div><div><h3>Materials and Methods</h3><div>We conducted an observational case-control study in patients aged ≥18 years who underwent cardiovascular surgery in Caldas. Cases were defined as patients without a prior history of atrial fibrillation who developed POAF within the first 7 postoperative days.</div></div><div><h3>Results</h3><div>A total of 606 medical records were reviewed. After excluding 137 cases, 469 patients were included, of whom 97 (20.7%) developed POAF. In the logistic regression model, mitral stenosis (OR: 22.2; 95% CI: 2.47–200.79; <em>P</em>=.006), levosimendan use (OR: 2.62; 95% CI: 1.50–4.57; <em>P</em>=.001), surgical reintervention (OR: 2.44; 95% CI: 1.18–4.67; <em>P</em>=.015), and age ≥70 years (OR: 1.03; 95% CI: 1.02–1.05; <em>P</em>&lt;.001) were significantly associated with POAF.</div></div><div><h3>Conclusion</h3><div>The incidence of postoperative atrial fibrillation was comparable to that reported worldwide. Mitral stenosis, levosimendan use, surgical reintervention, and advanced age were independently associated with its occurrence.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 1","pages":"Article 100581"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418807","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}