Acta Colombiana de Cuidado Intensivo最新文献_第8页

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

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