Acta Colombiana de Cuidado Intensivo最新文献

{"title":"Historia de los coloides","authors":"Maria Ortiz-Lasa,&nbsp;Alejandro Gonzalez Castro","doi":"10.1016/j.acci.2023.02.004","DOIUrl":"https://doi.org/10.1016/j.acci.2023.02.004","url":null,"abstract":"<div><p>Sepsis is one of the fundamental causes of hospital care, both at the emergency level, as well as in intensive care units as well as hospitalization facilities. The recognition of this syndrome as well as the beginning of an early treatment, has shown to decrease the mortality of our patients. Within the treatment of sepsis, in addition to antibiotics, aggressive resuscitation with fluids, the most frequently used are crystalloids. However, there are other types of fluids, such as colloids, more specifically albumin, which could be considered to be administered in the resuscitation process of the septic patient when they require large amounts of crystalloids during it. In the present review, a systematic search was carried out on articles published in English and Spanish, without a deadline, within the Pubmed, Medline, Latindex and Google Scholar databases and those that included the keywords “colloids”, “history of colloids”, “sepsis”, “fluids”, “resuscitation fluids” and related studies. In addition, specific topics were consulted according to the bibliographical references presented. This work has allowed us to build a narrative description of the world history of the origin of colloids, their lights and shadows, as well as the current situation in everything that refers to this type of resuscitation fluid.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 3","pages":"Pages 267-272"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49713460","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":"Cerebral fat embolism: Report of two cases and literature review","authors":"Eder Caceres ,&nbsp;Andre Emilio Viñan Garces ,&nbsp;Juan Sebastian Vargas","doi":"10.1016/j.acci.2023.04.004","DOIUrl":"https://doi.org/10.1016/j.acci.2023.04.004","url":null,"abstract":"<div><p><span><span>Fat embolism syndrome was first described in 1861 and several theories have emerged about its physiopathology and criteria without reaching a consensus. This case report will add to the knowledge and awareness of an entity that can be easily unrecognized when not suspected. Furthermore, clinical evidence is scarce and each case must be evaluated individually according to the context and diagnostic work up. Diagnosis has been based on clinical grounds and require a high index of suspicion </span>in patients who had a decline on their respiratory and/or neurological condition. In addition, the context and timing of the event is key in a proper diagnosis as well as ruling out differential diagnoses. Two cases of high energy trauma secondary to traffic accidents are presented here. During </span>ICU<span> stay these patients presented neurological deterioration not attributable to any other cause. There were other systemic symptoms and signs that lead to the diagnosis of fat embolism. Both cases received respiratory support<span> in the Intensive Care Unit, however clinical course and outcomes were completely different. The divergent outcomes for these two cases emphasize the importance of a timely diagnosis in order to guide interventions and counsel family. We highlight the fact that despite a slow or uncertain clinical course there is a potential for good recovery, hence a premature prognosis can mislead interventions and family. Our primary goal is to raise awareness of this entity in the trauma population and the importance of further research aimed to improve the clinical evidence for treatment and outcomes.</span></span></p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 3","pages":"Pages 314-320"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49713247","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":"Tratamiento exitoso con alectinib administrado por sonda nasogástrica en adenocarcinoma de pulmón avanzado ALK-positivo en ventilación mecánica: reporte de caso","authors":"Juan Duran ,&nbsp;Federico Verga ,&nbsp;Guianeya Santander ,&nbsp;Laura Bodega ,&nbsp;Marcelo Barbato","doi":"10.1016/j.acci.2023.01.001","DOIUrl":"https://doi.org/10.1016/j.acci.2023.01.001","url":null,"abstract":"<div><p>Lung cancer is the most frequently diagnosed malignancy and one of the leading causes of cancer-related mortality. The admission of this type of patients to intensive care is frequent, fundamentally due to the development of respiratory insufficiency and infections. In recent years there have been advances in the study and treatment of this pathology, where the molecular profile of the tumor allows for oncospecific treatments. There are very few reports of the application of this type of treatment in critically ill patients on mechanical ventilation. We present the case of a young patient assisted in our center, who was admitted due to severe respiratory insufficiency and who required invasive mechanical respiratory assistance. A diagnosis of non-small cell lung cancer of the adenocarcinoma type with ALK-positive mutation was made, from which oncospecific treatment was successfully carried out with the tyrosine kinase inhibitor alectinib through an enteral tube.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 3","pages":"Pages 299-302"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49713622","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":"Síndrome serotoninérgico debido a la coadministración de linezolid y fentanilo: reporte de caso","authors":"Esteban Agudelo Quintero ,&nbsp;Gilberto Andrés Rodríguez Rincón ,&nbsp;Juan Santiago Serna Trejos ,&nbsp;Ana María Osorio Gomez ,&nbsp;José Mauricio Cárdenas Prieto","doi":"10.1016/j.acci.2023.04.003","DOIUrl":"https://doi.org/10.1016/j.acci.2023.04.003","url":null,"abstract":"<div><p>Serotonergic syndrome is a potentially fatal clinical condition caused by serotonergic hyperactivity associated mainly with the administration of drugs with serotonin metabolism such as SSRIs, monoamine oxidase inhibitors (such as linezolid), among others. Its diagnosis is clinical and is characterized by a triad of manifestations which are: altered state of consciousness, autonomic hyperactivity and neuromuscular alterations. Despite its frequent use in clinical practice, linezolid is a rare cause of this syndrome and, associated with the fact that the diagnosis is clinical and that its treatment is the withdrawal of the triggering drugs, it can sometimes go unnoticed by physicians, making reports in the literature limited, especially in the Latin American population. It is important that the physician always takes into account these drugs and the potential interactions between serotonergic drugs; even more so given the fact that approximately 85% of physicians do not recognize serotonergic syndrome in clinical practice.</p><p>The following is a case report of serotonergic syndrome associated with the use of linezolid and fentanyl in a patient admitted to the intensive care unit.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 3","pages":"Pages 309-313"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49713321","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":"Evidencia sobre estrategias de prevención y rehabilitación del síndrome post-UCI en adultos: una revisión de revisiones sistemáticas","authors":"Sarita Soto Valencia ,&nbsp;Sara Carolina Navarro Salgado ,&nbsp;Angelly Daniela Paternina Vergara","doi":"10.1016/j.acci.2023.04.001","DOIUrl":"https://doi.org/10.1016/j.acci.2023.04.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Post-ICU syndrome (PICS) is a syndrome that is becoming increasingly important due to the growing number of patients surviving critical illness, a phenomenon that has been accentuated especially after the COVID-19 pandemic. The focus of the medical practice that cares for these patients should be oriented toward the best available interventions to prevent and rehabilitate the sequelae of PICS.</p></div><div><h3>Objective</h3><p>To synthesize the evidence on the efficacy and effectiveness of strategies for preventing and rehabilitating PICS in adult patients.</p></div><div><h3>Methods</h3><p>Umbrella review (CRD42022321610). PubMed, Scopus, Ovid (Cochrane), and LILACS were searched for systematic reviews evaluating any intervention to prevent or rehabilitate PICS and its effect on any of the PICS domain(s) (i.e., mental, cognitive, or physical outcomes).</p></div><div><h3>Results</h3><p>20 studies were included, and 10<!--> <!-->were classified as of low or very-low methodological quality, so they were not included in the summary of results. Therapies at the mental and cognitive levels seem to have a beneficial effect but with limited evidence. The interventions analyzed in the physical sphere are very heterogeneous and have contradictory results, with little quality of evidence.</p></div><div><h3>Conclusions</h3><p>Considering the systematic reviews included in this work, this research allows us to conclude that there is low-quality and contradictory information on the efficacy of interventions for the prevention or rehabilitation of PICS. Future practice should focus on developing high- quality studies.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 3","pages":"Pages 273-285"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49713376","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":"«Juntos somos más». Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva (FEPIMCTI)","authors":"Agamenón Quintero Villareal","doi":"10.1016/j.acci.2023.03.003","DOIUrl":"https://doi.org/10.1016/j.acci.2023.03.003","url":null,"abstract":"","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 3","pages":"Pages 229-230"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49728843","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":"C-reactive protein to albumin ratio in critical care settings","authors":"María Vargas-Hernandez ,&nbsp;Miguel Aguilar-Schotborgh ,&nbsp;José Rojas-Suarez ,&nbsp;Sandra Contreras-Arrieta ,&nbsp;Liseth García-Uribe ,&nbsp;Wilfrido Coronell-Rodriguez ,&nbsp;Carmelo Dueñas-Castell","doi":"10.1016/j.acci.2023.05.002","DOIUrl":"https://doi.org/10.1016/j.acci.2023.05.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Compare the performance of the C-reactive protein to albumin ratio (CAR) in predicting in-hospital death between patients with and without COVID-19.</p></div><div><h3>Materials and methods</h3><p>This prospective cohort study included critically ill patients with and without COVID-19. CAR was obtained at admission and on Day 3, along with fluid balance and other predictive scores. The primary outcome was all-cause in-hospital death, and the Youden index was used to determine CAR cut-off points.</p></div><div><h3>Results</h3><p>We included the data of 176 patients; 85 had COVID-19. All-cause in-hospital death was 31.3%. The CAR cut-off points for patients without COVID-19 were 28.5<!--> <!-->mg/g and 31.6<!--> <!-->mg/g at admission and on Day 3, respectively, and 13.5<!--> <!-->mg/g and 7.4<!--> <!-->mg/g for COVID-19 patients. Day 3 CAR was a better predictor of all-cause in-hospital death than CAR at admission in both groups. Non-survivors in the COVID and non-COVID groups had higher positive fluid balance rates than survivors.</p></div><div><h3>Conclusions</h3><p>The CAR predicted in-hospital death in both groups, with different cut-off points. CAR on Day 3 had better diagnostic performance than that at admission. Cumulative fluid balance may influence CAR kinetics. An optimal CAR cut-off point for critically ill patients, optimal measuring time, and impact of fluids therapy still need to be established.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 3","pages":"Pages 255-266"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49713478","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":"Enfoque de la miocardiopatía séptica como causa de choque refractario en escenarios de recursos limitados: reporte de caso","authors":"Liliana Correa-Pérez ,&nbsp;Diana Carolina Otálora Álvarez ,&nbsp;Gloria Camila Álvarez Gallego","doi":"10.1016/j.acci.2023.04.002","DOIUrl":"https://doi.org/10.1016/j.acci.2023.04.002","url":null,"abstract":"<div><p>Worldwide, more than 18 million cases of sepsis are reported, which affects all age groups, with greater susceptibility in people at the extremes of life; within the wide debate on the definition of cardiomyopathy induced by sepsis, the depression of intrinsic contractility induced by sepsis is evident, and it is a common finding in patients with sepsis or septic shock in intensive care units; however, the inequity in the regional distribution of resources and the difficulties in achieving specialized medicine and diagnostic images in settings with limited resources make it necessary to socialize the challenges found in the management of critical patients in settings with limited resources, and reflect through of a case, the strategies that could have improved the outcome and demonstrate the need to provide tools as POCUS to all intensive care units, particularly in low and middle income countries with scenarios where the access to early diagnostic images by cardiology is limited. The inequity in the regional distribution of resources and the difficulties to achieve specialized medicine and diagnostic imaging in scenarios with limited access, make mandatory to socialize the challenges of critical patient management through a case in which the patient is admitted with septic shock of abdominal origin, high suspicion of cholangitis, electrocardiogram with sinus tachycardia, complete right branch block, ST depression in DI, abnormal R in V1, troponin negative, in which the patient is management with fluid resuscitation, vasopressor and inotropic support, empirical antibiotic management and anti-ischemic management; with progressive clinical deterioration, presenting ventilatory failure requiring invasive mechanical ventilation and requiring increased vasopressor support. Despite management, dynamic electrocardiographic changes associated with hypoperfusion persist. On the first day of ICU stay, the patient is in progressive multi-organ failure, with refractory septic shock, and finally the patient died. After the patient's death, blood cultures were reported with evidence of <em>Escherichia coli</em> ESBL. There are strategies that could have improved the outcome and evidenced the need to provide tools such as the critical POCUS to all intensive care units, particularly in low- and middle-income countries where early diagnostic imaging by cardiology is not available.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 3","pages":"Pages 303-308"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49713320","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":"Is the immobilization of a traumatized patient still the best practice? A literature review","authors":"Caterina Zardo ,&nbsp;Antonello Carta","doi":"10.1016/j.acci.2023.03.002","DOIUrl":"https://doi.org/10.1016/j.acci.2023.03.002","url":null,"abstract":"<div><p><span>Cervical spine immobilization methods were adopted worldwide and were not questioned until the 2000s. From the 1970s to the 1980s, the incidence and mortality of spinal injuries decreased significantly, and as this coincided with the introduction of modern spinal management strategies, several experts credited spinal stabilization with this reduction. As the literature has provided little empirical evidence on the benefits of traditional immobilization and has indicated potential negative consequences, some authors have suggested that a culture of immobilization has been created without evidence of patient benefit. Although the effect of spinal immobilization on patient mortality and outcome remains uncertain due to the lack of </span>randomized controlled trials<span>, current guidelines strictly recommend spinal immobilization for patients with traumatic spinal cord injury. The practice of spinal immobilization remains controversial regarding its possible benefits or harms in trauma patients. Comparative studies are needed to evaluate the safety of cervical and spinal immobilization. The aim of this Mini-Review is to investigate whether the current systems of immobilization of a trauma patient still represent best practice in out-of-hospital emergency care.</span></p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 3","pages":"Pages 293-298"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49713405","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":"Usos del videolaringoscopio C-MAC en una Unidad de Cuidados Intensivos. Estudio prospectivo, observacional","authors":"Manuel Taboada ,&nbsp;Agustín Cariñena ,&nbsp;Minia Rodríguez ,&nbsp;Sara Vázquez ,&nbsp;Cristina Francisco ,&nbsp;Julia Regueira ,&nbsp;Antía Osorio ,&nbsp;Julia Castillo ,&nbsp;Kora Wiliams ,&nbsp;Laura Barreiro ,&nbsp;Javier Segurola ,&nbsp;Pablo Otero","doi":"10.1016/j.acci.2023.04.009","DOIUrl":"https://doi.org/10.1016/j.acci.2023.04.009","url":null,"abstract":"<div><h3>Objective</h3><p>To describe the main uses of the C-MAC video laryngoscope (VL) in an Intensive Care Unit (ICU) during a period of 29 months.</p></div><div><h3>Material and methods</h3><p>Prospective, observational study during a period of 29 months. All patients admitted to our ICU where the VL C-MAC was used were included. Indications, efficacy, and complications were recorded.</p></div><div><h3>Results</h3><p>The VL C-MAC has been used 297 times in 250 patients. The mean age of the patients was 68 ± 13 years. The most frequent use of the VL C-MAC was orotracheal intubation (IOT), in 103 (34.7%) cases. 86.4% of the patients were intubated at the first attempt. Intubation with the VL C-MAC accounted for 60.6% (103/170) of all IOTs performed during the study period. The VL C-MAC was used in 76 (25.6%) cases to review the pharynx-larynx area, and in 68 (22.9%) cases to facilitate the introduction of the transesophageal echocardiography (TEE) probe. Other uses were facilitating percutaneous tracheostomy placement (10.1%), nasogastric tube placement (3%), orotracheal tube exchange (3.4%) and Sengstaken balloon placement (0.3%).</p></div><div><h3>Conclusions</h3><p>The IOT, the review of the pharynx-larynx area and the introduction of the TEE probe were the most frequent uses of the VL C-MAC in our ICU. The use of VL C-MAC in an ICU is broader than tracheal intubation and can facilitate the management of critical patients.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"23 3","pages":"Pages 247-254"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49734365","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}