Acta Colombiana de Cuidado Intensivo最新文献_第9页

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

Hemólisis aguda severa secundaria a cuerpo extraño en la membrana de oxigenación extracorpórea: reporte de caso 体外氧合膜异物继发严重急性溶血：病例报告

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-07-01 DOI: 10.1016/j.acci.2024.01.002

引用次数: 0

Diabetes mellitus neonatal permanente, variante del gen KCNJ11: Reporte de caso 新生儿永久性糖尿病，KCNJ11 基因变异：病例报告

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-07-01 DOI: 10.1016/j.acci.2024.03.001

{"title":"Diabetes mellitus neonatal permanente, variante del gen KCNJ11: Reporte de caso","authors":"","doi":"10.1016/j.acci.2024.03.001","DOIUrl":"10.1016/j.acci.2024.03.001","url":null,"abstract":"<div><p>Neonatal diabetes mellitus is a monogenic hereditary disease in 80-90% of cases. It presents in two forms: a transient one, generally in the first week of life, characterized by the association of hyperglycemia and intrauterine growth restriction; and a permanent one that presents with severe hyperglycemia and ketoacidosis that manifests before 6 months of life. Clinical forms depend on genetic variation, which is identified by whole exome sequencing. The right treatment is based on the correction of hyperglycemia with insulin, as well as management with high doses of sulfonylureas. This case shows an infant, 1 month and 26 days old, who presents with diabetic ketoacidosis intially in delicate general condition; who was treated with insulin therapy with an adequate response to the metabolic and neurological alterations; <em>KCNJ11</em> gene mutation was confirmed, suggesting permanent neonatal diabetes mellitus. Currently the patient is being treated with glibenclamide, there is no deterioration in neurodevelopment and his growth is satisfactory. We conclude that all patients under 6 months of age with a diagnosis of diabetes mellitus, regardless of the clinical manifestations, should be studied with genetic or molecular tests to identify associated mutations that will determine the severity of the disease and therefore allow to make an early diagnosis, timely treatment and avoiding long-term complications.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"24 3","pages":"Pages 310-314"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140770754","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

Caracterización de pacientes con COVID-19 y falla respiratoria con requerimiento de cánula nasal de alto flujo a 2.600 m sobre el nivel del mar en Bogotá, Colombia 哥伦比亚波哥大海拔 2,600 米处 COVID-19 和呼吸衰竭患者需要高流量鼻插管的特征。

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-07-01 DOI: 10.1016/j.acci.2024.05.005

{"title":"Caracterización de pacientes con COVID-19 y falla respiratoria con requerimiento de cánula nasal de alto flujo a 2.600 m sobre el nivel del mar en Bogotá, Colombia","authors":"","doi":"10.1016/j.acci.2024.05.005","DOIUrl":"10.1016/j.acci.2024.05.005","url":null,"abstract":"<div><h3>Objective</h3><p>To characterize patients with SARS-CoV-2 infection and respiratory failure requiring high-flow nasal cannula at 2600 m above sea level.</p></div><div><h3>Design</h3><p>Descriptive, cross-sectional.</p></div><div><h3>Frame of reference</h3><p>Coronavirus disease (COVID-19) can cause respiratory failure, an alternative for its management is high-flow nasal cannula, however, it is necessary to define which patients benefit from invasive mechanical ventilation and which from high-flow nasal cannula.</p></div><div><h3>Patients</h3><p>One hundred and thirty six patients hospitalized in Bogotá, with diagnosis of COVID-19.</p></div><div><h3>Interventions</h3><p>Non-invasive ventilatory support with high-flow nasal cannula and mechanical ventilation.</p></div><div><h3>Measurements</h3><p>Sociodemographic and clinical characteristics, arterial and paraclinical gases at admission and on days 1, 2 and 3 in ICU, mortality in ICU.</p></div><div><h3>Results</h3><p>The 61.76% were men, mean age was 58.82 years, the most prevalent comorbidities were obesity (37.50%) and hypertension (33.82%). The 53.65% required invasive mechanical ventilation and mortality was 34.56%; the variable associated with the need for intubation was the lymphocyte count on admission. There was a significant statistical association between respiratory frequency, lactate, leukocytes, lymphocytes at admission and age with mortality.</p></div><div><h3>Conclusions</h3><p>In patients with COVID-19 who received oxygen by high-flow nasal cannula at 2600 m above sea level, male sex was predominant, comorbidities and mortality were higher in patients with COVID-19.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"24 3","pages":"Pages 236-242"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141409774","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

Síndrome de distrés respiratorio agudo secundario a inhalación de tóxicos 吸入有毒吸入剂引起的急性呼吸窘迫综合征

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-07-01 DOI: 10.1016/j.acci.2023.12.003

引用次数: 0

Posicionamiento prono en pacientes con síndrome de distrés respiratorio agudo grave por COVID-19 en Cuidados Intensivos Adultos del Hospital de Clínicas: estudio descriptivo Clínicas 医院成人重症监护病房中因 COVID-19 导致严重急性呼吸窘迫综合征的患者的俯卧位：一项描述性研究。

Acta Colombiana de Cuidado Intensivo Pub Date : 2024-07-01 DOI: 10.1016/j.acci.2024.01.006

{"title":"Posicionamiento prono en pacientes con síndrome de distrés respiratorio agudo grave por COVID-19 en Cuidados Intensivos Adultos del Hospital de Clínicas: estudio descriptivo","authors":"","doi":"10.1016/j.acci.2024.01.006","DOIUrl":"10.1016/j.acci.2024.01.006","url":null,"abstract":"<div><h3>Objectives</h3><p>To describe the evolution of patients with Severe Acute Respiratory Distress Syndrome (ARDS) due to COVID-19 who required mechanical ventilation and prone position.</p></div><div><h3>Methods</h3><p>Descriptive, retrospective, cross-sectional study.</p></div><div><h3>Background</h3><p>COVID-19 in its severe form presents ARDS and admission to intensive care unit (ICU) for ventilatory support. Prone position is a well-known technique, which consists of ventilating the patient in the ventral position, optimizing alveolar recruitment and thus improving the oxygenation of these patients.</p></div><div><h3>Patients</h3><p>Adults of both sexes admitted from August 2021 to August 2022 at ICU with a diagnosis of ARDS due to COVID-19 who received orotracheal intubation, mechanical ventilation and prone position as treatment.</p></div><div><h3>Results</h3><p>In this period, 214 patients with COVID-19 were admitted to the intensive care unit of the Hospital de Clínicas. Of these, 127 patients (59.3%) were on invasive mechanical ventilation and prone position, with improvement in PaO2/FiO2 in 85% of them. They presented non-infectious complications: 13 patients with facial sores, while 2 patients were accidentally extubated. Pneumonia occurred in 87 patients (68%), catheter infection in 12 (9.4%), 5 of which were associated with bacteremia. Bacteremia without a known portal of entry 35 (27.5%). The mortality was 51.18%.</p></div><div><h3>Conclusions</h3><p>In our study, 60% of the patients required prone position with improved oxygenation in 85% of them, with a low rate of complications associated.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"24 3","pages":"Pages 208-213"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140463310","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