Pub Date : 2025-01-01DOI: 10.1016/j.acci.2024.08.011
Jose Correa Guerrero
Of the frequentist methods in statistics, the “p-values” when interpreting the results do not inform about the effect size, they are based only on the 5% threshold to declare a real effect in the hypothesis test, and at the same time do not provide probabilistic information. That is why it is important to consider other alternatives or statistical methods in the current context. Bayesian inference or approach as this alternative method addresses the above limitations by having the ability to directly estimate the probability of a significant clinical benefit, and allowing researchers to quantify the influence of prior information on the interpretation of the final results, in order to provide temporary solutions to the problem of significance in the frequentist framework. As a general objective we will review the Bayesian approach or inference trying to address these limitations, some aspects such as statistical and mathematical formulas are beyond the scope of this review.
{"title":"Ensayos clínicos en UCI: «Más allá del valor p»","authors":"Jose Correa Guerrero","doi":"10.1016/j.acci.2024.08.011","DOIUrl":"10.1016/j.acci.2024.08.011","url":null,"abstract":"<div><div>Of the frequentist methods in statistics, the “p-values” when interpreting the results do not inform about the effect size, they are based only on the 5% threshold to declare a real effect in the hypothesis test, and at the same time do not provide probabilistic information. That is why it is important to consider other alternatives or statistical methods in the current context. Bayesian inference or approach as this alternative method addresses the above limitations by having the ability to directly estimate the probability of a significant clinical benefit, and allowing researchers to quantify the influence of prior information on the interpretation of the final results, in order to provide temporary solutions to the problem of significance in the frequentist framework. As a general objective we will review the Bayesian approach or inference trying to address these limitations, some aspects such as statistical and mathematical formulas are beyond the scope of this review.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 1","pages":"Pages 106-110"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610547","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}
Pub Date : 2025-01-01DOI: 10.1016/j.acci.2024.10.009
Jorge Eliecer Pinzón Bernal , Lina María Castro Rojas , Pedro Fernando Giraldo , Abel Yurialdy Espinoza Rios , Peter Vergara Ramírez
Kocuria kristinae is a gram-positive catalase-positive cocci-type microorganism that can normally be isolated from the skin and oral cavity of humans. It is not usually related to the production of infections, however, in recent years it has been found. important isolates of it that generate infections on immunocompromised patients around the world.
Pelvic inflammatory disease is a common entity in our environment, it includes a wide range of infectious processes that compromise the female genital tract that can compromise the endometrium, fallopian tubes, ovaries and even the peritoneum at the pelvic level, it is predominant in women of fertile age and sexually active. The germs commonly associated with the genesis of pelvic inflammatory disease are mainly Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium. However, it is important to keep in mind that up to the time of the review in our environment no cases of pelvic inflammatory disease secondary to K. kristinae have been documented in both immunosuppressed and immunocompetent patients, which is why the case report in question about an immunocompetent patient who presented a case of these characteristics becomes vitally important.
{"title":"Descripción de la Kocuria kristinae como agente causal de choque distributivo por sepsis en enfermedad pélvica inflamatoria en una paciente inmunocompetente: reporte de caso","authors":"Jorge Eliecer Pinzón Bernal , Lina María Castro Rojas , Pedro Fernando Giraldo , Abel Yurialdy Espinoza Rios , Peter Vergara Ramírez","doi":"10.1016/j.acci.2024.10.009","DOIUrl":"10.1016/j.acci.2024.10.009","url":null,"abstract":"<div><div>Kocuria kristinae is a gram-positive catalase-positive cocci-type microorganism that can normally be isolated from the skin and oral cavity of humans. It is not usually related to the production of infections, however, in recent years it has been found. important isolates of it that generate infections on immunocompromised patients around the world.</div><div>Pelvic inflammatory disease is a common entity in our environment, it includes a wide range of infectious processes that compromise the female genital tract that can compromise the endometrium, fallopian tubes, ovaries and even the peritoneum at the pelvic level, it is predominant in women of fertile age and sexually active. The germs commonly associated with the genesis of pelvic inflammatory disease are mainly Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium. However, it is important to keep in mind that up to the time of the review in our environment no cases of pelvic inflammatory disease secondary to K. kristinae have been documented in both immunosuppressed and immunocompetent patients, which is why the case report in question about an immunocompetent patient who presented a case of these characteristics becomes vitally important.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 1","pages":"Pages 231-234"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610458","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}
Ventricular septal rupture as a mechanical complication after acute myocardial infarction (AMI) is rare after the use of fibrinolytic drugs, but highly fatal. It should be suspected in patients with dyspnea, chest pain, pansystolic murmur in the left sternal border and cardiogenic shock, confirming the defect, location and size through echocardiography and color Doppler. Surgical management remains the best therapeutic option compared to medical management. We present a case report of an elderly male patient with arterial hypertension who developed an anterolateral ST segment elevation myocardial infarction. Fibrinolysis with alteplase was performed and subsequently coronary angiography plus rescue percutaneous coronary intervention in the first 24 hours in the anterior descending artery. On the fourth day after the onset of the clinical picture, ventricular septal rupture was documented, leading to cardiogenic shock and subsequent death.
{"title":"Rotura del septum ventricular como complicación del infarto agudo de miocardio con elevación del segmento ST: reporte de un caso","authors":"Carlos Rebolledo Maldonado , Ricardo Luis Romero Figueroa , Mayra Manrique , Víctor Jaimes , Jorge Salazar Amaris , Claudia Pacheco Escorcia","doi":"10.1016/j.acci.2024.10.001","DOIUrl":"10.1016/j.acci.2024.10.001","url":null,"abstract":"<div><div>Ventricular septal rupture as a mechanical complication after acute myocardial infarction (AMI) is rare after the use of fibrinolytic drugs, but highly fatal. It should be suspected in patients with dyspnea, chest pain, pansystolic murmur in the left sternal border and cardiogenic shock, confirming the defect, location and size through echocardiography and color Doppler. Surgical management remains the best therapeutic option compared to medical management. We present a case report of an elderly male patient with arterial hypertension who developed an anterolateral ST segment elevation myocardial infarction. Fibrinolysis with alteplase was performed and subsequently coronary angiography plus rescue percutaneous coronary intervention in the first 24<!--> <!-->hours in the anterior descending artery. On the fourth day after the onset of the clinical picture, ventricular septal rupture was documented, leading to cardiogenic shock and subsequent death.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 1","pages":"Pages 214-219"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610551","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}
Pub Date : 2025-01-01DOI: 10.1016/j.acci.2024.09.004
Juan Sanjuan , Emanuel Cruz , María Paula Uchima-Vera , Alan Andrés Camargo-Rojasc , Gustavo Adolfo Villegas-Gomez
Dysphagia, defined as difficulty in swallowing, significantly impacts critically ill patients, especially those in intensive care units (ICUs). It can arise from neuromuscular disorders or mechanical obstructions, often exacerbated by prolonged mechanical ventilation and other medical interventions. Dysphagia poses risks such as aspiration pneumonia, malnutrition, and prolonged hospital stays. Early detection and intervention are crucial. A comprehensive literature search was conducted using PubMed, SCOPUS, and SPRINGER databases from December 2023 to February 2024. Search terms included “screening,” “dysphagia,” “ICU,” “ultrasonography,” “swallowing function,” and “deglutition disorders.” The search yielded 43 relevant articles, which were subjected to narrative analysis. Traditional dysphagia assessment methods include bedside evaluations, swallow tests, and instrumental strategies like video fluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES). Ultrasonography (US) emerges as a promising, non-invasive alternative for evaluating swallowing function. US can assess tongue and hyolaryngeal movements, and upper esophageal sphincter function, offering real-time feedback and aiding in diagnosis and therapeutic planning. Despite its benefits, US lacks standardized protocols and comprehensive diagnostic criteria, necessitating further research. Ultrasonography shows significant potential in evaluating and managing dysphagia in critically ill patients due to its non-invasive nature and real-time feedback capabilities. However, variations in techniques and the need for standardized diagnostic criteria present challenges. Future research should focus on standardizing ultrasound parameters and refining diagnostic criteria to enhance its reliability and accuracy. Despite these challenges, ultrasonography remains a promising tool for dysphagia assessment and intervention.
{"title":"Role of ultrasonography in the evaluation of dysphagia in critically ill patients: A narrative review","authors":"Juan Sanjuan , Emanuel Cruz , María Paula Uchima-Vera , Alan Andrés Camargo-Rojasc , Gustavo Adolfo Villegas-Gomez","doi":"10.1016/j.acci.2024.09.004","DOIUrl":"10.1016/j.acci.2024.09.004","url":null,"abstract":"<div><div>Dysphagia, defined as difficulty in swallowing, significantly impacts critically ill patients, especially those in intensive care units (ICUs). It can arise from neuromuscular disorders or mechanical obstructions, often exacerbated by prolonged mechanical ventilation and other medical interventions. Dysphagia poses risks such as aspiration pneumonia, malnutrition, and prolonged hospital stays. Early detection and intervention are crucial. A comprehensive literature search was conducted using PubMed, SCOPUS, and SPRINGER databases from December 2023 to February 2024. Search terms included “screening,” “dysphagia,” “ICU,” “ultrasonography,” “swallowing function,” and “deglutition disorders.” The search yielded 43 relevant articles, which were subjected to narrative analysis. Traditional dysphagia assessment methods include bedside evaluations, swallow tests, and instrumental strategies like video fluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES). Ultrasonography (US) emerges as a promising, non-invasive alternative for evaluating swallowing function. US can assess tongue and hyolaryngeal movements, and upper esophageal sphincter function, offering real-time feedback and aiding in diagnosis and therapeutic planning. Despite its benefits, US lacks standardized protocols and comprehensive diagnostic criteria, necessitating further research. Ultrasonography shows significant potential in evaluating and managing dysphagia in critically ill patients due to its non-invasive nature and real-time feedback capabilities. However, variations in techniques and the need for standardized diagnostic criteria present challenges. Future research should focus on standardizing ultrasound parameters and refining diagnostic criteria to enhance its reliability and accuracy. Despite these challenges, ultrasonography remains a promising tool for dysphagia assessment and intervention.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 1","pages":"Pages 111-123"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610552","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}
Pub Date : 2025-01-01DOI: 10.1016/j.acci.2024.06.002
Jose Dario Portillo-Miño , José Leonel Zambrano-Urbano , Diego Fernando Taramuel-Gómez , Franco Andrés Montenegro-Coral , Nasly Violedy Ipia Ordoñez , Luis Guillermo Andino-Bucheli , Leopoldo Javier Eraso-García , Hector Fabio Sanchez-Galvez , Jorge Ignacio Martínez-Díaz
Sepsis and septic shock associated with tuberculosis are such critical diseases that are life-threatening to the patient. TB bacteremia has been associated with sepsis and septic shock, especially in immunosuppressed patients with high mortality. In this sense, it has been seen that 1 in 4 patients infected with human immunodeficiency virus (HIV) hospitalized for sepsis had TB bacteremia. Acute forms of tuberculosis can progress in severity and between 1 and 3% of cases require an Intensive Care Unit (ICU) and high mortality. Given this scenario, the authors consider it pertinent to carry out this Review article, which allows a diagnostic and therapeutic approach to this acute form of TB to provide key aspects of the disease that are decisive in saving the lives of patients in critical condition.
{"title":"Sepsis and septic shock associated with tuberculosis “Landouzy's tifobacilosis”: A dark and unpredictable enemy – From pathophysiology to clinical implications","authors":"Jose Dario Portillo-Miño , José Leonel Zambrano-Urbano , Diego Fernando Taramuel-Gómez , Franco Andrés Montenegro-Coral , Nasly Violedy Ipia Ordoñez , Luis Guillermo Andino-Bucheli , Leopoldo Javier Eraso-García , Hector Fabio Sanchez-Galvez , Jorge Ignacio Martínez-Díaz","doi":"10.1016/j.acci.2024.06.002","DOIUrl":"10.1016/j.acci.2024.06.002","url":null,"abstract":"<div><div><span>Sepsis and septic shock associated with tuberculosis are such critical diseases that are life-threatening to the patient. TB bacteremia has been associated with </span>sepsis and septic shock, especially in immunosuppressed patients with high mortality. In this sense, it has been seen that 1 in 4 patients infected with human immunodeficiency virus (HIV) hospitalized for sepsis had TB bacteremia. Acute forms of tuberculosis can progress in severity and between 1 and 3% of cases require an Intensive Care Unit (ICU) and high mortality. Given this scenario, the authors consider it pertinent to carry out this Review article, which allows a diagnostic and therapeutic approach to this acute form of TB to provide key aspects of the disease that are decisive in saving the lives of patients in critical condition.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 1","pages":"Pages 71-81"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141690506","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}
Pub Date : 2025-01-01DOI: 10.1016/j.acci.2024.10.010
José Correa-Guerrero , Hugo Corrales Santander , Jorge Yepes Caro , Jesús Bello Simanca , Luis Rodríguez Arrieta , Alejandro Castellanos Pinedo , Elguis Rodríguez Garizabalo , Carmelo Dueñas Castell
Thyroid storm (TT) is a rare but potentially fatal condition if not detected and treated promptly. It is characterized by severe clinical manifestations at the level of the central nervous system, cardiovascular system, and gastrointestinal system, associated with elevated levels of free triiodothyronine (T3) and free thyroxine (T4). Infections and/or treatment discontinuation are the most frequent triggers. Identifying the triggering factor, reducing circulating levels of thyroid hormones, and admission to an intensive care unit become the cornerstone of treatment. In this review, based on a clinical scenario, we will provide information regarding the diagnostic and therapeutic approach to TT.
{"title":"Tormenta tiroidea: abordaje diagnóstico y terapéutico","authors":"José Correa-Guerrero , Hugo Corrales Santander , Jorge Yepes Caro , Jesús Bello Simanca , Luis Rodríguez Arrieta , Alejandro Castellanos Pinedo , Elguis Rodríguez Garizabalo , Carmelo Dueñas Castell","doi":"10.1016/j.acci.2024.10.010","DOIUrl":"10.1016/j.acci.2024.10.010","url":null,"abstract":"<div><div>Thyroid storm (TT) is a rare but potentially fatal condition if not detected and treated promptly. It is characterized by severe clinical manifestations at the level of the central nervous system, cardiovascular system, and gastrointestinal system, associated with elevated levels of free triiodothyronine (T3) and free thyroxine (T4). Infections and/or treatment discontinuation are the most frequent triggers. Identifying the triggering factor, reducing circulating levels of thyroid hormones, and admission to an intensive care unit become the cornerstone of treatment. In this review, based on a clinical scenario, we will provide information regarding the diagnostic and therapeutic approach to TT.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 1","pages":"Pages 159-173"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610558","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}
Rhabdomyolysis is a syndrome characterized by muscle destruction and the release of intracellular contents into the plasma, this being one of the main potential causes of nephrotoxicity. Being a syndrome, its etiology is diverse; however, little has been described about rhabdomyolysis secondary to the consumption of HMG-CoA reductase inhibitor drugs such as Phenoverine.
The case of a 54-year-old female patient with no significant history is described, with a clinical picture characterized by asthenia, adynamia, muscle pain, arthralgia, and serum creatine kinase (CPK) of 53,032 IU/L, after the consumption of Phenoverine, complying with diagnostic criteria for rhabdomyolysis secondary to drug use. After the initial evaluation, conservative management was established, based on nephroprotective measures, presenting satisfactory improvement, with resolution of rhabdomyolysis and acute kidney injury.
The objective of this article is to report the case of rhabdomyolysis secondary to the use of this frequently used antispasmodic agent, and of which this complication is underestimated, which can become so serious and leave permanent kidney damage as a consequence.
{"title":"Rabdomiólisis asociada a fenoverina: reporte de caso","authors":"Felipe Arturo Valenzo Hernández , Sofía Jiménez Lomas , Martín Iván Patiño Rosillo , Dulce Guadalupe Márquez Jiménez","doi":"10.1016/j.acci.2024.07.003","DOIUrl":"10.1016/j.acci.2024.07.003","url":null,"abstract":"<div><div>Rhabdomyolysis is a syndrome characterized by muscle destruction and the release of intracellular contents into the plasma, this being one of the main potential causes of nephrotoxicity. Being a syndrome, its etiology is diverse; however, little has been described about rhabdomyolysis secondary to the consumption of HMG-CoA reductase inhibitor drugs such as Phenoverine.</div><div>The case of a 54-year-old female patient with no significant history is described, with a clinical picture characterized by asthenia, adynamia, muscle pain, arthralgia, and serum creatine kinase (CPK) of 53,032<!--> <!-->IU/L, after the consumption of Phenoverine, complying with diagnostic criteria for rhabdomyolysis secondary to drug use. After the initial evaluation, conservative management was established, based on nephroprotective measures, presenting satisfactory improvement, with resolution of rhabdomyolysis and acute kidney injury.</div><div>The objective of this article is to report the case of rhabdomyolysis secondary to the use of this frequently used antispasmodic agent, and of which this complication is underestimated, which can become so serious and leave permanent kidney damage as a consequence.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 1","pages":"Pages 174-177"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610451","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}
Pub Date : 2025-01-01DOI: 10.1016/j.acci.2024.08.008
Fabián Muñoz Ramírez , Santiago Morón-Serrano
Purpose
This review aims to provide clear and precise information about Clostridioides difficile infection (CDI), with the goal of enabling physicians to understand it and proceed with timely diagnosis and treatment.
Data Sources and Study Selection
Databases such as PubMed, Ovid, SciELO, Embase, and MEDLINE were consulted, along with general web searches and references previously known to the authors. Studies, guidelines, and reviews addressing the epidemiology, diagnosis, treatment, and prevention of CDI were included.
Data Extraction and Synthesis
Data were extracted from studies analyzing clinical presentation, diagnostic methods, and therapeutic options. The data synthesis aimed to provide a comprehensive view of best practices based on current evidence.
Conclusions
CDI is a significant cause of gastrointestinal disease in healthcare settings, particularly following antibiotic use. Its incidence is increasing, even in young people without risk factors. Diagnosis is based on clinical suspicion and the detection of C. difficile toxins or toxigenic genes using molecular biology techniques or enzyme immunoassays. This review emphasizes the importance of rapid detection and the implementation of effective therapies to reduce associated morbidity.
{"title":"Infección por Clostridioides difficile en el adulto","authors":"Fabián Muñoz Ramírez , Santiago Morón-Serrano","doi":"10.1016/j.acci.2024.08.008","DOIUrl":"10.1016/j.acci.2024.08.008","url":null,"abstract":"<div><h3>Purpose</h3><div>This review aims to provide clear and precise information about <em>Clostridioides difficile</em> infection (CDI), with the goal of enabling physicians to understand it and proceed with timely diagnosis and treatment.</div></div><div><h3>Data Sources and Study Selection</h3><div>Databases such as PubMed, Ovid, SciELO, Embase, and MEDLINE were consulted, along with general web searches and references previously known to the authors. Studies, guidelines, and reviews addressing the epidemiology, diagnosis, treatment, and prevention of CDI were included.</div></div><div><h3>Data Extraction and Synthesis</h3><div>Data were extracted from studies analyzing clinical presentation, diagnostic methods, and therapeutic options. The data synthesis aimed to provide a comprehensive view of best practices based on current evidence.</div></div><div><h3>Conclusions</h3><div>CDI is a significant cause of gastrointestinal disease in healthcare settings, particularly following antibiotic use. Its incidence is increasing, even in young people without risk factors. Diagnosis is based on clinical suspicion and the detection of <em>C. difficile</em> toxins or toxigenic genes using molecular biology techniques or enzyme immunoassays. This review emphasizes the importance of rapid detection and the implementation of effective therapies to reduce associated morbidity.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 1","pages":"Pages 91-97"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610549","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}
There are multiple monitoring strategies for the follow-up of patients with brain injuries admitted to the intensive care unit (ICU). These strategies begin with a neurological assessment, include imaging studies, and culminate with the implementation of cutting-edge, high-definition technologies. Clinical outcomes depend on the interpretation of the generated data. Neuromonitoring has received increasing attention in recent years. Current scientific evidence recommends practice standards for the use of neuromonitoring in critically ill patients, emphasizing the need to standardize technologies, efforts, and training necessary to integrate and interpret information from multimodal neuromonitoring (NMM). The future of neuromonitoring is oriented towards the integration and innovation of invasive and non-invasive NMM techniques. In terms of intracranial pressure (ICP), monitoring with an intraventricular catheter remains the reference technique or gold standard. Additionally, technologies for measuring cerebral oxygenation, ultrasonographic evaluations such as transcranial Doppler, optic nerve sheath measurement, and emerging techniques such as automated pupillometry and near-infrared spectroscopy (NIRS), should motivate intensivists to understand their foundation and interpretation, as well as their application to generate treatment strategies, monitor them, and impact better clinical outcomes. This review offers an updated assessment of the status of various neuromonitoring modalities and their use in different scenarios, highlighting the advantages and limitations of each method for implementation, emphasizing their utility in the ICU.
{"title":"Monitoreo neurológico multimodal en cuidado intensivo","authors":"Jaime Sarmiento-Calderón , Diana Borré-Naranjo , Carmelo Dueñas-Castell","doi":"10.1016/j.acci.2024.10.005","DOIUrl":"10.1016/j.acci.2024.10.005","url":null,"abstract":"<div><div>There are multiple monitoring strategies for the follow-up of patients with brain injuries admitted to the intensive care unit (ICU). These strategies begin with a neurological assessment, include imaging studies, and culminate with the implementation of cutting-edge, high-definition technologies. Clinical outcomes depend on the interpretation of the generated data. Neuromonitoring has received increasing attention in recent years. Current scientific evidence recommends practice standards for the use of neuromonitoring in critically ill patients, emphasizing the need to standardize technologies, efforts, and training necessary to integrate and interpret information from multimodal neuromonitoring (NMM). The future of neuromonitoring is oriented towards the integration and innovation of invasive and non-invasive NMM techniques. In terms of intracranial pressure (ICP), monitoring with an intraventricular catheter remains the reference technique or gold standard. Additionally, technologies for measuring cerebral oxygenation, ultrasonographic evaluations such as transcranial Doppler, optic nerve sheath measurement, and emerging techniques such as automated pupillometry and near-infrared spectroscopy (NIRS), should motivate intensivists to understand their foundation and interpretation, as well as their application to generate treatment strategies, monitor them, and impact better clinical outcomes. This review offers an updated assessment of the status of various neuromonitoring modalities and their use in different scenarios, highlighting the advantages and limitations of each method for implementation, emphasizing their utility in the ICU.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 1","pages":"Pages 124-141"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610555","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}
Pub Date : 2025-01-01DOI: 10.1016/j.acci.2024.10.011
Hans Altamar Polo , Izeth Sallas Rodríguez , Adriana Gamboa Dallos , Carlos Rebolledo Maldonado
We present an interesting case of acute meningoencephalitis due to reactivation of the varicella zoster virus in an immunocompromised patient in the absence of dermatomal neuralgia or skin lesions attributable to varicella zoster virus.
{"title":"Meningoencefalitis por reactivación del virus de varicela zóster sin erupción cutánea en paciente inmunocomprometido: reporte de caso y revisión de la literatura","authors":"Hans Altamar Polo , Izeth Sallas Rodríguez , Adriana Gamboa Dallos , Carlos Rebolledo Maldonado","doi":"10.1016/j.acci.2024.10.011","DOIUrl":"10.1016/j.acci.2024.10.011","url":null,"abstract":"<div><div>We present an interesting case of acute meningoencephalitis due to reactivation of the varicella zoster virus in an immunocompromised patient in the absence of dermatomal neuralgia or skin lesions attributable to varicella zoster virus.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 1","pages":"Pages 225-230"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610457","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号