{"title":"Las decisiones médicas en condiciones de apremio","authors":"Alberto Lifshitz, Fernando Molinar Ramos","doi":"10.35366/113099","DOIUrl":"https://doi.org/10.35366/113099","url":null,"abstract":"","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135152664","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}
Mercedes del Pilar Álvarez-Goris, M. Díaz-Carrillo
RESUMEN Las cardiopatías complican 4% de los embarazos y 60% son por valvulopatías reumáticas; la más común es la estenosis mitral. Por esta razón, reportamos el caso de una puérpera en apariencia sana con embarazo normoevolutivo que debutó con falla cardiaca derecha. Se integró el diagnóstico de estenosis mitral grave por enfermedad reumática, la cual se estabilizó de manera precoz para realizar de forma externa corrección quirúrgica. Aunque en la actualidad la prevalencia de enfermedades reumáticas ha disminuido, la estenosis mitral sigue siendo la valvulopatía más común en las embarazadas y es una entidad potencialmente mortal si no se lleva el control adecuado. Palabras clave: Falla cardiaca, estenosis mitral, complicaciones del embarazo, muerte materna.
{"title":"Insuficiencia cardiaca aguda secundaria a estenosis mitral reumática durante el puerperio","authors":"Mercedes del Pilar Álvarez-Goris, M. Díaz-Carrillo","doi":"10.35366/81267","DOIUrl":"https://doi.org/10.35366/81267","url":null,"abstract":"RESUMEN Las cardiopatías complican 4% de los embarazos y 60% son por valvulopatías reumáticas; la más común es la estenosis mitral. Por esta razón, reportamos el caso de una puérpera en apariencia sana con embarazo normoevolutivo que debutó con falla cardiaca derecha. Se integró el diagnóstico de estenosis mitral grave por enfermedad reumática, la cual se estabilizó de manera precoz para realizar de forma externa corrección quirúrgica. Aunque en la actualidad la prevalencia de enfermedades reumáticas ha disminuido, la estenosis mitral sigue siendo la valvulopatía más común en las embarazadas y es una entidad potencialmente mortal si no se lleva el control adecuado. Palabras clave: Falla cardiaca, estenosis mitral, complicaciones del embarazo, muerte materna.","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123358392","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}
C. Contreras, A. Morales, J. Pérez, Víctor Manuel López Raya
SUMMARYThe incidence of Acinetobacter baumannii has increased and is associated with greater morbility. Objective: We determined the incidence of Acinetobacter baumannii isolation in critically ill transfused. Material and methods: Retrospective cohort, sequential sample from January 2016 to January 2017. We reviewed the information on the records of patients over 15 years of age, men and women, of the local transfusion registry and culture reports. The population was divided into transfused and not transfused to identify the isolation of Acinetobacter baumannii in those transfused. It was analyzed with descriptive statistics, Chi square, Pearson. Results: 415 critically ill patients, average age: 48 years, main diagnosis upon admission: non-septic, non-surgical (32.5%); most had mechanical ventilation at admission (56.4%); average hospital stay: 6.9 days; transfusion requirement: 29.4%, erythrocytes being 26%, Most of the transfusions were done between day one and four. There was an incidence of Acinetobacter baumannii isolation of 9.8%; the highest number of isolations occurred between days five and eight; they were mainly of bronchial origin. A positive correlation was identi fi ed between the isolation and the transfusion of erythrocytes by means of Pearson (p = 0.001), and with mechanical ventilatory assistance, particularly after day 15 (p = 0.0001). Conclusions: There was a correlation between the transfusion of erythrocytes and the isolation of Acinetobacter baumannii in the population studied.
{"title":"Evaluación de la incidencia de aislamiento de Acinetobacter baumannii y su relación con la transfusión de productos sanguíneos en terapia intensiva","authors":"C. Contreras, A. Morales, J. Pérez, Víctor Manuel López Raya","doi":"10.35366/81265","DOIUrl":"https://doi.org/10.35366/81265","url":null,"abstract":"SUMMARYThe incidence of Acinetobacter baumannii has increased and is associated with greater morbility. Objective: We determined the incidence of Acinetobacter baumannii isolation in critically ill transfused. Material and methods: Retrospective cohort, sequential sample from January 2016 to January 2017. We reviewed the information on the records of patients over 15 years of age, men and women, of the local transfusion registry and culture reports. The population was divided into transfused and not transfused to identify the isolation of Acinetobacter baumannii in those transfused. It was analyzed with descriptive statistics, Chi square, Pearson. Results: 415 critically ill patients, average age: 48 years, main diagnosis upon admission: non-septic, non-surgical (32.5%); most had mechanical ventilation at admission (56.4%); average hospital stay: 6.9 days; transfusion requirement: 29.4%, erythrocytes being 26%, Most of the transfusions were done between day one and four. There was an incidence of Acinetobacter baumannii isolation of 9.8%; the highest number of isolations occurred between days five and eight; they were mainly of bronchial origin. A positive correlation was identi fi ed between the isolation and the transfusion of erythrocytes by means of Pearson (p = 0.001), and with mechanical ventilatory assistance, particularly after day 15 (p = 0.0001). Conclusions: There was a correlation between the transfusion of erythrocytes and the isolation of Acinetobacter baumannii in the population studied.","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"30 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131625851","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}
Pablo Calzada Torres, Felipe de Jesús Montelongo, J. López, Aurea Carmona Domínguez
Discussão: O uso do ultrassom oferece um método alternativo de colocação do cateter sem apoio de fl uoroscopia, curvas de monitoramento ou pressões intracavitárias; e reduz as complicações. Conclusões: A colocação do cateter de Swan Ganz por ultrassom é um método alternativo e seguro, com um tempo médio de 91 segundos na sua inserção. É necessária uma amostra maior para determinar se o método é efi caz e talvez um estudo multicêntrico. Palavras-chave: Cateter de Swan Ganz, protocolo FATE, artéria pulmonar.
{"title":"Eficacia y seguridad de la técnica de colocación de catéter de arteria pulmonar guiado por ultrasonido","authors":"Pablo Calzada Torres, Felipe de Jesús Montelongo, J. López, Aurea Carmona Domínguez","doi":"10.35366/79697","DOIUrl":"https://doi.org/10.35366/79697","url":null,"abstract":"Discussão: O uso do ultrassom oferece um método alternativo de colocação do cateter sem apoio de fl uoroscopia, curvas de monitoramento ou pressões intracavitárias; e reduz as complicações. Conclusões: A colocação do cateter de Swan Ganz por ultrassom é um método alternativo e seguro, com um tempo médio de 91 segundos na sua inserção. É necessária uma amostra maior para determinar se o método é efi caz e talvez um estudo multicêntrico. Palavras-chave: Cateter de Swan Ganz, protocolo FATE, artéria pulmonar.","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126277767","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":"Asociación del índice de masa corporal con ventilación mecánica invasiva prolongada en pacientes con infección por SARS-CoV-2 en la Unidad de Cuidados Intensivos","authors":"Jonatan Estrada Pérez, Eduardo Agustín Jaramillo Solís, Nancy Verónica Alva Arroyo","doi":"10.35366/108713","DOIUrl":"https://doi.org/10.35366/108713","url":null,"abstract":"","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115627580","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}
Introduction : Traumatic brain injury (TBI) is the leading cause of death and disability in young adults around the world. The secondary lesion develops with the release of oxygen free radicals. In addition to its powerful action as a free radical scavenger, ascorbic acid stabilizes the endothelium and promotes the integrity of the blood-brain barrier (BBB). Objective : To determine the usefulness of ascorbic acid in patients with severe TBI and its impact on the length of hospital stay in the Adult Intensive Care Unit (ICU). Material and methods : Randomized clinical trial, open in the ICU of the Centro Médico Nacional del Bajío UMAE No. 1, León, Guanajuato, Mexico, from April 2020 to July 2020. 24 patients (12 experimental group and 12 controls) were admitted by probabilistic sampling with Severe TBI in people over 18 years of age. Administration of ascorbic acid one gram every six hours intravenously. Ascorbic acid administration was correlated with length of stay in ICU and hospitalization, mortality and neurological scales. Analysis of SPSS version 21 results. Results : 24 patients were included, mean ages 26 and 49 years, experimental and control group respectively (p = 0.004). Average of the Glasgow Coma Scale at the time of admission was 7 and 6.7 points respectively (p = 0.378). Stay in the ICU with 7 and 3.71 days (p = 0.001), hospital stay 12.5 and 5.85 days respectively (p = 0.001). At discharge, the Glasgow scale resulted in 3.50 and 3.57 points respectively (p = 0.630). 28-day mortality of 1 and 3 cases respectively (p = 0.59); the survival analysis reflected higher survival for the experimental group (p = 0.010). Conclusion : The use of ascorbic acid in severe TBI had a negative impact on the ICU stay, as well as the length of hospitalization. Survival analysis showed lower mortality at 28 days for the experimental group compared to the control.
{"title":"Uso de ácido ascórbico en pacientes con traumatismo craneoencefálico severo y su impacto en el tiempo de estancia en la Unidad de Cuidados Intensivos adultos","authors":"Macías Limón, H. Plata, Bravo Santibáñez","doi":"10.35366/100002","DOIUrl":"https://doi.org/10.35366/100002","url":null,"abstract":"Introduction : Traumatic brain injury (TBI) is the leading cause of death and disability in young adults around the world. The secondary lesion develops with the release of oxygen free radicals. In addition to its powerful action as a free radical scavenger, ascorbic acid stabilizes the endothelium and promotes the integrity of the blood-brain barrier (BBB). Objective : To determine the usefulness of ascorbic acid in patients with severe TBI and its impact on the length of hospital stay in the Adult Intensive Care Unit (ICU). Material and methods : Randomized clinical trial, open in the ICU of the Centro Médico Nacional del Bajío UMAE No. 1, León, Guanajuato, Mexico, from April 2020 to July 2020. 24 patients (12 experimental group and 12 controls) were admitted by probabilistic sampling with Severe TBI in people over 18 years of age. Administration of ascorbic acid one gram every six hours intravenously. Ascorbic acid administration was correlated with length of stay in ICU and hospitalization, mortality and neurological scales. Analysis of SPSS version 21 results. Results : 24 patients were included, mean ages 26 and 49 years, experimental and control group respectively (p = 0.004). Average of the Glasgow Coma Scale at the time of admission was 7 and 6.7 points respectively (p = 0.378). Stay in the ICU with 7 and 3.71 days (p = 0.001), hospital stay 12.5 and 5.85 days respectively (p = 0.001). At discharge, the Glasgow scale resulted in 3.50 and 3.57 points respectively (p = 0.630). 28-day mortality of 1 and 3 cases respectively (p = 0.59); the survival analysis reflected higher survival for the experimental group (p = 0.010). Conclusion : The use of ascorbic acid in severe TBI had a negative impact on the ICU stay, as well as the length of hospitalization. Survival analysis showed lower mortality at 28 days for the experimental group compared to the control.","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117347692","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}
Christian de Jesús Sifuentes Hernández, Nancy Trujillo Ramírez, María del Carmen Marín Romero
{"title":"Relación de la categoría tomográfica inicial y la respuesta a la ventilación mecánica en decúbito prono en pacientes en la unidad de cuidados intensivos del hospital público Hospital Regional 1° de Octubre ISSSTE","authors":"Christian de Jesús Sifuentes Hernández, Nancy Trujillo Ramírez, María del Carmen Marín Romero","doi":"10.35366/110439","DOIUrl":"https://doi.org/10.35366/110439","url":null,"abstract":"","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127281106","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":"Mortalidad previa y posterior a la implementación código infarto en un hospital de segundo nivel de atención","authors":"Jesse Álvarez Domínguez, Daniel Pacheco Ambriz","doi":"10.35366/104473","DOIUrl":"https://doi.org/10.35366/104473","url":null,"abstract":"","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123587237","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}
Héctor Alejandro Ramírez García, Juana María Cerda Arteaga, Carlos Eduardo Chávez Pérez, Víctor Manuel Sánchez Nava
{"title":"Sedación con sistema AnaConDa en pacientes COVID-19 crítico y su impacto en días de ventilación mecánica","authors":"Héctor Alejandro Ramírez García, Juana María Cerda Arteaga, Carlos Eduardo Chávez Pérez, Víctor Manuel Sánchez Nava","doi":"10.35366/105378","DOIUrl":"https://doi.org/10.35366/105378","url":null,"abstract":"","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125539858","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}
Paul Palacios Moguel, Andrés Domínguez Borgua, G. Camarena Alejo, Janet Silvia Aguirre Sánchez, Juvenal Franco Granillo
{"title":"Índice de fuga capilar como una nueva herramienta pronóstica en el choque séptico","authors":"Paul Palacios Moguel, Andrés Domínguez Borgua, G. Camarena Alejo, Janet Silvia Aguirre Sánchez, Juvenal Franco Granillo","doi":"10.35366/81260","DOIUrl":"https://doi.org/10.35366/81260","url":null,"abstract":"","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122770344","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}
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