Medicina intensiva
-
Many vasopressants have been studied in cardiopulmonary resuscitation (CPR) to increase cerebral and coronary perfusion. Although there is a debate on the utility of epinephrine, this is the one that has been used historically, above all after verifying that other agents such as norepinephrine, metoxamine or phenylephrine, have not been shown to be more effective. Currently, due to the good experimental results, the use of vasopressin (ADH) in CPR is being evaluated. ⋯ Once these are reviewed, it can be concluded: The results of the three randomized studies in humans obtain different results regarding the utility of ADH in cardiorespiratory arrest (CRA) secondary to ventricular fibrillation, electro-mechanical dissociation or asystole. More prospective studies are needed to know the role of ADH in prolonged CRA and in asystole, that may be the subgroups that can benefit the most from this drug. The neurological repercussion of a drug in the context of CRA should be evaluated before its inclusion in the CPR guides.
-
Comparative Study
[Epidemiology, initial management and analysis of morbidity-mortality of severe burn patient].
Describe the epidemiological characteristics of severe burn patients and analyze the factors related with morbidity-mortality. ⋯ Mortality of these patients is very high and is conditioned largely by initial care. Percentage of burned body surface (BBS) and kidney failure entails greater mortality in our series.
-
Comparative Study
[Sedoanalgesia with remifentanil in definitive pacemaker implant].
Describe the use of remifentanil in definitive pacemaker implant. ⋯ Remifentanil is useful in the implant of DPM as a sedoanalgesia method. Serious undesired effects are rare. Future studies are necessary to completely establish its effectiveness and safety in these types of procedures.
-
Practice Guideline
[Monitoring pain: recommendations of the Analgesia and Sedation Work Group of SEMICYUC].
In critically ill patients, pain is frequently underestimated and so insufficiently managed. Psychological, haemodynamic and neuroendocrine responses, secondary to untreated pain, could produce morbidity and even increases in patient mortality. All members of the intensive care team must have abilities to assess and to manage pain. ⋯ Adequate and regular patient assessment leads to improved pain control. Scores higher than 3 points should not be permitted. A pain-free Intensive Care Unit should be a quality standard healthcare aim.
-
Letter Case Reports
[Meningococcal sepsis associated to ST segment and cardiac enzymes elevation].