Medicina intensiva
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Multicenter Study Comparative Study
[Characteristics and evolution of cardiopulmonary arrest in children in Spain: comparison between autonomous communities].
In Spain there are many differences between autonomous regions in terms of geography, population distribution and health care organisation. We do not know if these differences could have influenced the characteristics and evolution of cardiopulmonary arrest in children. ⋯ There are no important differences in the characteristics of pediatric cardiopulmonary arrest, resuscitation, evolution and survival between the autonomous regions in Spain. Additional studies are needed to analyze the hypothetical influence of health care organization and life support training on survival.
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It is considered that in Spain, every year, we have more than 24,500 out-of-hospital cardiac arrests. Around 85% of these are secondary to ventricular fibrillation, with possibility of reversion in more than 90% if defibrillation is performed in the first minute of arrhythmia. However, if we delay this defibrillation, survival possibilities disappear in a few minutes. ⋯ Thus, their introduction should be preceded by a cost-effectiveness study. Effectiveness of automated defibrillators at home, where up to 80% of cardiac arrest are produced, has still not been evaluated. Nevertheless, in the USA, its marketing with this indication has been authorized.
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Severe sepsis is a complex syndrome to define, diagnose and treat. This population-based study describes the epidemiology of sepsis in the Region of Madrid, estimates its incidence and mortality, and assesses its impact on hospital stays and costs. ⋯ Severe sepsis is a frequent process, with a high mortality and a significant impact on health care resource utilization.
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Acute respiratory distress syndrome (ARDS) is defined according to the criteria of the 1994 consensus conference. These criteria aim to
. ⋯ These studies have been basically done in experimental animals, but also by the description of the pulmonary biopsy findings and post-mortem study findings. The present article aims to show discrepancy between clinical and histological diagnosis of the acute pulmonary lesion, basically having an effect on the difficulty of the ARDS diagnosis when its origin is pulmonary and the implications of this discrepancy in the clinical practice and research. -
The pathology related with the altitude is a common entity above 3000 m. It includes mild symptoms to severe illness such as cerebral or pulmonary edema. ⋯ Recognition is made mainly through symptoms. Adequate treatment of these patients allows for rapid resolution of the symptoms and improves outcome.