Medicina intensiva
-
Observational Study
[Epidemiological profile of late mortality in severe polytraumatisms].
A study is made of the epidemiology, chronogramand causes of late mortality in traumatized patients. ⋯ Age, severity and type of injuries have an influence upon the time distribution and causality of late mortality. Brain death remains predominant, with multiorgan failure as the most frequent cause. This knowledge should contribute to the identification of problems, and to better organization of the structural and educational resources, thereby reducing the likely factors leading to death from trauma.
-
The third edition of the Surviving Sepsis Campaign guidelines opens the door to the use of albumin for fluid resuscitation in patients with severe sepsis and septic shock. This recommendation is based on a recent meta-analysis that included studies with evidence of insufficient plasma expansion in the control group and studies performed in children with malaria with clear statistical heterogeneity (P for interaction=.02). ⋯ Two new randomized studies reported after publication of the meta-analysis found no benefit in patients treated with albumin. Given the uncertainty about the true effect of albumin (due to the existence of indirectness and imprecision) and its cost considerations, it is suggested not to use albumin in the initial resuscitation of patients with severe sepsis and septic shock (GRADE2C).
-
Lung transplant recipients are at high risk of suffering many complications during the immediate postoperative period, such as primary graft dysfunction, acute graft rejection or infection. The most common symptom is the presence of acute respiratory failure, and the use of biomarkers could be useful for establishing an early diagnosis of these conditions. Different biomarkers have been studied, but none have proven to be the gold standard in the differential diagnosis of acute respiratory failure. This paper offers a review of the different biomarkers that have been studied in this field.