Medicina intensiva
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Case Reports
[Cardiac arrest due to accidental hypothermia and prolonged cardiopulmonary resuscitation].
In cardiac arrest produced by accidental hypothermia, cardiopulmonary resuscitation must be prolonged until normal body temperature is achieved. There are different rewarming methods. In theory, the more invasive ones are elective in patients with cardiac arrest because of their higher rewarming speed. ⋯ This is the longest successful cardiopulmonary resuscitation known up-to-date in Spain. In order to rewarm the body, a combination of non-invasive methods was used: active external rewarming with convective warm air, gastric and bladder lavage with warm saline solution and intravenous warm saline infusion. This case shows that it is possible to treat hypothermic cardiac arrest successfully through these rewarming methods, which are both easy to apply and feasible in any hospital.
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Invasive aspergillosis is a common condition in patients with hematologic malignancies. Symptoms are extremely non-specific, and therefore it is necessary to be familiar with the diagnostic tests for early diagnosis. This review has attempted to clarify the current evidence regarding the following areas: clinical presentation, methods of study and treatment of this condition in hemato-oncological critical patients.
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Randomized Controlled Trial Comparative Study
[Spontaneous breathing trial in chronic obstructive pulmonary disease: continuous positive airway pressure (CPAP) versus T-piece].
To determine if the spontaneous breathing trial (SBT) with continuous positive airway pressure (CPAP) is superior to SBT with a T-piece in patients with Chronic Obstructive Pulmonary Disease (COPD). ⋯ In a COPD patient cohort, the performance of spontaneous breathing with CPAP showed a tendency to better outcome than with T-Piece, however, further research is needed.
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Multicenter Study
[Epidemiology of the primary and vascular catheter-related bacteriemias in critical patients admitted to an Intensive Medicine Department].
In recent years, changes have occurred in the setting of bacteriemia related with the use of vascular catheters (BVC) and with the appearance of multiresistant gram positive cocci (MR-GPC), knowledge of the limitations regarding the antibiotics used most for their treatment (glycopeptides) and the appearance of new antibiotics active against these pathogens. This article analyzes the evolution of the rates, etiologies and markers of multiresistance of the most common pathogens in the BVC (including the primary bacteriemias) in the Spanish Intensive Medicine Departments (ICU). ⋯ The empirical treatment in situations of extreme seriousness should consider coverage of the most frequent pathogens such as the MR-GPC and GNB and in special conditions, the fungi.