Revista médica de Chile
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Revista médica de Chile · Mar 2011
Review[Vasoplegic syndrome and its treatment with vasopressin during cardiac surgery with cardiopulmonary bypass].
Cardiac surgery with cardiopulmonary bypass is associated with systemic inflammatory response. In some cases this clinical condition is characterized by severe hypotension due to low systemic vascular resistance during and after cardiopulmonary bypass. A few of these cases do not respond to volume or catecholamines. ⋯ Supplementary vasopressin improves blood pressure and might be considered as an alternative treatment. Several reports have shown benefits when used alone or in combination with catecholamines. However, further studies are necessary to find the most appropriate use of the drug for vasoplegic syndrome.
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Revista médica de Chile · Mar 2011
Review[Mechanical ventilation in patients with acute brain injury].
In about 20% of patients admitted to an Intensive Care Unit (ICU) the indication of mechanical ventilation (MV) is a neurological disease. These patients have a prolonged MV stay and high mortality. The appropriate use of MV in patients with acute brain injury (ABI) is critical considering that MV by itself is able to induce or worsen an underlying lung injury. ⋯ Its use should be limited to the emergency management of intracranial hypertension, while the underlying cause is being treated. Non-conventional ventilatory modes as prone position ventilation, high-frequency oscillatory ventilation and extracorporeal C02 removal can be used in patients with ABI. All of them have specific risks and should be employed cautiously This paper reviews upper airway management and MV in patients with acute brain injury.