Revista médica de Chile
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Revista médica de Chile · Sep 2022
Review[Intravenous sodium bicarbonate. When, how and why to use it?].
Severe metabolic acidosis is defined by a pH < 7.2 with HCO3- < 8 mE- q/L in plasma. Its best treatment is to correct the underlying cause. However, acidemia produces multiple complications such as resistance to the action of catecholamines, pulmonary vasoconstriction, impaired cardiovascular function, hyperkalemia, immunological dysregulation, respiratory muscle fatigue, neurological impairment, cellular dysfunction, and finally, it contributes to multisystemic failure. ⋯ However, the calculations are only for reference. More important is to start intravenous NaHCO3 when needed, administer it judiciously, manage its side effects, and continue it to a safe goal. In this review we address all the necessary elements to consider in the administration of intravenous NaHCO3, highlighting why it is the best buffer for the management of severe metabolic acidosis.
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Despite recent initiatives and efforts, gender inequality still exists in medicine and academia. There is a higher proportion of male authors in international scientific publications. ⋯ There are fewer female authors in scientific publications. Chile is one of the countries with a high rate of gender gap in the world. The underrepresentation of women in academia is an example of this.
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Revista médica de Chile · Sep 2022
Review[Challenges for training medical professionalism values in times of COVID-19 and social crisis].
The essence of professional education not only involves transmitting knowledge, but also values and attitudes for a practice that allows us to face changing global and national scenarios. Physicians are currently facing new challenges derived from the impacts of the pandemic as well as the social crisis. Increased workload, limited access to health systems, economic uncertainty, and increased public scrutiny hamper physicians to fulfill their responsibilities to patients and society. ⋯ Medical professionalism acts as a stabilizing and morally protective social force. Thus, it is critical to fathom essential values of professionalism that characterize medical practice today. Indeed, the explicit incorporation of these values in undergraduate and postgraduate programs will undoubtedly allow the training of better professionals for the practice of medicine. (Rev Med Chile 2022; 150: 1248-1255).