Clinical Practice Guidelines for Early Weaning from Mechanical Ventilation.

Clinical Practice Guidelines for Early Weaning from Mechanical Ventilation. Weaning is the process, gradual or rapid, that leads to the turn off of mechanical ventilation and allows restoring spontaneous ventilation. The guidelines describe the procedure for rapid weaning from mechanical ventilation and emphasizes on spontaneous ventilation test. It includes assessment guidelines focused on the most important aspects to be accomplished

Cardiovascular Complications in a Patient with COVID-19. A Case Report

Sars-Cov-2, is a virus belonging to the coronaviridae family, responsible for the pandemic that has been plaguing the world since December 2019, which produces the infectious disease called COVID-19. This disease is expressed in more than half of the cases in a mild and even asymptomatic way, however, in a non-negligible number of patients it manifests itself in its most severe form, with multiple complications, and can even cause death. Along with respiratory complications, cardiovascular complications are present mainly in those patients who require admission to intensive care units, which make medical management difficult, as well as entail a worse prognosis. The case of a 70-years-old patient with a history of apparent health, who was admitted with respiratory symptoms and who, after performing the polymerase chain reaction technique with reverse transcriptase in real time, was positive for the Sars-Cov virus. -2, it was decided to transfer him to the Playa Girón Heroes Specialized Ambulatory Center, where he was hospitalized in the Intensive Care Unit for 6 days and died mainly as a result of cardiovascular complications is presented. The aim of this research is to present the case of a patient who suffered from respiratory symptoms as an initial presentation of the infection, for which a real-time polymerase chain reaction was performed, which was positive for SARS-CoV- 2

Infección hospitalaria en la Unidad de Cuidados Intensivos Polivalente de un hospital universitario cubano Hospital infection at the Polyvalent Intensive Care Unit of a Cuban university hospital

Se realizó un estudio retrospectivo, descriptivo a 212 pacientes con infección hospitalaria. Se revisaron actas y reportes estadísticos para obtener indicadores como: tasas de infección hospitalaria, tipos de infección hospitalaria, fallecidos y microorganismos aislados. El riesgo de infección de algunos procederes se expresó en tasas de incidencia acumulada por 100 pacientes y densidad de incidencia x 1 000 d del proceder. La tasa de infección hospitalaria promedio fue de 7,9 %. Se reportaron 247 infecciones hospitalarias, mostrando mayor incidencia la respiratoria con predominio en pacientes que recibieron ventilación mecánica. Este proceder presentó las mayores tasas de riesgo. Acinetobacter baumannii multirresistente y estafilococos predominaron en los 244 aislamientos. De los pacientes reportados, 28,3 % falleció asociado a infecciones hospitalarias y 6,7 %, por este motivo. La infección hospitalaria en esta unidad ha mantenido tasas generales aceptables con predominio de la infección respiratoria en pacientes sometidos a ventilación mecánica y la infección intravascular en pacientes con catéteres intravenosos insertados, procederes con alto riesgo demostrado. La presencia de Acinetobacter baumanni y estafilocococos como microorganismos más aislados demanda un mayor control y estrategias de prevención. El conocimiento del comportamiento de los indicadores del CPCIH constituye una herramienta de trabajo útil para desencadenar la toma de decisiones necesarias y mejorar continuamente la calidad del trabajo.Summary A retrospective descriptive study of 212 patients with hospital infection was undertaken. Acts and statistical reports were reviewed to obtain indicators such as hospital infection rates, types of hospital infections, deceased individuals and isolated microorganisms. The infection risk of some procedures was expressed by accumulated incidence rate per 100 patients and incidence density x 1 000 d of the procedure. The average hospital infection was 7.9 %. 247 hospital infections were reported. The respiratory infection showed the highest incidence with predominance in patients that receive mechanical ventilation. This procedure presented the greatest risk rates. Multiresistant Acinetobacter baumannii and staphylococcus prevailed in the 244 isolates. Of the reported patients, 28.3 % died associated with hospital infections and 6.7 for this reason. Hospital infection in this unit has maintained acceptable general rates with predominance of the respiratory infection in patients undergoing mechanical ventilation and of intravascular infection in patients with inserted intravenous catheters, procedures with a high risk proved. The presence of Acinetobacter baumanni and staphylococcus as the most isolated microorganisms demand a better control and prevention strategies. The knowledge of the behavior of the CPCIH indicators is a useful working tool to trigger the making of necessary decisions and to continuously improve the quality of work

Clinical Practice Guidelines for Exogenous Poisoning.

Clinical Practice Guidelines for Exogenous Poisoning. Medical emergencies determined by the exposure to different substances (drugs, medicines, physical or chemical corrosive agents, etc). It includes the classification of toxic substances, clinical diagnosis (main syndromes), and description of therapeutic variations (vital support, antidotes, absorption measurements and increase of elimination and depuration of the toxic substance). It includes assessment guidelines focused on the most important aspects to be accomplished

Clinical Practice Guidelines for Exogenous Poisoning.

Clinical Practice Guidelines for Exogenous Poisoning. Medical emergencies determined by the exposure to different substances (drugs, medicines, physical or chemical corrosive agents, etc). It includes the classification of toxic substances, clinical diagnosis (main syndromes), and description of therapeutic variations (vital support, antidotes, absorption measurements and increase of elimination and depuration of the toxic substance). It includes assessment guidelines focused on the most important aspects to be accomplished

Clinical Practice Guidelines for Acute Renal Failure.

Clinical Practice Guidelines for Acute Renal Failure. It a syndrome characterized by the abrupt deterioration of basal renal functions (abrupt reduction of glomerular filtration) and the consequent increase of nitrogenous products in the blood as well as the homeostasis of the body. It aetiological agents, clinical presentation, therapeutic and diagnostic methods are described. It includes assessment guidelines focused on the most important aspects to be accomplished.</span

Clinical Practice Guidelines for Ventilation Associated Pneumonia.

Clinical Practice Guidelines for Ventilation Associated Pneumonia. Conceptualized as the bacterial pneumonia that develops in patients receiving mechanical ventilation for more than 48 hours, which is not present at the beginning of the ventilation. We review the concept, prevention and treatment. It includes assessment guidelines focused on the most important aspects to be accomplished

Infarto agudo de miocardio. Guía de práctica clínica

La elaboración de esta Guía de Práctica Clínica se justifica, en primer lugar, por la elevada frecuencia de presentación y mortalidad del infarto agudo del miocardio en la población general. Las enfermedades cardiovasculares constituyen en la actualidad la principal causa de muerte en los países industrializados, y se espera que también lo sean en los países en vías de desarrollo en el año 2020.  La presente guía se refiere a los pacientes que presentan síntomas isquémicos o sus equivalentes, y una elevación persistente del segmento ST en el electrocardiograma, o cambios del electrocardiograma de infradesnivel del ST o de la onda T, compatibles con el diagnóstico de IAM sin elevación del ST. Esta Guía no aborda los elementos relacionados directamente con los procedimientos de intervencionismo coronario percutáneo ni la revascularización miocárdica quirúrgica.</p