Factores asociados con mortalidad de pacientes afectos de Meningitis Bacteriana Adquirida en la Comunidad

Introducción: La meningitis bacteriana es responsable de un elevada morbimortalidad en todo el mundo. Es una emergencia neurológica y su manejo rápido es crucial. El objetivo del estudio es la búsqueda de factores de riesgo asociados con mortalidad en los pacientes afectos de meningitis bacteriana comunitaria. Pacientes y Métodos: estudio retrospectivo de pacientes con meningitis bacteriana comunitaria ingresados en el departamento de medicina intensiva de un hospital de III nivel. Resultados: Fueron 36 los pacientes incluidos. Fallecieron 6. Las medianas de edad y de APACHE II  fueron 59 años y  19 respectivamente.  En el análisis estadístico se objetivó que el shock séptico estaba presente en el 7.69% en los pacientes que sobrevivieron, mientras que en el grupo de los fallecidos fue de un 60% ( OR 18, p= 0.025).  Conclusiones: El shock es un factor asociado a mal pronóstico en pacientes afectos de meningitis bacteriana comunitaria Palabras clave: menigitis bacteriana comunitaria DOI: http://dx.doi.org/10.17268/rmt.2021.v16i02.0

Decisions of refusal Intensive Care Units' admission as a measure of limitation of life support treatments: geographical variability in Spain

From a post hoc analysis of the ADENI-UCI study (multicenter, observational, cohort, prospective study, with a follow-up period of 13 months, in 62 Intensive Medicine Services in Spain. geographical differences in the reason for denial of income in UCI as a LTSV measure are analyzed. A total of 2284 with an average age of 75.25 (12.45) years were included. 59.43% male. By means of multinominal regression adjusted by age, sex, APACHE and SOFA, was evident (by choosing the northern for reference) that age in the south was a less significantly exposed reason (OR: 0.48 (IC95%: 0.35-0.65). p

An intensive lung donor treatment protocol does not have negative influence on other grafts: a multicentre study.

Competing requirements for organ perfusion may call for antagonistic strategies such as fluid replacement or high positive end-expiratory pressure. We recently proposed an intensive lung donor treatment protocol that nearly tripled lung procurement rates and validated it in a multicentre study. The next step was to evaluate the impact of our proposal on the other organ grafts recovered from lung donors and on the recipients' outcome after transplantation of those grafts. A quasi-experimental study was conducted in six Spanish hospitals during 2013 (2010-12 was historical control). Organ donor management was led by a trained and experienced intensive care staff. A total of 618 actual donors after brain death (DBDs) were included, 453 DBDs in the control period (annual average 151) and 165 in the protocol period. No baseline differences were found between the periods. Heart, liver, kidney and pancreas retrieval rates were similar in both periods, and heart, liver, kidney and pancreas recipients' survival at 3 months showed no differences between both periods. Our lung donor treatment protocol is safe for other grafts obtained from donors undergoing these procedures with the aim of increasing lungs available for transplantation. It has no negative impact on the recovery rates of other grafts or on early survival of heart, liver, pancreas or kidney recipients