Movilización Temprana Como Prevención Y Tratamiento Para La Debilidad Adquirida En La Unidad De Cuidados Intensivos En Pacientes En Ventilación Mecánica. Experiencia En Un Hospital De Segundo Nivel

Introduction: The weakness acquired in the UCI is a condition that appears often in the critical patient, causing deficiencies in their physical and functional state. The early mobilization has proved to be safe and feasible demonstrating an improvement in the muscular strength and functionality of the patient during his stay in the ICU. Objectives: To describe the benefit of early mobilization in relation to muscle strength and functionality of critical patients upon discharge from the ICU. Material and methods: A retrospective, observational and descriptive study was conducted in the period from June to December of 2017, with a convenience sample of patients admitted to the ICU who were under mechanical ventilation and sedation, registration was obtained in the clinical files of muscle strength, functionality and mobility after the withdrawal of sedation and previous discharge of the patient, and the changes found were recorded. Results: A sample of 8 patients was obtained, of which 25% of the patients met the criterion of weakness acquired in the ICU, in the IB it was observed that 100% of the patients obtained a severe dependency with a score between 21 -60 points and the IMS showed that 100% of the patients performed mobilization out of bed with or without assistance. A statistically significant difference was obtained with the Wilcoxon test: MRC (p = 0.012) and IB (p = 0.012). Conclusion: An early mobilization intervention favors the partial recovery of the complications of the stay in the ICU

Adverse Effects Associated with the First Dose of the Pfizer–BioNTech COVID-19 Vaccine in Healthcare Workers from Mexico: A Case Serie from Passive Surveillance

Almost a year after the declaration of the pandemic due to the SARS-CoV-2 virus which causes the COVID-19 disease and the need to contain the progression and treatment, the promising option was designing an effective and safe vaccine to reach a state of massive immunity. The first vaccine approved was the one produced by Pfizer–BioNTech, and its application started in December 2020. Within days of the first applications, 0.2% of adverse events were reported. Herein, a series of 26 cases with the manifestation of adverse events related to the application of the first dose of the BNT162b2 vaccine from Pfizer–BioNTech in healthcare workers from Mexico. Of these cases, only five patients were classified with a certainty of anaphylaxis; two of them presented seizures, and their management is described individually. After the examination of all the cases, the symptoms were resolved. In Mexico and around the globe, the vaccination process continues, and the report of possible AEFIs is still needed to contribute to the pharmacovigilance of this new vaccine and improve its safety profile

Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study

Purpose In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. Conclusions HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes