RESUMEN
Plasmapheresis is an extracorporeal technique that eliminates macromolecules involved in pathological processes from plasma. A review is made of the technical aspects, main indications in critical care and potential complications of plasmapheresis, as well as of other extracorporeal filtration techniques such as endotoxin-removal columns and other devices designed to eliminate cytokines or modulate the inflammatory immune response in critical patients.
Asunto(s)
Cuidados Críticos/métodos , Hemoperfusión , Plasmaféresis , Humanos , Plasmaféresis/efectos adversosRESUMEN
The clinical use of human tissues is a therapeutic reality in many diseases, observing a spectacular increase in their demand in recent years. This has also generated an increase in the demand for donors which, in regarding to obtaining tissues, is not limited to brain death donors. Consequently, tissues obtained from cardiorespiratory arrest donors must be promoted in our hospitals. With this purpose, we present our experience in the last five years and the mechanisms we used to reach these goals. During this period, an awareness and health care staff information campaign was carried out in the Emergency and Hemodynamic areas. The next step will be to extend this campaign to the rest of the hospital staff. We believe that the mechanisms needed to obtain hospital staff collaboration in the detection of multi-tissue donors is to offer updated information on the indications and therapeutic advantages of clinical use of human tissues, favoring hospital awareness on this subject and therefore the detection of potential donors.
Asunto(s)
Donantes de Tejidos , Obtención de Tejidos y Órganos , Adulto , Anciano , Humanos , Persona de Mediana Edad , Obtención de Tejidos y Órganos/métodos , Obtención de Tejidos y Órganos/normas , Adulto JovenAsunto(s)
Muerte , Trasplante de Hígado , Donantes de Tejidos , Recolección de Tejidos y Órganos/métodos , Obtención de Tejidos y Órganos , Isquemia Encefálica/complicaciones , Carcinoma Hepatocelular/cirugía , Hemorragia Cerebral/complicaciones , Femenino , Glucosa , Paro Cardíaco/diagnóstico , Paro Cardíaco/etiología , Humanos , Cirrosis Hepática Alcohólica/cirugía , Neoplasias Hepáticas/cirugía , Masculino , Manitol , Persona de Mediana Edad , Preservación de Órganos/métodos , Soluciones Preservantes de Órganos , Cloruro de Potasio , Guías de Práctica Clínica como Asunto , Procaína , Donantes de Tejidos/provisión & distribución , Obtención de Tejidos y Órganos/normas , Resultado del TratamientoRESUMEN
Pulmonary hypertension is a severe disease with complex treatment based on general measurements, anticoagulation and use of specific vasodilator drugs. Right heart failure initiated in final stages of the disease is treated with diuretics. We present the case of slow continuous ultrafilitration as treatment in right heart failure secondary to pulmonary hypertension associated to collagen disease refractory to diuretic treatment.
Asunto(s)
Síndrome CREST/complicaciones , Hemofiltración , Hipertensión Pulmonar/terapia , Enfermedad Cardiopulmonar/terapia , Femenino , Hemofiltración/métodos , Humanos , Hipertensión Pulmonar/etiología , Persona de Mediana Edad , Enfermedad Cardiopulmonar/etiología , Factores de TiempoRESUMEN
We discuss the plasmapheresis (PE) carried out in an 18-bed polyvalent intensive care unit between the years 2003-2007. This article aims to report our experience in plasmapheresis performed with specific monitors for continuous renal replacement therapy (CRRT) that shows the versatility of the use of these procedures in intensive care. The utility of these procedures include many different critical disease settings in our units (neurology, hematology, and rheumatology patients). In short, our experience in PE has led us to the conclusion that plasmapheresis is a simple extracorporeal depuration treatment that can be performed by staff trained in intensive care at any moment within a wide spectrum of clinical indications, with CRRT monitors and with minimum adverse effects.
Asunto(s)
Cuidados Críticos/métodos , Plasmaféresis/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades Autoinmunes/terapia , Femenino , Síndrome Hemolítico-Urémico/terapia , Hospitales Universitarios/estadística & datos numéricos , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Pancreatitis/terapia , Púrpura Trombocitopénica Trombótica/terapia , Terapia de Reemplazo Renal/instrumentación , Estudios Retrospectivos , España , Resultado del Tratamiento , Vasculitis/terapia , Adulto JovenRESUMEN
Organ transplant constitutes one of the most encouraging advances in the history of the medicine. The organ transplants that were a distant challenge in the seventies currently are a routine procedure in the medical practice that has contributed to extending survival and quality of life in the general population. Spain has reached the highest rate for donation and transplants per one million inhabitants worldwide, this extraordinary health care work being a combined achievement of Spanish Health Care System. The objective of this article is to review the indications of solid organ transplants and their long-term outcomes, evaluating the impact on the health-related quality of life in solid organ transplant recipients.