RESUMEN
BACKGROUND: The development of new-onset atrial fibrillation in sepsis has been associated with adverse outcomes. METHODS: A systematic literature search was conducted to retrieve articles that investigated the association of new-onset atrial fibrillation in patients diagnosed with sepsis. The primary outcome of interest was the pooled risk ratio (RR) of in-hospital mortality in patients with new-onset atrial fibrillation and sepsis. RESULTS: Six studies included 3100 patients with new-onset atrial fibrillation in sepsis and 36,900 patients without new-onset atrial fibrillation in sepsis. The pooled RR for in-hospital mortality was 1.45 (95 % CI 1.32-1.60, p < 0.00001, I (2 = )24 %). New-onset atrial fibrillation was also associated with increased ICU mortality, ICU and in-hospital length of stay and stroke. New-onset atrial fibrillation occurred more in the elderly, those with a prior history of cardiovascular and respiratory disease, and those with increased severity of illness. CONCLUSION: Prospective randomised trials are needed to clarify the significance of new-onset atrial fibrillation in sepsis, optimal treatment strategies for these patients, and the benefit of systemic anticoagulation. Physicians should be aware that new-onset atrial fibrillation in sepsis is not merely an observed temporary arrhythmia but a marker of poor prognosis and should be managed accordingly.
Asunto(s)
Medios de Contraste/administración & dosificación , Medios de Contraste/efectos adversos , Angiografía Coronaria , Reestenosis Coronaria/diagnóstico por imagen , Desensibilización Inmunológica/métodos , Hipersensibilidad a las Drogas/prevención & control , Ácidos Triyodobenzoicos/administración & dosificación , Administración Intravenosa , Anciano de 80 o más Años , Angiografía Coronaria/efectos adversos , Reestenosis Coronaria/terapia , Esquema de Medicación , Hipersensibilidad a las Drogas/diagnóstico , Hipersensibilidad a las Drogas/etiología , Hipersensibilidad a las Drogas/inmunología , Femenino , Humanos , Factores de Tiempo , Resultado del TratamientoRESUMEN
Pulmonary sequestration is described as a dysplastic mass of lung tissue that lacks communication with the tracheobronchial tree and receives systemic rather than pulmonary arterial blood supply. Two distinct classifications, intralobar and extralobar, have been described. The present article discusses the etiology, clinical and radiographic features of pulmonary sequestration as well as the management of this condition when it is discovered incidentally.