Asunto(s)
Aorta Torácica/fisiopatología , Aneurisma de la Aorta Abdominal/complicaciones , Disección Aórtica/complicaciones , Tronco Braquiocefálico/fisiopatología , Electrocardiografía , Frecuencia Cardíaca/fisiología , Enfermedad Aguda , Anciano , Disección Aórtica/diagnóstico , Disección Aórtica/cirugía , Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Abdominal/diagnóstico , Aneurisma de la Aorta Abdominal/cirugía , Tronco Braquiocefálico/diagnóstico por imagen , Angiografía por Tomografía Computarizada , Diástole , Ecocardiografía Transesofágica , Procedimientos Endovasculares/métodos , Humanos , MasculinoRESUMEN
Guillain-Barré Syndrome after cardiac surgery is very uncommon. Mechanism remains elusive although immunological reaction post surgery has been postulated. This disease can potentially increase the morbidity of the postoperative patients and generally cannot be explained by the cardiac disease or interventions. It is very much essential to diagnose the condition as appropriate management can substantially and profoundly change the course of treatment.
Asunto(s)
Rotura de la Aorta/cirugía , Insuficiencia de la Válvula Aórtica/cirugía , Síndrome de Guillain-Barré/diagnóstico , Seno Aórtico , Adulto , Rotura de la Aorta/complicaciones , Insuficiencia de la Válvula Aórtica/complicaciones , Diagnóstico Diferencial , Disnea/etiología , Síndrome de Guillain-Barré/etiología , Síndrome de Guillain-Barré/terapia , Humanos , Masculino , Intercambio Plasmático , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/terapiaRESUMEN
AIMS: To obtain information on organizational aspects, case mix and practices in Indian Intensive Care Units (ICUs). PATIENTS AND METHODS: An observational, 4-day point prevalence study was performed between 2010 and 2011 in 4209 patients from 124 ICUs. ICU and patient characteristics, and interventions were recorded for 24 h of the study day, and outcomes till 30 days after the study day. Data were analyzed for 4038 adult patients from 120 ICUs. RESULTS: On the study day, mean age, Acute Physiology and Chronic Health Evaluation (APACHE II) and sequential organ failure assessment (SOFA) scores were 54.1 ± 17.1 years, 17.4 ± 9.2 and 3.8 ± 3.6, respectively. About 46.4% patients had ≥1 organ failure. Nearly, 37% and 22.2% patients received mechanical ventilation (MV) and vasopressors or inotropes, respectively. Nearly, 12.2% patients developed an infection in the ICU. About 28.3% patients had severe sepsis or septic shock (SvSpSS) during their ICU stay. About 60.7% patients without infection received antibiotics. There were 546 deaths and 183 terminal discharges (TDs) from ICU (including left against medical advice or discharged on request), with ICU mortality 729/4038 (18.1%). In 1627 patients admitted within 24 h of the study day, the standardized mortality ratio was 0.67. The APACHE II and SOFA scores, public hospital ICUs, medical ICUs, inadequately equipped ICUs, medical admission, self-paying patient, presence of SvSpSS, acute respiratory failure or cancer, need for a fluid bolus, and MV were independent predictors of mortality. CONCLUSIONS: The high proportion of TDs and the association of public hospitals, self-paying patients, and inadequately equipped hospitals with mortality has important implications for critical care in India.