ABSTRACT
OBJECTIVE: To assess the effectiveness and safety of a topical silicone gel (BE + Gel reductor y reparador de cicatrices) and a polyurethane dressing (BE + Apósito reductor y reparador de cicatrices) on the evolution of scars of patients who were previously recruited in the emergency care unit while seeking wound care. METHOD: A single center, stratified observational, open label study was performed in the emergency care unit of Donostia Universitary Hospital (recruitment) and in the Biodonostia Health Research Institute (intervention). Scars located in unexposed body areas with the dressing, and scars located in exposed areas with either the gel or the dressing. Investigators assessed interventions at day 1 and on weeks 4, 8 and 12. Vancouver Scar Scale (VSS) and a photographical assessment were used to determine the scars evolution, and the subjective perception of the scar was evaluated by means of a questionnaire administered to the patients. RESULTS: Patients whose scars were treated with the silicone gel had an average initial VSS score of 5.4 ± 2.08. This value was reduced to 0.86 ± 1.17 after 90 days of treatment. Patients treated with the polyurethane dressing had an average initial VSS score of 5.8 ± 2.29. After 90 days of treatment, this average score was reduced to 0.33 ± 0.66. Positive evolution of scars was also supported by photographs and by a patient questionnaire. CONCLUSIONS: Both treatments appear to be safe and effective, objectively, and subjectively, in the context of scar evolution.
Subject(s)
Humans , Female , Adult , Heart Transplantation/instrumentation , Heart Transplantation/methods , Antibodies , Tissue DonorsABSTRACT
No disponible
Subject(s)
Humans , Emergency Treatment/trends , Respiration, Artificial/nursing , Critical Care , Physician-Nurse Relations , Advanced Cardiac Life SupportABSTRACT
La administración de fluidos para la reanimación del paciente grave en las unidades de cuidados intensivos es una de las intervenciones más frecuentes y hasta en un 40% de las ocasiones es el equipo de enfermería el que toma la decisión de administrar un bolo de fluido a un paciente crítico según protocolos establecidos, por lo que en el presente trabajo se realiza una revisión del estado actual de la fluidoterapia y su empleo en este tipo de pacientes. Asimismo, para optimizar los conocimientos y el tratamiento administrado a este tipo de pacientes, se describen los distintos tipos de fluidos existentes y los posibles efectos adversos que se puedan desarrollar derivados de su administración
The administration of fluids for the resuscitation of the seriously ill patient in intensive care units is one of the most frequent interventions. Up to 40% of the time it is the nursing team that makes the decision to administer a fluid bolus to a critically ill patient according to established protocols. Therefore we perform a review in this paper of the current status of fluid therapy and its use in this type of patient. In order to optimize the knowledge and the treatment administered to this type of patient, we also describe the different types of fluids currently used and possible adverse effects that may develop after their administration
Subject(s)
Humans , Critical Care Nursing , Fluid Therapy/methods , Critical Care , Critical Illness/nursing , Intensive Care Units , Hydrologic Balance/methods , Crystalloid Solutions/administration & dosage , Colloids/administration & dosageABSTRACT
No disponible
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Humans , Male , Middle Aged , Diabetic Ketoacidosis/therapy , Treatment Outcome , Hemofiltration , Fluid TherapyABSTRACT
No disponible
Subject(s)
Humans , History, 16th Century , History, 18th Century , History, 19th Century , History, 20th Century , History, 21st Century , Fluid Therapy/history , Resuscitation/history , Saline Solution/history , Fluid Therapy/methods , Resuscitation/methods , Saline Solution/therapeutic use , United StatesSubject(s)
Fluid Therapy/history , Resuscitation/history , Saline Solution/history , Cholera/history , Cholera/therapy , Europe , Fluid Therapy/methods , History, 16th Century , History, 18th Century , History, 19th Century , History, 20th Century , History, 21st Century , Humans , Resuscitation/methods , Saline Solution/therapeutic use , United StatesABSTRACT
The administration of fluids for the resuscitation of the seriously ill patient in intensive care units is one of the most frequent interventions. Up to 40% of the time it is the nursing team that makes the decision to administer a fluid bolus to a critically ill patient according to established protocols. Therefore we perform a review in this paper of the current status of fluid therapy and its use in this type of patient. In order to optimize the knowledge and the treatment administered to this type of patient, we also describe the different types of fluids currently used and possible adverse effects that may develop after their administration.
Subject(s)
Critical Illness/therapy , Fluid Therapy , Resuscitation , HumansSubject(s)
Blood Glucose/analysis , Diabetic Ketoacidosis/blood , Combined Modality Therapy , Continuous Renal Replacement Therapy , Diabetes Mellitus, Type 1/blood , Diabetes Mellitus, Type 1/drug therapy , Diabetes Mellitus, Type 1/genetics , Diabetic Ketoacidosis/chemically induced , Diabetic Ketoacidosis/drug therapy , Emergencies , Fluid Therapy , Humans , Insulin/therapeutic use , Male , Middle Aged , Respiration, Artificial , Sodium Bicarbonate/therapeutic use , Sodium-Glucose Transporter 2 Inhibitors/adverse effects , Sodium-Glucose Transporter 2 Inhibitors/therapeutic useABSTRACT
El síndrome de Wünderlich, o hematoma retroperitoneal espontáneo, secundario a una rotura espontánea de la vena iliaca es una entidad clínica poco común que constituye una urgencia médica. No está claro el desencadenante en muchos casos, proponiéndose diferentes hipótesis etiológicas relacionadas con factores hormonales, inflamatorios y/o mecánicos; y en este punto, puede ser importante valorar la existencia de un factor que desencadene la trombosis venosa profunda y que, secundariamente, se genere la rotura de la vena iliaca y el hematoma retroperitoneal. Presentamos un caso clínico donde la trombosis venosa pudo ser la causa de la rotura de la vena iliaca y realizamos una discusión del tema con base en la literatura médica encontrada
Wünderlich syndrome, or spontaneous retroperitoneal hematoma, secondary to spontaneous rupture of the iliac vein is a rare clinical entity and a medical emergency. Often the aetiology is difficult to identify and different hypotheses have been proposed, such as the presence of hormonal, inflammatory and/or mechanical factors. It may be important to assess the presence of a factor that triggered the deep vein thrombosis and secondary rupture of the iliac vein and retroperitoneal hematoma. We present a case where venous thrombosis could have caused rupture of the iliac vein and we discuss the entity in light of the current literature
Subject(s)
Humans , Female , Middle Aged , Hematoma/pathology , Iliac Vein/injuries , Venous Thrombosis/complications , Retroperitoneal Space/injuries , Rupture, Spontaneous/complicationsABSTRACT
Wünderlich syndrome, or spontaneous retroperitoneal hematoma, secondary to spontaneous rupture of the iliac vein is a rare clinical entity and a medical emergency. Often the aetiology is difficult to identify and different hypotheses have been proposed, such as the presence of hormonal, inflammatory and/or mechanical factors. It may be important to assess the presence of a factor that triggered the deep vein thrombosis and secondary rupture of the iliac vein and retroperitoneal hematoma. We present a case where venous thrombosis could have caused rupture of the iliac vein and we discuss the entity in light of the current literature.
Subject(s)
Hematoma/etiology , Iliac Vein , Venous Thrombosis/complications , Female , Humans , Middle Aged , Retroperitoneal Space , Rupture, Spontaneous , SyndromeABSTRACT
Resumen Antecedentes: El síndrome de takotsubo secundario a traumatismo raquimedular cervical es infrecuente y no se describen series de casos en la literatura. Pacientes y método: Se describe el caso clínico de una mujer de 82 años que ingresó en la Unidad de Cuidados Intensivos tras traumatismo raquimedular cervical y como consecuencia desarrolló miocardiopatía de takotsubo. Resultado: Desarrollo de una miocardiopatía de takotsubo tras un traumatismo raquimedular cervical. Conclusiones: En la actualidad el diagnóstico de miocardiopatía de takotsubo en Cuidados Intensivos está en aumento, en parte por el uso de la ecocardiografía trastorácica por parte de los Intensivistas; con ello se descartan otras causas posibles de la misma y no sólo la cardiológica o la descarga catecolaminérgica secundaria a una situación de estrés.
Abstract Background: Takotsubo syndrome secondary to spinal cord injury is rare, and there are no case series described in the literature. Patients and method: A clinical case is presented of an 82 year-old woman admitted to the Intensive Care Unit after a spinal cord injury, and as a results developed Takotsubo cardiomyopathy. Results: A Takotsubo cardiomyopathy developed after a spinal cord injury. Conclusions: The diagnosis of Takotsubo cardiomyopathy is currently increasing in Intensive Care Units. This is partly due to use of transthoracic echocardiography by intensive care specialists. Using this technique they can rule out other possible causes of this condition, and not just the cardiological ones, or the catecholamine release following a stressful event.
Subject(s)
Humans , Female , Aged, 80 and over , Takotsubo Cardiomyopathy , Cardiomyopathies , Wounds and Injuries , EchocardiographyABSTRACT
El suero salino normal (SSN) ha sido clásicamente el fluido de resucitación elegido en el periodo perioperatorio del trasplante renal frente a aquellas soluciones balanceadas con potasio. Sin embargo, los problemas derivados de la hipercloremia desencadenada por la infusión de SSN han llevado a la realización de estudios que comparaban esta solución con los fluidos equilibrados. Mediante la presente revisión narrativa se deduce que el uso de cristaloides balanceados con contenido de potasio en su formulación, en el perioperatorio de trasplante renal, puede considerarse seguro. Estas soluciones no provocan una alteración del potasio sérico mayor que la provocada por el SSN y mantienen mejor el equilibrio ácido-base en estos enfermos (AU)
Normal saline has traditionally been the resuscitation fluid of choice in the perioperative period of kidney transplantation over balanced potassium solutions. However, the problems arising from hyperchloraemia triggered by the infusion of normal saline have led to studies being conducted that compare this solution with balanced solutions. From this narrative review it can be concluded that the use of balanced crystalloids containing potassium in the perioperative period of kidney transplantation can be considered safe. These solutions do not affect serum potassium levels any more than normal saline, whilst maintaining a better acid-base balance in these patients (AU)
Subject(s)
Humans , Kidney Transplantation/methods , Perioperative Period/methods , Saline Solution, Hypertonic/therapeutic use , Calcium/therapeutic use , Kidney Transplantation/rehabilitation , Hyperkalemia/complications , Acidosis/metabolismABSTRACT
Normal saline has traditionally been the resuscitation fluid of choice in the perioperative period of kidney transplantation over balanced potassium solutions. However, the problems arising from hyperchloraemia triggered by the infusion of normal saline have led to studies being conducted that compare this solution with balanced solutions. From this narrative review it can be concluded that the use of balanced crystalloids containing potassium in the perioperative period of kidney transplantation can be considered safe. These solutions do not affect serum potassium levels any more than normal saline, whilst maintaining a better acid-base balance in these patients.
Subject(s)
Acid-Base Imbalance/prevention & control , Fluid Therapy/methods , Kidney Transplantation , Perioperative Care/methods , Plasma Substitutes/therapeutic use , Solutions/therapeutic use , Acid-Base Equilibrium , Blood Volume , Chlorides/administration & dosage , Chlorides/adverse effects , Colloids/administration & dosage , Crystalloid Solutions , Diuresis/drug effects , Double-Blind Method , Fluid Therapy/adverse effects , Humans , Intraoperative Complications/prevention & control , Isotonic Solutions , Osmolar Concentration , Plasma Substitutes/adverse effects , Postoperative Complications/prevention & control , Potassium/administration & dosage , Randomized Controlled Trials as Topic , Sodium Chloride/administration & dosage , Sodium Chloride/adverse effects , Solutions/adverse effectsABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Acidosis, Lactic/chemically induced , Metformin/adverse effects , Risk Factors , Shock/rehabilitation , Cardiotonic Agents/therapeutic use , Vasoconstrictor Agents/therapeutic use , Bicarbonates/therapeutic use , Acidosis, Lactic/physiopathology , Pulmonary Disease, Chronic Obstructive/complications , Diabetes Mellitus, Type 2/complications , Acidosis, Lactic/complicationsSubject(s)
Acidosis, Lactic/chemically induced , Diabetes Mellitus, Type 2/drug therapy , Hypoglycemic Agents/adverse effects , Metformin/adverse effects , Acidosis, Lactic/diagnosis , Aged , Diabetes Mellitus, Type 2/complications , Humans , Hypoglycemic Agents/therapeutic use , Male , Metformin/therapeutic use , Middle AgedABSTRACT
No disponible