ABSTRACT
En el tratamiento de la insuficiencia respiratoria en la insuficiencia cardiaca aguda se utilizan diferentes métodos de oxigenación. En ocasiones los pacientes, tras ser estabilizados con dichos modos ventilatorios, mantienen un grado de disnea o hipoxemia que no mejora y no es atribuible a un empeoramiento del grado funcional o la necesidad de optimizar el tratamiento farmacológico. Los sistemas de alto flujo con interfase nasal con un calentador humidificador acoplado (AFHC) son una buena alternativa como método de oxigenación, de fácil aplicación y escasas complicaciones. Presentamos una serie de 5 pacientes con insuficiencia cardiaca aguda por edema agudo de pulmón con disnea o hipoxemia mantenidas tras la aplicación de ventilación no invasiva. Todos ellos fueron tratados con sistemas de AFHC de forma satisfactoria, con mejoría clínica y gasométrica, sin complicaciones ni fracasos de la técnica. Describimos nuestra experiencia y discutimos diversos aspectos relacionados con dicho sistema de oxigenación (AU)
Various oxygenization methods are used in the treatment of respiratory failure in acute heart failure. Occasionally, after patients are stabilized by these ventilation methods, some maintain a degree of dyspnea or hypoxemia which does not improve and is unrelated to deterioration in the functional class or the need to optimize pharmacological treatment. High-flow oxygen systems administered via nasal cannula that are connected to heated humidifiers (HFT) are a good alternative for oxygenation, given that they are easy to use and have few complications. We studied a series of 5 patients with acute heart failure due to acute pulmonary edema with stable dyspnea or hypoxemia following noninvasive ventilation. All the patients were successfully treated with HFT, showing clinical and gasometric improvement and no complications or technical failures. We report our experience and discuss different aspects related to this oxygenation system (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Heart Failure/therapy , Oxygenation/methods , 28599 , Myocardial Ischemia/complications , Myocardial Ischemia/diagnosis , Blood Gas Analysis/methods , Blood Gas Analysis , Comorbidity , Heart Rate/physiologyABSTRACT
Various oxygenization methods are used in the treatment of respiratory failure in acute heart failure. Occasionally, after patients are stabilized by these ventilation methods, some maintain a degree of dyspnea or hypoxemia which does not improve and is unrelated to deterioration in the functional class or the need to optimize pharmacological treatment. High-flow oxygen systems administered via nasal cannula that are connected to heated humidifiers (HFT) are a good alternative for oxygenation, given that they are easy to use and have few complications. We studied a series of 5 patients with acute heart failure due to acute pulmonary edema with stable dyspnea or hypoxemia following noninvasive ventilation. All the patients were successfully treated with HFT, showing clinical and gasometric improvement and no complications or technical failures. We report our experience and discuss different aspects related to this oxygenation system.
Subject(s)
Heart Failure/therapy , Oxygen Inhalation Therapy/instrumentation , Oxygen Inhalation Therapy/methods , Acute Disease , Aged, 80 and over , Catheters , Female , Humans , Male , NoseABSTRACT
Varón de 28 años, que acude al servicio de urgencias de un hospital terciario tras haber presentado cuadros breves repetidos de déficit neurológico focal recuperados completamente, además de varios episodios de visión doble de una hora de duración. El paciente no presenta antecedentes médicos o familiares relevantes. Refiere haber presentado dolor cervical y occipital derecho desde hace dos semanas después de dormir en un coche al acudir a un Gran Premio de Fórmula Uno. En las últimas semanas ha presentado además múltiples accesos de tos. La exploración clínica del paciente fue normal. El electrocardiograma, la radiografía de tórax y una tomografía computarizada craneal realizadas no demostraron anomalías. Se realizó una exploración de resonancia magnética en la que se observó una disección en la porción distal (V3) dela arteria vertebral derecha. Se describe la utilidad de la realización de la resonancia magnética en los servicios de urgencias en patología neurológica (AU)
A 28-year-old man came to the emergency department of a tertiary hospital after suffering several brief episodes of focal neurological deficit, with complete recovery, and various hour-long episodes of diplopia. There was no relevant pastpersonal or family medical history. He reported feeling neck and right occipital pain that had developed after sleeping in a car during a Formula 1 Grand Prix event 2 weeks earlier, and had suffered repeated coughing fits over the previous weeks. There were no abnormal findings on clinical examination and the electrocardiogram, chest radiograph, and cranial computed tomography were normal. Magnetic resonance imaging was diagnostic, revealing dissection of the distal segment (V3) of the right vertebral artery. We discuss the utility of magnetic resonance imaging requested from the emergency room for neurological disorders (AU)
