Perfil de la unidad de cuidados intensivos del Hospital Regional de Temuco entre junio 2002 a junio 2003 / Profile of the intensive-care unit at the Regional Hospital of Temuco, between June 2002 to June 2003

Temuco's ICU is the only center who receives critical patients in all the ninth Region, which has a high number of mapuche population and the higher poverty index in Chile. Since 2002 Temuco has a new Critical Patient Unit. We wanted to show our reality from june 2002 to june 2003. Method: Discharges from the one year period described were visited and analized age sex, etnicity, procedence, admission diagnosis, Apache II, comorbility, hospitalization days, mechanical ventilation and mortality. Results: from 876 discharges in the study period, were obtained 369 (42 per cent) clinicals files with enough data for revision: 59 per cent male and 41 per cent female. Mean age 58,3 per cent (16-100), 17 per cent mapuche ethnicity. 71 per cent comorbility (Diabetes, Arterial hipertension, Chronic obstructive lung disease, Coronary cardiopathy). 44 per cent of the patient came from surgery, 28 per cent from Emergency room, 17 per cent UTI and 10 per cent from other services. Admission diagnosis were 33 per cent cardiovascular, 27 per cent sepsis, 14 per cent neurologic, 8 per cent digestive, 7 per cent respiratory, 5 per cent trauma and intoxication and 3 per cent others. Admission's Apache II was 16 (1-46). Hospitalization days were 6,5 per cent. 80 per cent of the admissions were patients who needed mechanical ventilation, mostly because of acute respiratory failure 45 per cent (ADRS, pneumonia, APE), post anesthesic respiratory depression 40 per cent (cardiosurgery, neurosurgery and emergency surgeries), neurological 6 per cent Mortality of 25 per cent. Conclusions: we are a high complex unit in part because of the complexity of the surgeries here perfomed, which needs post surgery ICU stay. Our mortality correlates with the scores obtained. Most of our admissions were for mechanical ventilation.

Primer caso de síndrome cardiopulmonar por hantavirus secundario a mordedura de ratón / First case of hantavirus cardiopulmonary syndrome occurring after a rodent bite

Describimos el primer caso de síndrome cardiopulmonar por hantavirus (SCPH) ocurrido por la mordedura de un Oligoryzomys longicaudatus. Un estudiante fue mordido al manipular una trampa en la que había sido capturado el ratón. A los 14 días desarrolló un SCPH de evolución moderada, requiriendo oxígeno suplementario, sin necesidad de conexión a ventilación mecánica ni administración de drogas vasoactivas. El monitoreo hemodinámico se efectuó mediante la técnica de termodilución transcardiopulmonar, utilizando el computador Pulse Contour Cardiac Output (PiCCO). Esta técnica, menor invasiva que el catéter arterial pulmonar permite medir índices hemodinámicos, y el agua pulmonar extravascular, índice que pareciera ser útil en el manejo del SCPH de evolución moderada. Describimos la epidemiología, cuadro clínico, monitoreo y manejo del SCPH en este paciente