ABSTRACT
Ventilator-associated pneumonia is a life-threatening disease causing an increased morbidity, cost and length of stay in the intensive care unit. This document is an evidence based consensus which discusses preventive measures including medical recommendations and practices for cleaning and handling mechanical ventilators. Standard and contact precautions are critical preventive measures
Subject(s)
Humans , Pneumonia/prevention & control , Respiration, Artificial/adverse effects , Antibiotic Prophylaxis , Sterilization/methods , Gastrointestinal Hemorrhage , Intubation, Intratracheal/methods , Pneumonia/etiology , Risk FactorsSubject(s)
Humans , Microcirculation/physiology , Oxygenation , Shock, Septic/physiopathology , Lactic Acid , Acidosis, Lactic/etiology , Acidosis, Lactic/drug therapy , Hydrogen-Ion Concentration , Manometry , Multiple Organ Failure/physiopathology , Oxygen Transfer , Cardiopulmonary Resuscitation , Sepsis/therapy , Shock, Septic , Splanchnic CirculationABSTRACT
Se comunica caso de lactante que adquirió meningitis neumocóccica causada por una cepa medianamente sensible a penicilina-CIM 1 µg/ml y resistente a ceftriaxona- CIM 3 µg/ml. El tratamiento inicial incluyó ceftriaxona 100 mg/kg/día y dexametasona. Hubo una esterilización tardía del LCR y graves secuelas neurológicas al egreso pese al tratamiento con vancomicina sistémica e intraventricular. Este es el primer caso documentado de resistencia a cefalosporinas de tercera generación, relacionado a fracaso terapéutico en meningitis, en nuestro hospital