ABSTRACT
INTRODUCCIÓN. El uso de un oxímetro como método de monitoreo no invasivo para el paciente permite al profesional odontólogo detectar, evaluar y prevenir situaciones de urgencia. OBJETIVO. Analizar la pulsioximetría en pacientes atendidos por extracciones dentales en el Centro Quirúrgico de la Facultad de Odontología de la Universidad Central del Ecuador. MATERIALES Y MÉTODOS. Estudio observacional, descriptivo realizado a 30 pacientes bajo protocolo de exodoncia quirúrgica y 30 bajo protocolo de exodoncia simple; a los cuales se monitoreó constantes vitales con pulsioxímetro, los datos se pro-cesaron con el programa estadístico International Business Machines Statistical Package for the Social Sciences Versión 2.0 para determinar varianza a través de distribución de frecuencias, medias, desviación estándar, pruebas de T Student y Anova. RESULTADOS. Existió mayor alteración en pulso durante la fase de exodoncia en ambos protocolos de atención, mientras que la saturación de oxígeno aumentó desde la fase de anestesia, sin tener varianzas significativas. Las mujeres presentaron valores elevados de saturación de oxígeno 95,5% y pulso (87,07 ± 1,39 latidos por minuto) en comparación con los hombres durante todas las fases de ambos protocolos. Existieron variaciones significativas de pul-so en pacientes sometidos a exodoncias quirúrgicas con ansiedad leve o nula mientras que en exodoncia simple existió mayor varianza de pulso en aquellos con ansiedad mode-rada según la Escala de Ansiedad de Corah. Se presentaron cuatro urgencias 6,66% (4; 60). CONCLUSIÓN. El monitoreo constante mediante el pulsioxímetro durante la atención odontológica permitió identificar a tiempo eventos que hubiesen comprometido la integri-dad del paciente y evitar que se conviertan en emergencia.
INTRODUCTION. The use of an oximeter as a non-invasive monitoring method for a pa-tient, allows dentist to detect, evaluate and prevent emergency situations. OBJECTIVE. Analyze the pulse oximetry in patients attended for dental extractions in the Faculty of Dentistry Ìs Surgical Center at the Universidad Central del Ecuador. MATERIALS AND ME-THODS. Observational, descriptive study of 30 patients treated under surgical exodontics protocol and 30 under simple exodontics protocol.Vital signs were measured with pulse oximeter and the data was processed with the International Business Machines Statistical Package for the Social Sciences Version 2.0 to determine the variance through distribution of frequencies, means, standard deviation, Student T tests and Anova. RESULTS. The-re was a greater alteration in pulse, during the exodontic phase in both protocols, while oxygen saturation increased at the anesthesic phase, without having relevant variances. Women patients have increased values of oxygen saturation (95,5%) and pulse (87,07 ± 1,39 beats per minute) compared to men during all phases of both protocols. There were significant pulse variations in patients who had surgical extractions with mild level anxiety. In the other hand, in simple extractions, there was greater pulse variance in patients who have moderate anxiety according to the Corha Anxiety Scale. During the study four ur-gencies 6,66% (4; 60) were identified. CONCLUSION. Constant monitoring by the pulse oximeter during dental care, allowed to identify events that might have compromised the integrity of the patient, in order to prevent and avoid they become an emergency situation.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Anxiety , Pulse , Surgery, Oral , Tooth Extraction , Oximetry , Dental Care , Oxygen , Patients , Dentistry , Dentists , AnesthesiaABSTRACT
Background: To recognize the etiological agent responsible for severe acute respiratory failure (ARF) in patients in mechanical ventilation (MV) is important to determine their treatment and prognosis, and to avoid the excessive use of antibiotics. Mini bronchoalveolar lavage (mini BAL) is a blind, non bronschoscopic procedure, used to obtain samples from the lower respiratory tract from patients on mechanical ventilation (MV). Aim: To assess the feasibility, complications and preliminary results of mini BAL among patients with severe ARF on MV. Material and Methods: Prospective study in 17 patients with acute lung injury (ALI ) or acute respiratory distess syndrome (ARDS) on MV and with negative conventional microbiological studies. Mini BAL was performed using standardized protocols. Hemodynamic and respiratory parameters where measured before and after the procedure. Samples obtained were sent to quantitative cultures. Results: At baseline: APACHE II score of 22 ± 6,7, PaO2/FiO2 ratio was 176.6 ± 48.6 and the oxygenation index was 9.74 ± 3.78. All procedures were performed by an ICU resident. Thirty five percent of the procedures had positive cultures and no complications related to the procedures were reported. The procedure lasted an average of 12 minutes and the instilled and rescued volume were 60 ml and 19.6 ml, respectively. There were no significant differences between hemodynamic and respiratory variables before and after the procedure. Conclusions: Mini BAL is a safe, fast and easy technique for obtaining samples from the inferior airway in patients with ALI or ARDS on MV.
Subject(s)
Female , Humans , Male , Middle Aged , Bronchoalveolar Lavage/methods , Lung Injury/etiology , Respiration, Artificial , Respiratory Insufficiency/etiology , APACHE , Bronchoalveolar Lavage/adverse effects , Feasibility Studies , Hemodynamics/physiology , Prospective Studies , Respiratory Function TestsABSTRACT
Hairy cell leukemia (HCL) is a rare chronic B cell lymphoproliferative disorder that affects mostly men. It usually presents with pancytopenia, splenomegaly and bone marrow infiltration, without lymphadenopathy. Diagnosis is based on the presence of mononuclear cells with cytoplasmic projections in a blood smear, the typical bone marrow infiltration pattern and the immunophenotypic profile. HCL occurs seldom in young women and even more exceptionally during pregnancy. We report a 31-year-old woman in whom a splenomegaly was detected during routine prenatal care. Pancytopenia with 25 percent of hairy cells was found in her blood count. The patient was subjected to an open splenectomy and had an uneventful pregnancy. After two years of follow up, she has a normal blood count and has not required chemotherapy.