Factores pronósticos de supervivencia en pacientes con reanimación cardiopulmonar en un servicio de emergencias / Survival prognosis factors in patients with cardiopulmonary reanimation in an emergency service

Introducción: Los factores que influyen en que el paciente sobreviva luego de una reanimación cardiopulmonar hasta el alta hospitalaria no han sido descritos con certeza. Objetivo: Identificar los factores relacionados con la supervivencia al alta hospitalaria en pacientes que recibieron reanimación cardiopulmonar en un servicio de emergencias. Métodos: Se realizó un estudio analítico de cohortes, prospectivo, en 76 pacientes que recibieron reanimación cardiopulmonar en la Unidad de Cuidados Intensivos Emergentes del Hospital Provincial Docente Clínico-Quirúrgico Saturnino Lora Torres de Santiago de Cuba, de enero del 2016 a igual mes del 2018. Resultados: En el análisis univariado los factores que de manera independiente se asociaron a la supervivencia fueron el origen cardíaco (76,5 por ciento), el trazado electrocardiográfico de fibrilación ventricular-taquicardia ventricular sin pulso (64,7 por ciento), la no prolongación de la ventilación y la ausencia de sepsis (con 88,2 por ciento cada uno). Conclusiones: Se identificaron la recuperación neurológica y la no necesidad de drogas vasoactivas como los factores que influyeron directamente en la sobrevida hasta el alta hospitalaria

Introduction: The factors influencing in the survival of the patient after a cardiopulmonary reanimation up to the hospital discharge have not been described with accuracy. Objective: To identify the factors related to the survival at discharge in patients who received cardiopulmonary reanimation in an emergency service. Methods: An analytic cohorts prospective study was carried out in 76 patients who received cardiopulmonary reanimation in the Intensive Care Emergent Unit from Saturnino Lora Torres Teaching Clinical-Surgical Provincial Hospital in Santiago de Cuba, from January, 2016 to same month of 2018. Results: In the univariate analysis the associated factors to survival in an independent way were the heart origin (76.5 percent), the pattern of ventricular fibrillation/ ventricular tachicardia without pulse (64.7 percent), the non-continuation of ventilation and the sepsis absence (with 88.2 percent each of them). Conclusions: The neurological recovery and unnecessary use of vasoactive drugs were identified as the directly influencing factors in the survival up to the hospital discharge

Competencias en reanimación cardiopulmonar pediátrico en residentes del Hospital del Niñ@ Manuel Ascencio Villarroel / Cardiopulmonary pediatric reanimation skills in residents from the Niñ@ Manuel Ascencio Villarroel hospital

El paro cardiorrespiratorio es la vía final de una serie de condiciones y enfermedades graves. Motivo por el cual la reanimación cardiopulmonar es importante para la sobrevivencia y secuelas que podría tener en los niños que se encuentran en estado crítico. El objetivo de este trabajo fue evaluar en conocimiento teórico y práctico sobre reanimación pediátrico a los residentes de la especialidad de pediatría del Hospital del Niño Manuel Ascencio Villarroel de Cochabamba. El método de estudio aplicado fue de tipo observacional descriptivo; cuya evaluación fue por tribunal especializado en resucitación cardiopulmonar pediátrico mediante una prueba estructurada y examen práctico con estaciones clínicas en muñecos simuladores. En cuanto los resultados se pudieron evidenciar que existe marcada deficiencia en conocimientos teóricos en las aéreas de resucitación cardiopulmonar básica, acceso vascular, arritmias y administración de medicación, en prevención de paro cardiorrespiratorio se observó buena respuesta en la mayoría de los participantes. En cuanto al grado de residencia los de primer año tuvieron mala respuesta en general, en cambio entre los residentes de segundo y tercer año no existe diferencia significativa. Finalmente se concluye que la mayoría de los residentes no han realizado cursos o capacitaciones sobre el tema; el rendimiento tanto teórico como práctico fue deficiente con marcada diferencia entre los residentes de primer año y superiores. Existe mucha deficiencia en manejo teórico practico de ventilación adecuada con máscara y bolsa, manejo de arritmias y también masaje cardiaco.

The cardiac arrest is the final outcome of a serial number of conditions and illnesses. For which reason cardiopulmonary reanimation is important for the survival and aftermath that it may have on children who are in critical condition. The aim of this work it was to evaluate the theoretical and practical knowledge about pediatric resuscitation in residents from pediatric specialty in the Niño Manuel Ascencio Villarroel Hospital from Cochabamba. A descriptive observational study was applied; whose evaluation it was performed by a specialized court in cardiopulmonary reanimation pediatric through a structural test and practical exam in simulators dolls from clinical stations. In the results it can be show that there is marked deficiency in theoretical knowledge about basic cardiopulmonary reanimation area, vascular access, arrhythmias and drugs administration; but the cardiorespiratory arrest prevention showed good response in most of the participants. Regarding the degree of residence, generally the freshmen had poor response, however residents between second and third year had no significant difference. Finally it was concluded that most of the residents had not realized courses about this topic; the theoretical and practical performance was deficient with marked difference in the freshmen and senior years, but no difference between the second and third year specialty. There is much theoretical and practical deficieney in the practice of adequate ventilation management with mask and bag, arrhythmias management and heart massage.

Uma breve história da ressuscitação cardiopulmonar / The short history of cardiopulmonary resuscitation

JUSTIFICATIVA E OBJETIVOS: É grande o número de artigos científicos e descrições fascinantes publicado descrevendo as primeiras técnica de reanimação/ressuscitação cardiopulmonar e sua evolução; as ações fundamentais atuais estão fortemente baseadas nesta evolução do conhecimento sobre mecânica de compressões torácicas e aplicabilidade da desfibrilação. Este artigo é o primeiro de uma série que tem por objetivo apresentar uma revisão narrativa histórica de algumas das maiores contribuições na área da ressuscitação cardiopulmonar, delineando uma breve síntese deste rico capítulo da história da Medicina de urgência. CONTEÚDO: Foram selecionados 405 artigos na base de dados Medline (1969-2009), por meio das palavras-chave: ressuscitação cardiopulmonar, parada cardiorrespiratória, parada cardíaca e história. Adicionalmente, referencias desses artigos, capítulos de livros e artigos históricos fornecidos pelo arquivo pessoal dos próprios autores foram também incluídos para esta revisão. Consideraram-se artigos de revisão em inglês, português, alemão, francês e espanhol. CONCLUSÃO: Foram utilizadas 66 referências. Os dados apresentados são os mais relevantes encontrados, sem a interferência direta da analise pessoal dos autores deste estudo.

BACKGROUND AND OBJECTIVES: It is large the number of fascinating first descriptions scientific articles published describing the technique and evolution of reanimation and cardiopulmonary resuscitation; the current basic actions are strongly based on this knowledge evolution of thoracic mechanics of compressions and applicability of the defibrillation. This article is first one of a series that has as objective present an historical narrative review of the some of the biggest contributions in the area of the cardiopulmonary reanimation/resuscitation, delineating one brief synthesis of this rich chapter of history inemergence medicine. CONTENTS: Were selected 405 articles in the database Med-Line (1969-2009), using the keywords: cardiopulmonary resuscitation, cardiopulmonary arrest, cardiac arrest and history. Additionally, references of these articles, chapters of books and historical articles of the gets by the personal archives of the authors were evaluated for this review. We considered reviews articles of English, Portuguese, German, French and Spanish. CONCLUSION: 66 references had been used for the article. We are presenting the findings most relevant of the major articles from this review, without the interference of direct personal analysis of the authors of this study.