ABSTRACT
Introduction: The risk of complications and death related to difficult airway (DA) in critically ill patients is higher than in controlled settings such as the operating room. Statistics on DA in intensive care in Colombia are scarce, as are the intervention data and resources available in the units. The main objective was to determine the prevalence and characteristics of anatomical and physiological difficult airway. Methods: An observational, cross-sectional, multicentre study was conducted in adult Intensive Care Units (ICU) in Quindío. Links to two Google® forms were sent to the Coordinating Intensivists, one general and one specific related to DA anatomical factors (Mallampati, obstructive apnoea, stiff cervical spine, obesity, external appearance, Cormack-Lehane > 2, etc.) and physiological (oxygenation disorder, state of collapse, anaemia, etc.). Results: Four units participated, with 62 beds (83.9% of the beds in the department);56 hospitalized patients were found, 38 patients (67.8%) were intubated. Of the patients, 29% had some type of difficult airway. Of the patients with difficult airway, 100% had physiological DA parameters and 27.3% anatomical difficult airway: 18.2% Cormack-Lehane (CL) > 2, and 9.1% subglottic stenosis. Obesity was the best predictor of CL > 2. LR+: 4.5, LR−:. 001. Conclusions: Physiological DA is highly prevalent in the adult ICU, which represents a challenge for the intensivist, and a high risk of complications for patients. In this study, obesity was the main predictor of anatomical DA in critically ill patients. Intensive care units must have sufficient resources and personnel trained in the management of difficult airway. © 2022 Asociación Colombiana de Medicina Crítica y Cuidado lntensivo
ABSTRACT
Background During the SARS-COV 2 pandemic, Mexico has dealt with different manifestations unrelated to the information that is disseminated in different media based on scientific evidence, which has generated anti-vaccine expressions based on information of dubious scientific quality. Objective To determine the association between the use of information from social networks and the acceptance of the vaccine for SARS-COV2. A comparative, observational, cross-sectional and prospective study was carried out in Veracruz, Mexico, between January and April 2021, including residents of this city over 18 years of age through a non-probability sampling through virtual surveys conducted in Google forms. Results 704 subjects were included in the study, of which 426 (60.6%) were women. 93.9% of the participants stated that they would agree to be vaccinated when appropriate. The source of information most used by those who accept the vaccination were social networks (43%), and of these, Facebook is the one they use the most (42.7%) and where they find more information about COVID (52.0%), without However, the social network in which they most frequently take your information into account is tweeter (29.4%). The OR for not accepting to be vaccinated was 0.2 (95% CI 0.08-0.6) for those who use information mainly from tweeters, as well as for those whose neighbors are their main source of information OR 17.6 (95% CI 5.4-57.4), both with value of p < 0.05. Having as the main source of information other social networks, television, radio, medical or newspaper personnel, resulted in p values> 0.05 for not accepting the vaccine. Key messages Informal information decreases the likelihood of accepting the sarscov2 vaccine. Tweeter is a source of information that favors vaccination.