ABSTRACT
La pandemia de COVID-19 producida por SARS-CoV-2 actualmente en curso anticipa una gran demanda por ventiladores mecánicos (VM), ya que un porcentaje relevante de los contagiados cae rápidamente en insuficiencia respiratoria y requiere de cuidados intensivos. Anticipándose a ese exceso de demanda y considerando que es muy probable que el número actual de ventiladores mecánicos en las unidades de cuidados intensivos (UCI) sean insuficientes, se ha solicitado a la SACH un informe técnico en relación al uso de las máquinas de anestesia como VM.
Subject(s)
Pneumonia, Viral/therapy , Pneumonia, Viral/epidemiology , Ventilators, Mechanical/supply & distribution , Coronavirus Infections/therapy , Coronavirus Infections/epidemiology , Pandemics , Betacoronavirus , Anesthesia/methods , Chile/epidemiologyABSTRACT
En diciembre de 2019, una serie de casos de neumonía de causa desconocida surgieron en Wuhan, Hubei, China, con presentaciones clínicas muy parecidas a la neumonía viral. El análisis de secuenciación profunda de muestras del tracto respiratorio inferior indicó un nuevo coronavirus, que se denominó nuevo coronavirus 2019 (2019-nCoV o SARS-CoV2) [15]. La propagación del virus ha sido extremadamente rápida, tanto así que el 11 de marzo de 2020 y luego de más de 118.000 infectados en 114 países con 4.300 fallecidos a esa fecha, la organización mundial de la salud declaró a la enfermedad COVID-19, causada por 2019-nCoV, como una pandemia.
Subject(s)
Pneumonia, Viral/prevention & control , Hand Disinfection , Coronavirus Infections/diagnosis , Perioperative Care/nursing , Perioperative Period/nursing , Airway Extubation/instrumentation , BetacoronavirusABSTRACT
BACKGROUND: Amphotericin B is efficacious for the treatment of systemic candidiasis, however it has potentially serious toxic effects. Administration as lipid emulsions has been advocated to decrease its toxicity. AIM: To compare the safety and tolerance of amphotericin B administered as lipid emulsion or dissolved in dextrose in water. PATIENTS AND METHODS: Forty five patients with confirmed or highly suspected systemic candidiasis were studied. Between January 1996 and June 1997 amphotericin B was administered in dextrose in water to 17 patients (group 1). Between July 1997 and December 1998, the drug was delivered in lipid emulsions (Intralipid, group 2). Clinical and laboratory parameters (serum creatinine, urea nitrogen and potassium), were assessed daily. RESULTS: Both treatment groups were clinically comparable and had the same survival. Accumulative amphotericin B dose administered was 343.2 +/- 197 and 414.6 +/- 518 mg respectively. Hypokalemia was more frequent in group 2 (52 and 25% respectively, p < 0.05). There were no differences in the outcome of renal function or other adverse reactions. CONCLUSIONS: Administration of amphotericin B as lipid emulsions did not reduce its toxicity in critical patients (Rev Méd Chile 2000; 128: 1101-07).
