Impacto de la Terapia de Alto Flujo de Oxigeno (TAFO) en un Hospital Pediátrico de la Provincia de Buenos Aires / Impact of High Flow Oxygen Therapy (TAFO) in a Pediatric Hospital of the Province of Buenos Aires

Introducción: Las infecciones respiratorias agudas bajas (IRAB), representan la causa más frecuente de consulta e internación en los meses de invierno. La insuficiencia respiratoria aguda es la complicación que motiva la internación de los pacientes y la necesidad de Unidad Terapia Intensiva (UTI).El objetivo del trabajo fue describir los resultados de la implementación de la Terapia de Alto Flujo (TAFO) en pacientes con IRAB grave internados en Terapia Intermedia Métodos: Estudio prospectivo y descriptivo que incluyó pacientes de 1 a 36 meses internados en Terapia Intermedia en el Hospital Sor María Ludovica de la ciudad de La Plata, desde junio de 2018 a septiembre de 2019. Se ingresaron a TAFO pacientes sin respuesta al tratamiento con oxígeno a bajo flujo. El ingreso a UTI se consideró fracaso de la TAFO Resultados: De 760 pacientes internados con IRAB, 91(11,9%) ingresaron a TAFO de los cuales 59 (64,8 %) tuvieron respuesta favorable con disminución de la frecuencia respiratoria (FR), frecuencia cardiaca (FC) y mejoría de la mecánica respiratoria; el resto (35,2%) pasó a UTI por fracaso terapéutico. Presentaron complicaciones a la TAFO el 5,5% de los pacientes Conclusión: La TAFO fue una terapéutica segura, de fácil utilización que, a través de un aporte de oxígeno conocido, permitió la corrección de la hipoxemia, logrando la disminución de la FR, FC y mejoría de la mecánica respiratoria, dándole mayor comodidad al paciente durante su enfermedad

Introduction: Respiratory infections remain the major cause of outpatient consultation and hospital admissions during the winter season. Lower respiratory illness may cause severe acute respiratory insufficiency and hypoxemic respiratory failure, thus determining the need for hospitalization and eventual intensive care (ICU). The purpose of this paper is to describe the results of High Flow Oxygen Therapy (HFOT) implementation for patients with acute lower respiratory infections (ALRI) admitted to intermediate therapy unit. Methods: Prospective and descriptive study which included patients from age 1 to 36 months, hospitalized at intermediate therapy care unit at "Sor María Ludovica", Hospital, in La Plata, from June, 2018 to September, 2019. Patients who did not show any improvement to low flow oxygen therapy were the subjects of this study. Further submission to ICU was considered as HFOT failure Results: From 760 patients hospitalized with ALRI, 91 (11.9%) were admitted to TAFO. Fifty nine, (64.8%) had a favorable response with decreased respiratory and heart frequency rate, and an improvement of the work of breathing. The rest (35.1%) went to ICU due to therapeutic failure. Five point five percent of patients presented complications to TAFO. Conclusion: HFOT was a safe, easy to implement therapy treatment which improved the hypoxemic respiratory failure. This therapy reduced the respiratory and heart rate, and yielded a better and lower respiratory work, making patients more comfortable during illness

Development of resistance to quinolones in five patients with campylobacteriosis treated with norfloxacin or ciprofloxacin.

Development of resistance to nalidixic acid, norfloxacin and ciprofloxacin was observed in five patients with Campylobacter jejuni or Campylobacter coli infection. From all these patients nalidixic acid- and quinolone-susceptible strains were isolated initially, whereas after therapy with norfloxacin or ciprofloxacin strains resistant to these antibiotics were found. Campylobacter strains from the same patient always belonged to the same species and, with the exception of one case, showed identical rRNA gene restriction (rDNA) patterns. This indicates that double-infection with a susceptible and a resistant strain was not responsible for the phenomenon but rather that the infecting strain rapidly developed resistance following treatment.

Dose finding study in chronic congestive heart failure patients. Results of a short- and long-term study.

A multi-center open trial was carried out with 103 patients with chronic congestive heart failure (CHF) of diverse etiologies with oedemas, 25 with hepatomegalia, placed in classes II or III of NYHA functional capacity, with increasing doses of 30, 60 and 90 mg of muzolimine qd to ascertain (1) the effective dose for the elimination of oedemas and hepatomegalia and (2) whether such a dose keeps its efficacy throughout a long administration period. After a wash-out period of 3-7 days, heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP) in supine and standing positions, body weight (BW) and 24 hour diuresis were controlled and laboratory tests were performed. Muzolimine was administered and an assessment of the therapeutic effect was carried out every week. When the clinical results were ineffective, the dose was increased weekly up to 90 mg. When the results were partial, the same dose was given for another week and when it was effective the search for the dose was concluded. Out of the 103 patients, 67 needed only 30 mg of muzolimine for an effective elimination of oedemas and hepatomegalia, 32 needed 60 mg and only 4 had to have the dose increased to 90 mg to obtain efficacy. The SBP and DBP diminished by 6.3% and 7.2% respectively, and HR was reduced, though not significantly. BW diminished an average of 2.4 Kg and the diuresis increased significantly from a mean value of 1.043 ml/24 h to 1.714 ml/24 h. Sixty-two patients with effective results agreed to undergo chronic treatment for 24 weeks and be controlled every 2 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)