ABSTRACT
We report a 77-year-old female patient who was admitted to the Emergency Department with impairment of consciousness, hypotension, bradycardia and hypothermia. She required endotracheal intubation and transfer to Intensive Care Unit (ICU). Computed tomography of the brain showed no lesions. Electrocardiogram showed abnormalities suggestive of severe hypothermia (bradycardia, marked elevation of J point associated with ST depression, a negative T wave in V2 to V6 and prolongation of QTc), which was confirmed with a pulmonary artery catheter. Myxedema coma, infections and neurological diseases were discarded. The cause of severe hypothermia was unclear, and the probable source was suspected to be accidental. After intensive treatment the patient improved, achieving normalization of electrocardiographic changes, recovery of organic functions and she was discharged home after 22 days.
Subject(s)
Bradycardia/etiology , Hypothermia/complications , Aged , Bradycardia/physiopathology , Electrocardiography , Female , Humans , Hypothermia/physiopathology , Severity of Illness IndexABSTRACT
We report a 77-year-old female patient who was admitted to the Emergency Department with impairment of consciousness, hypotension, bradycardia and hypothermia. She required endotracheal intubation and transfer to Intensive Care Unit (ICU). Computed tomography of the brain showed no lesions. Electrocardiogram showed abnormalities suggestive of severe hypothermia (bradycardia, marked elevation of J point associated with ST depression, a negative T wave in V2 to V6 and prolongation of QTc), which was confirmed with a pulmonary artery catheter. Myxedema coma, infections and neurological diseases were discarded. The cause of severe hypothermia was unclear, and the probable source was suspected to be accidental. After intensive treatment the patient improved, achieving normalization of electrocardiographic changes, recovery of organic functions and she was discharged home after 22 days.
Subject(s)
Aged , Female , Humans , Bradycardia/etiology , Hypothermia/complications , Bradycardia/physiopathology , Electrocardiography , Hypothermia/physiopathology , Severity of Illness IndexABSTRACT
La hipotermia es una técnica terapéutica de enfriamiento que busca minimizar los efectos de la isquemia o de otros insultos directos sobre uno o más órganos. Ahora contamos con un mejor conocimiento de sus fundamentos fisiopatológicos, a partir principalmente de modelos animales, han surgido nuevas evidencias clínicas y nuevos temas de controversias. Recientemente se han ido estableciendo con más evidencias sus potenciales beneficios en neuroprotección. Se presenta un artículo de revisión de esta técnica.
Subject(s)
Humans , Hypothermia, Induced/methods , Neurosurgical Procedures , Brain Injuries, Traumatic/therapy , Intracranial Hypertension/therapy , Hypothermia, Induced/adverse effects , Hypothermia, Induced/history , Cerebral Infarction/therapy , Heart Arrest/complications , Cardiopulmonary Resuscitation/methods , Time FactorsABSTRACT
Presentamos el caso de un paciente con pancreatitis aguda grave (PAG) que evolucionó rápidamente con un Síndrome de Respuesta Inflamatoria Sistémica (SIRS) severo manejado con Proteína C humana recombinante (PCHR). Entre 10 a 15 por ciento de las pancreatitis agudas desarrollarán un SIRS, que lleva a un curso fulminante con extensa necrosis y falla multiorgánica. En series internacionales esta condición se asocia a una mortalidad mayor al 25 por ciento, pero existen escasas publicaciones sobre el uso de PCHR en pacientes con PAG. Algunos estudios ya han descrito que en presencia de una respuesta inflamatoria severa documentada con score de APACHE mayor a 25 existe una recuperación sustancial con el uso del PCRH. Comunicamos su cuadro clínico, evolución y resultado.
