ABSTRACT
Background: Cardiac arrest is a public health problem related to high morbidity and mortality. In Colombia, objective data characterize in our population has been not available. The aim of this study has been to determined the epidemiological characteristics of patients with cardiorespiratory arrest treated in an emergency room. Methods: A retrospective observational cross-sectional cohort study was performed. We included adult patients admitted with a diagnostic of out-of-hospital cardiac arrest (OHCA) or who presented with in-hospital cardiac arrest while in the emergency department (ED). Results: A total of 415 patients were included 232 were men, and the median age was 67 years. OHCA was presented in 383 patients. In this group, 80.2% required orotracheal intubation, 90.1% received Epinephrine, and and 52.6% received immediate resuscitation. Survival after discharge was 43.1% in patients with non-shockable rhythm registered. Return of spontaneous circulation was achieved in 49.6%. The survival after hospital discharge was 22.2%. Cerebral performance category score <=2 was 20.4%. Conclusion: In our study, the epidemiological characteristics and outcomes of patients seen in the ED with cardiac arrest are similar to those described in the literature.
ABSTRACT
INTRODUCTION: Cardiac arrest (CA) is one of the leading causes of death worldwide. Among patients with CA, pulmonary embolism (PE) accounts for approximately 10% of all cases. OBJECTIVE: To compare the outcomes after cardiopulmonary-cerebral resuscitation (CCPR) with and without thrombolytic therapy (TT) in patients with CA secondary to PE. METHODS: We included patients older than 17 years admitted to our hospital between 2013 and 2017 with a diagnosis of CA with confirmed or highly suspected PE who received CCPR with or without TT. Measures of central tendency were used to depict the data. RESULTS: The study comprised 16 patients, 8 of whom received CCPR and thrombolysis with alteplase, whereas the remaining patients received CCPR without TT. The most frequent rhythm of CA in both groups was pulseless electrical activity. Return of spontaneous circulation (ROSC) occurred in 100% of patients who received TT and in 88% of non-thrombolysed patients. The mortality rate of patients who received TT and non-thrombolysed patients at 24 hours was 25% and 50%, respectively. However, at the time of hospital discharge, the mortality was the same in both groups (62%). In patients who received TT, mortality was related to sepsis and hemorrhage whereas in non-thrombolysed patients, mortality was due to myocardial dysfunction. CONCLUSION: Intra-arrest thrombolysis resulted in a higher likelihood of ROSC and a higher 24-hour survival in adults with CA secondary to acute PE. Overall, the survival at hospital discharge was the same in the two groups.
ABSTRACT
Se describen las características principales de la necrosis retinal aguda, la relación fisiopatológica con su principal diagnóstico diferencial, la necrosis retinal externa progresiva. Exponemos las diferencias clínicas y paraclínicas de ambas enfermedades, con base en las cuales construimos un sistema de clasificación que las contempla como un espectro continuo de enfermedad dependiente del estado inmunológico.
The main characteristics of acute retinal necrosis, the pathophysiological connection with the main differential diagnosis and progressive outer retinal necrosis are described. We analize the clinical and paraclinical differences of both diseases, based on which we built a classifi cation system that take them into a continuous spectrum dependent of the immune state.
