[Prognosis of patients who recovered after an episode of sudden death]. / Pronóstico de los pacientes recuperados tras un episodio de muerte súbita.

OBJECTIVES: Sudden death constitutes a major sanitary problem with high mortality and serious neurological complications. The objective of this study was to analyze the prognosis and the characteristics of patients who initially recovered after an episode of cardiac arrest and who were admitted to the intensive care unit (ICU). METHOD: We retrospectively studied the clinical characteristics and outcome of 65 patients admitted to the Intensive Care Unit during a 3 years period with aborted sudden death. RESULTS: 65 patients, 44 (67.7%) men and 21 (32.3%) women. Middle ages 69.1 +/- 13.9. 29 (44.6%) out of hospital and 36 (55.4%) into hospital sudden death. Cardiopulmonary resuscitation was <10 minutes in 28 cases (43.1%), and > 10 minutes in 37 (56.9%). 36 (55.4%) of all sudden deaths were of cardiac origin. 37 patients (56.9%) died and 28 (43.1%) survived the episode. It was LET in 11 cases (16.9%). 29 (44.6%) of all had post- anoxic encephalopathy and most died before discharge from ICU. Of 28 survivors, 5 patients were discharged alive with post-anoxic encephalopathy (17.8%) and 23 were discharged without neurological disturbances (82.2%). This was more frequent when sudden death was into hospital (p 0.009) and cardiopulmonary resuscitation was < 10 minutes (p 0.045). CONCLUSIONS: High number of the patients admitted to a Intensive Care unit with aborted sudden death died during ICU stay. Many patients had post-anoxic encephalopathy and most of these died. So, up to 35% of the patients admitted after an episode of cardiac arrest were discharged alive and without severe neurological damage.

Pronóstico de los pacientes recuperados tras un episodio de muerte súbita / Prognosis of patients who recovered after an episode of sudden death

Objetivos: La muerte súbita constituye un grave problema con alta mortalidad y serias complicaciones neurológicas. El objetivo de este estudio es analizar el pronóstico y las características de pacientes inicialmente reanimados tras un episodio de muerte súbita y que son ingresados en Unidades de Cuidados Intensivos (UCI). Método: Estudio retrospectivo de las características clínicas y estado al alta de 65 pacientes ingresados en UCI durante un periodo de 3 años tras una muerte súbita recuperada. Resultados: 65 pacientes, 44(67,7%) hombres y 21(32,3%) mujeres. Edad media 69,1 ± 13,9. 29 (44,6%) muertes súbitas extrahospitalarias y 36 intrahospitalarias. La reanimación cardiopulmonar (RCP) fue 10 minutos en 37 (56,9%). Más de la mitad de los episodios tuvo origen cardiaco 55,4% (36pacientes). 37 pacientes (56,9%) fallecieron y 28 (43,1%) sobrevivieron. Existió limitación del esfuerzo terapeutico (LET) en 11 casos (16,9%). 29 pacientes (44,6%) desarrollaron encefalopatía postanóxica (EPA) falleciendo la mayoría antes del alta. De los 28 supervivientes, 5 fueron dados de alta vivos con encefalopatía postanóxica (17,8%) y 23 lo hicieron libres de secuelas neurológicas (82,2%). Esto fué más frecuente cuando la parada cardiorrespiratoria (PCR) ocurrió dentro del hospital (p 0,009) y la reanimación duró menos de 10 minutos (p 0,045). Conclusiones: Un elevado número de pacientes ingresados en UCI tras sufrir una PCR fallecen durante su estancia. Muchos desarrollan encefalopatía postanóxica y de ellos la mayoría muere. Pero a pesar de esto, hasta un 35% de los pacientes admitidos tras una muerte súbita recuperada son dados de alta sin secuelas neurológicas

Objectives: Sudden death constitutes a major sanitary problem with high mortality and serious neurological complications. The objective of this study was to analyze the prognosis and the characteristics of patients who initially recovered after an episode of cardiac arrest and who were admitted to the intensive care unit (ICU). Method: We retrospectively studied the clinical characteristics and outcome of 65 patients admitted to the Intensive Care Unit during a 3 years period with aborted sudden death. Results: 65 patients, 44 (67.7%) men and 21 (32.3%) women. Middle ages 69.1 ± 13.9. 29 (44.6%) out of hospital and 36 (55.4%) into hospital sudden death. Cardiopulmonary resuscitation was 10 minutes in 37 (56.9%). 36 (55.4%) of all sudden deaths were of cardiac origin. 37 patients (56.9%) died and 28 (43.1%) survived the episode. It was LET in 11 cases (16.9%). 29 (44.6%) of all had post- anoxic encephalopathy and most died before discharge from ICU. Of 28 survivors, 5 patients were discharged alive with post-anoxic encephalopathy (17.8%) and 23 were discharged without neurological disturbances (82.2%). This was more frequent when sudden death was into hospital (p 0.009) and cardiopulmonary resuscitation was < 10 minutes (p 0.045). Conclusions: High number of the patients admitted to a Intensive Care unit with aborted sudden death died during ICU stay. Many patients had post-anoxic encephalopathy and most of these died. So, up to 35% of the patients admitted after an episode of cardiac arrest were discharged alive and without severe neurological damage

Estudio de susceptibilidad cuantitativa a 10 antimicrobianos de cepas de staphylococcus aureus, aisladas de secreción nasal de personal hospitalario / Quantitative susceptibility study of 10 antimicrobials of staphylococcus aureus isolated from nasal secretion in hospitalary personal

Se estudió la susceptibilidad antimicrobiana de 151 cepas de staphylococcus aureus aislados a partir de secreción nasal de 818 funcionarios. Se determinó la concentración inhibitoria mínima frente a 10 drogas antimicrobianas, utilizado el método cuantitativo de dilución en agar propuesto por Ericsson y Sherris. Los antibióticos utilizados fueron, ampicilina, oxacilina, eritromicina, cefradina, sulfametoxazol-trimetoprim, gentamicina y vancomicina. Las drogas antimicrobianas de mayor actividad in vitro fueron vancomicina, sulfametoxazol-trimetoprim y oxacilina y las drogas menos activas fueron penicilina y ampicilina