RESUMO
La infección por el coronavirus asociada al síndrome de distrés respiratorio agudo severo (SARS-CoV-2) produce un síndrome clínico denominado mundialmente covid-19 que ha generado 5.940.441 infectados y 362.813 muertes hasta mayo de 20201. En estadios moderados y severos de la infección se produce una reacción sistémica del organismo caracterizada por la hiperinflamación, tormenta de citocinas y elevación de biomarcadores de daño miocárdico. Además, se ha sugerido la relación entre covid-19 y manifestaciones neurológicas. Recientes autopsias sugieren microangiopatía trombótica en múltiples órganos. Presentamos la descripción de 2 casos de pacientes con covid-19 severo, ingresados en Reanimación, que presentaron afectación cerebrovascular y fallecieron posteriormente. Se recomienda estrictamente la aplicación de profilaxis farmacológica antitrombótica en los pacientes afectados por covid-19 ingresados en cuidados críticos y se sugiere administrar dosis profilácticas por encima de la media
Coronavirus associated severe acute respiratory syndrome (SARS-CoV-2) causes a worldwide syndrome called Covid-19 that has caused 5,940,441 infections and 362,813 deaths until May 2020. In moderate and severe stages of the infection a generalized swelling, cytokine storm and an increment of the heart damage biomarkers occur. In addition, a relation between Covid-19 and neurological symptoms have been suggested. The results of autopsies suggest thrombotic microangiopathy in multiple organs. We present 2 cases of patients infected with severe Covid-19 that were hospitalized in the Reanimation Unit that presented cerebrovascular symptoms and died afterwards. A high dose prophylaxis with antithrombotic medication is recommended in patients affected by moderate to severe Covid-19
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Pandemias , Betacoronavirus , Hemorragia Cerebral/virologia , Isquemia Encefálica/virologia , Acidente Vascular Cerebral/virologia , Evolução Fatal , Isquemia Encefálica/diagnóstico por imagem , Acidente Vascular Cerebral/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
Coronavirus associated severe acute respiratory syndrome (SARS-CoV-2) causes a worldwide syndrome called Covid-19 that has caused 5,940,441 infections and 362,813 deaths until May 2020. In moderate and severe stages of the infection a generalized swelling, cytokine storm and an increment of the heart damage biomarkers occur. In addition, a relation between Covid-19 and neurological symptoms have been suggested. The results of autopsies suggest thrombotic microangiopathy in multiple organs. We present 2 cases of patients infected with severe Covid-19 that were hospitalized in the Reanimation Unit that presented cerebrovascular symptoms and died afterwards. A high dose prophylaxis with antithrombotic medication is recommended in patients affected by moderate to severe Covid-19.
Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Hemorragia/complicações , Isquemia/complicações , Pneumonia Viral/complicações , Acidente Vascular Cerebral/etiologia , Idoso , COVID-19 , Evolução Fatal , Hemorragia/diagnóstico por imagem , Humanos , Isquemia/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2 , Acidente Vascular Cerebral/diagnóstico por imagem , Microangiopatias Trombóticas/complicações , Microangiopatias Trombóticas/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
El síndrome de Kounis engloba conceptos entre los que se incluyen la angina e infarto alérgico descritos en relación con la exposición a diferentes alérgenos. El objetivo de este artículo es describir un caso de síndrome de Kounis tipo II tras la exposición a rocuronio así como la fisiopatología y tratamiento de este síndrome
Kounis syndrome encompasses concepts including angina and allergic infarction described in relation to exposure to different allergens. The aim of this article is to describe a case of Kounis Syndrome type II after exposure to rocuronium as well as the patholophysiology and the treatment of this syndrome
Assuntos
Humanos , Masculino , Idoso , Síndrome Coronariana Aguda/complicações , Anafilaxia/complicações , Hipersensibilidade a Drogas/complicações , Anestésicos/efeitos adversos , Fármacos Neuromusculares Despolarizantes/efeitos adversos , Fatores de RiscoRESUMO
Kounis syndrome encompasses concepts including angina and allergic infarction described in relation to exposure to different allergens. The aim of this article is to describe a case of Kounis Syndrome type II after exposure to rocuronium as well as the patholophysiology and the treatment of this syndrome.
Assuntos
Síndrome de Kounis/etiologia , Fármacos Neuromusculares não Despolarizantes/efeitos adversos , Rocurônio/efeitos adversos , Idoso , Humanos , MasculinoRESUMO
La enfermedad pulmonar obstructiva crónica presenta una creciente incidencia en la última década. El manejo anestésico de estos pacientes en cirugía de abdomen superior supone un reto para el anestesiólogo, ya que la anestesia general se asocia con una elevada posibilidad de complicaciones pulmonares graves. La búsqueda de una alternativa adecuada ha sido objeto de estudio durante años. Presentamos el caso de un paciente con esta afección pulmonar que precisó ser intervenido de colecistectomía con carácter de urgencia. Se describe el tratamiento y se realiza una breve revisión de la literatura (AU)
The incidence of chronic obstructive pulmonary disease has increased in the last decade. The anesthetic management of these patients in upper abdomen surgery is a challenge to the anesthesiologist, since general anesthesia is associated with a high possibility of severe pulmonary complications. The search for a suitable alternative has been a subject of study for years. The case is presented of a patient with chronic obstructive pulmonary disease, who required an urgent cholecystectomy. The treatment of the case and brief review of the literature is presented (AU)
Assuntos
Idoso , Humanos , Masculino , Anestesia Epidural/instrumentação , Anestesia Epidural/métodos , Colecistectomia/métodos , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Bloqueio Atrioventricular/terapia , Respiração Artificial/instrumentação , Respiração Artificial/métodos , Broncodilatadores/uso terapêutico , Dispneia/tratamento farmacológico , Dispneia/terapiaRESUMO
The incidence of chronic obstructive pulmonary disease has increased in the last decade. The anesthetic management of these patients in upper abdomen surgery is a challenge to the anesthesiologist, since general anesthesia is associated with a high possibility of severe pulmonary complications. The search for a suitable alternative has been a subject of study for years. The case is presented of a patient with chronic obstructive pulmonary disease, who required an urgent cholecystectomy. The treatment of the case and brief review of the literature is presented.