[Invasive yeast infections in severely burned patients]. / Enfermedades invasivas por hongos levaduriformes en pacientes quemados graves.

Currently, there are few studies on candidaemia in the severely burned patient. These patients share the same risk factors for invasive fungal infections as other critically ill patients, but have certain characteristics that make them particularly susceptible. These include the loss of skin barrier due to extensive burns, fungal colonisation of the latter, and the use of hydrotherapy or other topical therapies (occasionally with antimicrobials). In addition, the increased survival rate achieved in recent decades in critically burned patients due to the advances in treatment has led to the increase of invasive Candida infections. This explains the growing interest in making an earlier and more accurate diagnosis, as well as more effective treatments to reduce morbidity and mortality of candidaemia in severe burned patients. A review is presented on all aspects of the burned patient, including the predisposition and risk factors for invasive candidiasis, pathogenesis of candidaemia, underlying immunodeficiency, local epidemiology and antifungal susceptibility, evolution and prognostic factors, as well as other non-Candida yeast infections. Finally, we include specific data on our local experience in the management of candidaemia in severe burned patients, which may serve to quantify the problem, place it in context, and offer a realistic perspective.

Ventilación mecánica no invasiva en la atención masiva a pacientes con lesiones térmicas / Non invasive mechanical ventilation in the massive care to patients with thermal injuries

Se realizó un estudio descriptivo y transversal de 32 pacientes (mayoritariamente jóvenes del sexo masculino), atendidos en el Servicio Provincial de Caumatología del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde agosto hasta septiembre de 2012, como consecuencia de un incendio de grandes magnitudes ocurrido en un servicentro de esta ciudad, con vistas a caracterizarles desde los puntos de vista clínico, epidemiológico y terapéutico. En la casuística predominaron las lesiones por inhalación en las personas con más de 20 % de superficie corporal quemada, a quienes se aplicó ventilación mecánica no invasiva desde las primeras 72 horas y se logró una respuesta positiva. Los 6 afectados que tenían más de 90 % de superficie corporal quemada y uno de los que presentaba entre 60-79 % fallecieron. Se demostró que con la utilización de esta técnica en las primeras 72 horas en los pacientes grandes quemados y con lesiones graves por inhalación se logra disminuir significativamente la mortalidad.

A descriptive and cross sectional study of 32 patients (mostly male young people), assisted in the Provincial Caumatology Service of "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba was carried out from August to September, 2012, as a consequence of a huge fire taking place in a servicenter from this city, with the aim of characterizing them from the clinical, epidemiological and therapeutic points of view. Injuries due to inhalation in people with more than 20% of burned body surface to whom non invasive mechanical ventilation was applied since the first 72 hours with a positive response, prevailed in the case material. The 6 affected patients who presented more than 90% of burned body surface and one of those who presented 60-79% died. It was demonstrated that with the use of this technique in the first 72 hours in the largely burned patients, with severe injuries due to inhalation it is possible to decrease mortality significantly.

Ventilación mecánica no invasiva en la atención masiva a pacientes con lesiones térmicas / Non invasive mechanical ventilation in the massive care to patients with thermal injuries

Se realizó un estudio descriptivo y transversal de 32 pacientes (mayoritariamente jóvenes del sexo masculino), atendidos en el Servicio Provincial de Caumatología del Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba, desde agosto hasta septiembre de 2012, como consecuencia de un incendio de grandes magnitudes ocurrido en un servicentro de esta ciudad, con vistas a caracterizarles desde los puntos de vista clínico, epidemiológico y terapéutico. En la casuística predominaron las lesiones por inhalación en las personas con más de 20 por ciento de superficie corporal quemada, a quienes se aplicó ventilación mecánica no invasiva desde las primeras 72 horas y se logró una respuesta positiva. Los 6 afectados que tenían más de 90 por ciento de superficie corporal quemada y uno de los que presentaba entre 60-79 por ciento fallecieron. Se demostró que con la utilización de esta técnica en las primeras 72 horas en los pacientes grandes quemados y con lesiones graves por inhalación se logra disminuir significativamente la mortalidad(AU)

A descriptive and cross sectional study of 32 patients (mostly male young people), assisted in the Provincial Caumatology Service of Dr Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba was carried out from August to September, 2012, as a consequence of a huge fire taking place in a servicenter from this city, with the aim of characterizing them from the clinical, epidemiological and therapeutic points of view. Injuries due to inhalation in people with more than 20% of burned body surface to whom non invasive mechanical ventilation was applied since the first 72 hours with a positive response, prevailed in the case material. The 6 affected patients who presented more than 90 percent of burned body surface and one of those who presented 60-79 percent died. It was demonstrated that with the use of this technique in the first 72 hours in the largely burned patients, with severe injuries due to inhalation it is possible to decrease mortality significantly(AU)