La traqueostomía independientemente de la técnica utilizada es un procedimiento indicado en pacientes con ventilación mecánica prolongada y/o de forma temprana en paciente neurocríticos con daño neurológico severo. Objetivo: Determinar la morbimortalidad a los 30 días de los pacientes neurocríticos traqueostomizados bajo técnica percutánea versus quirúrgica en la unidad de cuidados intensivos del hospital Cayetano Heredia durante el periodo enero 2016 a diciembre 2018. Materiales y métodos: Estudio observacional, descriptivo, longitudinal y retrospectivo, en el que se recolectaron los registros de pacientes traqueostomizados en la UCI desde el 2016 hasta el 2018. Se evaluaron variables demográficas, diagnóstico de ingreso, comorbilidades asociadas, SOFA, APACHE II, discapacidad, tiempo de realización e indicaciones de traqueostomía, así como los tipos y complicaciones. ...

Objective: To estimate mortality rates associated with hydroxichloroquine and azithromycin use in Covid-19 patients undergoing mechanical ventilation in an intensive care unit in Lima. Material and methods: This is a retrospective analytical cohort. One hundred and five patients with Covid-19 undergoing invasive mechanical ventilation who were admitted with a diagnosis of acute respiratory insufficiency to the intensive care unit of Cayetano Heredia Hospital in Lima during 2020. Results: The overall mortality rate was 38%. Most patients (79%) were male, their mean age was 50 ± 13 years, two thirds (65%) did not have comorbidities; APACHE II and SOFA scores were 12 ± 6 points and 5 ± 3 points, respectively. Thirty percent of all patients received hydroxichloroquine, 32% received azithromycin, and 32% received both drugs. Mortality was significantly higher in those patients who received...

Objetivos: Estimar la mortalidad relacionada a hidroxicloroquina y azitromicina en pacientes con COVID-19 en ventilación mecánica de una unidad de cuidados intensivos. Material y métodos: Cohorte analítica retrospectiva. Se incluyeron 105 pacientes con COVID-19 en ventilación mecánica invasiva que ingresaron con el diagnóstico de Insuficiencia Respiratoria Aguda a la unidad de cuidados intensivos del Hospital Cayetano Heredia durante el año 2020. Resultados: La mortalidad global fue 38%; el 79% fueron varones, la edad media fue 50±13 años, el 65% no tuvo comorbilidades; al ingreso la puntuación en la escala APACHE II fue 12±6 puntos y en la escala SOFA 5±3 puntos; el 30% recibió hidroxicloroquina, el 32% azitromicina y 32% la combinación de los mismos. La mortalidad fue significativamente mayor en pacientes que recibieron hidroxicloroquina (p=0.00), azitromicina (p=0.03), ...

Objective: To estimate mortality rates associated with hydroxichloroquine and azithromycin use in Covid-19 patients undergoing mechanical ventilation in an intensive care unit in Lima. Material and methods: This is a retrospective analytical cohort. One hundred and five patients with Covid-19 undergoing invasive mechanical ventilation who were admitted with a diagnosis of acute respiratory insufficiency to the intensive care unit of Cayetano Heredia Hospital in Lima during 2020. Results: The overall mortality rate was 38%. Most patients (79%) were male, their mean age was 50 ± 13 years, two thirds (65%) did not have comorbidities; APACHE II and SOFA scores were 12 ± 6 points and 5 ± 3 points, respectively. Thirty percent of all patients received hydroxichloroquine, 32% received azithromycin, and 32% received both drugs. Mortality was significantly higher in those patients who received...

Objective: To report on mortality and therapeutic interventions of patients with severe COVID-19 on mechanical ventilation in an intensive care unit (ICU). Methods: A retrospective cohort study of 105 patients with severe COVID-19 admitted to the ICU with respiratory failure needing mechanical ventilation from march to October 2020 was carried-out. Results: overall mortality of patients on mechanical ventilation was 38%; 79% were males: mean age was 49.8 ± 13 years; 65% did not have comorbidities; APACHE II score was 12±6; and the SOFA score was 5±3. Patients presented with lymphopenia, high serum levels of ferritin, lactic dehydrogenase and C-reactive protein. Thirty percent received hydroxychloroquine, 32% received azithromycin, 47% ceftriaxone and 27% received hydroxychloroquine plus azithromycin. Mortality was significantly higher in males (p=0,004), with high APACHE II (p=0.005) ...

Objectives: To describe clinical, epidemiological, mechanical ventilation (MV) parameters and to determine overall mortality and that related to MV parameters in patients with acute respiratory distress syndrome (ARDS) in an ICU in Lima, Peru. Methods: A retrospective cohort including 133 patients with ARDS due to Covid-19 requiring MV in the Hospital Cayetano Heredia’s ICU was built from March to November 2020. Results: Males accounted for 75% of the cohort; 68% had no comorbidities; 97% has severe ARDS and 82% received extended 72h prone MV. Overall mortality was 38%; bivariate analysis found that alive patients had lower plateau pressure 27±1 cm H20 vs. 30±1 cm H20 (p=0.007), lower driving pressure 15±4 vs. 17±5 (p=0.008), higher static lung compliance 32±1 vs. 28±1 ml/cm H20 (p=0.01) and higher Pa02/Fi02 ratio 194±86 mm Hg vs. 157±66 mm Hg (p=0.01) than patients who died. P...

Carrion´s disease is an endemic disease in Peru caused by Bartonella bacilliformis presenting with an acute or hemolytic form and a chronic verrucous form with asymptomatic bacteremia. The acute form is usually serious and is associated with high morbidity and mortality. We report the case of a case of a young pregnant woman from Yungay, Ancash who presented with the acute form complicated with multi organ failure and acute respiratory distress syndrome needing mechanical ventilation and dying.

El tromboembolismo pulmonar (TEP) masivo, es un evento vascular agudo caracterizado por choque obstructivo, con mortalidad alta. El objetivo del reporte fue resaltar la terapia de trombólisis con guía ecocardiográfica en un paciente con tromboembolismo pulmonar (TEP) masivo y arresto cardiopulmonar. Se presenta el caso de un varón de 48 años de edad, con fractura expuesta de tibia izquierda no operada, hospitalizado sin uso de heparina profiláctica, quién cursó con disnea súbita, dolor torácico y arresto cardiopulmonar dos veces, el primero en hospitalización general, y el segundo al ingreso a la unidad de cuidados intensivos (UCI). Post retorno de la circulación espontanea cursó con hipotensión, taquicardia, hipoxemia, Glasgow 4 puntos; en el electrocardiograma se encontró taquicardia sinusal, patrón S1Q3T3, bloqueo completo de rama derecha; en la ecocardiografía relaci...

Introduction: Shoshin Beriberi is a disease generated by thiamine deficiency and is characterized by acute fulminant cardiac dysfunction (1). Objective: To highlight cardiogenic shock and hyperlactacidemia in a patient with shoshin beriberi in an intensive care unit of a general hospital. Material and method: The information was taken from the electronic medical history of the intensive care unit (ICU) of the Cayetano Heredia National Hospital (HNCH) and from laboratory and image records. Case: 22-year-old female patient, with a history of anorexia nervosa, multisystem tuberculosis (TBC); with abdominal pain, vomiting, oral intolerance, prolonged fasting, received total parenteral nutrition (TPN) without thiamine intake and with hospitalization for 40 days on the general floor; Admission to the ICU in cardiogenic shock and hyperlactacidemia with serum lactate 13.8 mmol/L. With sepsis rul...