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Medicina Clínica
Article
License: CC BY NC SA
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Medicina Clínica
Article . 2021 . Peer-reviewed
License: Elsevier TDM
Data sources: Crossref
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Isquemia medular tras parada cardiaca

Authors: Lozano Gómez, H.; Isern de Val, I.; Zalba Etayo, B.;

Isquemia medular tras parada cardiaca

Abstract

La parada cardiorrespiratoria (PCR) en una de las principales causas de muerte a nivel mundial. En la monitorización del paciente el ritmo registrado más frecuente, entre un 25 y un 75% es la fibrilación ventricular (FV). El tratamiento de la PCR presenciada, es el inicio inmediato de las maniobras de resucitación, básica o avanzada, que garantice una adecuada perfusión cerebral y del resto de órganos con el objetivo de minimizar secuelas posteriores1. Presentamos el caso de un varón de 56 años, exadicto a drogas por vía parenteral y fumador, con antecedentes de infección por virus de la hepatitis C (en tratamiento con glecaprevir/pibrentasvir), insuficiencia mitral moderada-severa, insuficiencia cardiaca y EPOC GOLD A. Fue atendido en su centro de salud por disnea de varios días, 4 días de evolución, con test rápido de SARS-CoV-2 negativo. Durante la consulta sufrió una PCR, donde se registró una fibrilación ventricular (FV) y posteriormente una «torsade de pointes». Se iniciaron maniobras de resucitación avanzada con hasta 24 desfibrilaciones, administración de 5 mg de adrenalina, 900 mg de amiodarona e intubación orotraqueal. Recuperación del ritmo cardiaco con salida en ritmo sinusal sin alteraciones de la repolarización. Durante el traslado, sufrió nueva FV, que revirtió con 2 desfibrilaciones y requirió inicio de perfusión de dopamina por inestabilidad hemodinámica. A su llegada a la unidad de cuidados intensivos, se realizó coronariografía donde se visualizaron unas arterias coronarias sin lesiones. La ecocardiografía transtorácica demostró una fracción de eyección del 56% sin asimetrías segmentarias e .

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
Green
hybrid