Pronóstico de los pacientes VIH positivos ingresados en UCI
Prognosis of HIV/Positive Patiens Admitted to the Intensive Care Unit
Servicio de Medicina Intensiva. Hospital Arantzazu. San Sebastián
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Martínez sagasti, J.L. Iribarren sarrías, C. Naranjo jarillo, A. Lacruz urbina, A.M. De Vera González, M.L. Mora quintero" "autores" => array:6 [ 0 => array:2 [ "nombre" => "F." "apellidos" => "Martínez sagasti" ] 1 => array:2 [ "nombre" => "J.L." "apellidos" => "Iribarren sarrías" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Naranjo jarillo" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Lacruz urbina" ] 4 => array:2 [ "nombre" => "A.M." "apellidos" => "De Vera González" ] 5 => array:2 [ "nombre" => "M.L." "apellidos" => "Mora quintero" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021056910079632X?idApp=WMIE" "url" => "/02105691/0000002400000009/v1_201304241206/S021056910079632X/v1_201304241206/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "titulo" => "Pronóstico de los pacientes VIH positivos ingresados en UCI" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "392" "paginaFinal" => "397" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "G. Choperena, I. Arcega, P. Marco, I. Mintegi, K. Reviejo, A. Murgialdai, B. Azkarate, G. Lara" "autores" => array:8 [ 0 => array:3 [ "nombre" => "G." "apellidos" => "Choperena" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "I." "apellidos" => "Arcega" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Marco" ] 3 => array:2 [ "nombre" => "I." "apellidos" => "Mintegi" ] 4 => array:2 [ "nombre" => "K." "apellidos" => "Reviejo" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Murgialdai" ] 6 => array:2 [ "nombre" => "B." "apellidos" => "Azkarate" ] 7 => array:2 [ "nombre" => "G." "apellidos" => "Lara" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Medicina Intensiva. Hospital Arantzazu. San Sebastián" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia: Dr. G. Choperena Alzugaray. Servicio de Medicina Intensiva. Hospital Arantzazu. Paseo del Dr. Beguiristain, s/n. 20014 San Sebastián" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Prognosis of HIV/Positive Patiens Admitted to the Intensive Care Unit" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaAceptado" => "2000-05-22" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec82378" "palabras" => array:3 [ 0 => "virus de la inmunodeficiencia humana" 1 => "sida" 2 => "unidad de cuidados intensivos" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec82377" "palabras" => array:3 [ 0 => "human immunodeficiency virus" 1 => "AIDS" 2 => "intensive care unit" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Desde el diagnóstico de los primeros casos de infección por el virus de la inmunodeficiencia humana (VIH) en nuestro país, y a medida que la epidemia progresa, aumenta el número de personas infectadas por el VIH que necesitan tratamiento en UCI. Sin embargo, la idoneidad de su ingreso es objeto de amplio debate, con componentes médicos, sociales, emocionales, legales y económicos no resueltos en la actualidad. Por ello hemos querido conocer las características de pacientes VIH positivos ingresados en UCI en los primeros 12 años de la epidemia y determinar factores pronósticos que ayuden al intensivista a la hora de adoptar la decisión del ingreso de este grupo de enfermos.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio epidemiológico observacional, transversal, de morbimortalidad. Variables: se analizaron diferentes variables epidemiológicas, clínicas y analíticas medidas el día del ingreso.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 102 enfermos VIH positivos ingresados en UCI desde enero de 1985 a enero de 1997. La mayoría de los enfermos fueron varones (80/102), con una edad media de 32 años. El 60,8% cumplía criterios de sida-1987 y un 65,7 los ampliados de 1993. El 77,5% se había infectado por el uso de drogas por vía parenteral. Un 56,9% ingresó por insuficiencia respiratoria, siendo la mayoría neumonías por Pneumocystis carinii (NCP). La mortalidad en UCI fue del 48%. Los factores que se asociaron con un incremento significativo de la mortalidad (p < 0,05) fueron: sexo femenino, cumplimiento de criterios de sida, falta de conocimiento de infección VIH, ausencia de diagnóstico etiológico o presencia al ingreso de hipotensión, taquipnea, hipoxia severa, acidosis, anemia y un menor número de linfocitos CD4.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La determinación de factores pronósticos en los pacientes infectados por el VIH que requieren tratamiento en UCI es importante, tanto para informar adecuadamente a enfermos y familiares como para tomar decisiones clínicas y terapéuticas. Los continuos avances en el tratamiento de la infección VIH y enfermedades asociadas hacen necesario la realizacion de una puesta al día continua y la realización de nuevos estudios.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Since the first cases of human immunodeficiency virus (HIV) were diagnosed in Spain and as the epidemic develops, the number of HIV-infected individuals requiring treatment in intensive care units (ICUs) is increasing. However, the advisability of admitting these patients is debatable and involves medical, social, emotional, legal and economic issues that currently remain unresolved. Consequently, we decided to determine the characteristics of HIV-positive patients admitted to the ICU during the first 12 years of the epidemic and to determine the prognostic factors that are of use to intensivists when deciding to admit these patients.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Observational transversal epidemiological study of morbidity and mortality. Various epidemiological, clinical and analytical variables noted on admission were analyzed.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 102 HIV-positive individuals admitted to the ICU from January 1985 to January 1997 were studied. Most of the patients were male (80/102) with a mean age of 32 years. Criteria for acquired immunodeficiency syndrome (AIDS) were fulfilled by 60.8% of the patients in 1987 and by 65.7% in 1993. In 77.5% transmission was through parenteral drug use. Cause of admission was respiratory insufficiency in 56.9%, the majority being due to Pneumocystic carinii pneumonia. Mortality in the ICU was 48%. Factors associated with a significantly increased mortality (p < 0.05) were femenine sex, fulfilling the criteria for AIDS, lack of awareness of HIV-infection, absence of etiologic diagnosis or presence on admission of hypotension, tachypnea, severe hypoxia, acidosis, anemia ans depletion of CD4 lymphocytes.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Determination of prognostic factors in HIV- patients requiring treatment in ICUs is important in order to the appropriately inform the patients and their relatives as well as to be able to take clinical and therapeutic decisions. Because of the continual advances in the treatment of HIV infection and associated diseases, keeping up to date new studies are required.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:31 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cuidados intensivos a pacientes con infección por VIH" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.J. Rosen" 1 => "V.A. De Palo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Pulmonary and Critical Care Update" "fecha" => "1997" "volumen" => "13" "paginaInicial" => "2" "paginaFinal" => "6" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 11 | 19 | 30 |
| 2024 Octubre | 81 | 82 | 163 |
| 2024 Septiembre | 99 | 56 | 155 |
| 2024 Agosto | 99 | 70 | 169 |
| 2024 Julio | 108 | 42 | 150 |
| 2024 Junio | 111 | 51 | 162 |
| 2024 Mayo | 110 | 46 | 156 |
| 2024 Abril | 194 | 59 | 253 |
| 2024 Marzo | 127 | 43 | 170 |
| 2024 Febrero | 168 | 52 | 220 |
| 2024 Enero | 144 | 57 | 201 |
| 2023 Diciembre | 178 | 95 | 273 |
| 2023 Noviembre | 232 | 61 | 293 |
| 2023 Octubre | 254 | 45 | 299 |
| 2023 Septiembre | 261 | 67 | 328 |
| 2023 Agosto | 95 | 26 | 121 |
| 2023 Julio | 74 | 47 | 121 |
| 2023 Junio | 115 | 34 | 149 |
| 2023 Mayo | 57 | 29 | 86 |
| 2023 Abril | 107 | 37 | 144 |
| 2023 Marzo | 158 | 60 | 218 |
| 2023 Febrero | 142 | 53 | 195 |
| 2023 Enero | 145 | 47 | 192 |
| 2022 Diciembre | 120 | 46 | 166 |
| 2022 Noviembre | 247 | 51 | 298 |
| 2022 Octubre | 207 | 76 | 283 |
| 2022 Septiembre | 137 | 56 | 193 |
| 2022 Agosto | 113 | 56 | 169 |
| 2022 Julio | 87 | 48 | 135 |
| 2022 Junio | 103 | 45 | 148 |
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| 2022 Abril | 99 | 63 | 162 |
| 2022 Marzo | 117 | 70 | 187 |
| 2022 Febrero | 117 | 43 | 160 |
| 2022 Enero | 116 | 58 | 174 |
| 2021 Diciembre | 107 | 58 | 165 |
| 2021 Noviembre | 141 | 53 | 194 |
| 2021 Octubre | 153 | 79 | 232 |
| 2021 Septiembre | 118 | 65 | 183 |
| 2021 Agosto | 109 | 63 | 172 |
| 2021 Julio | 56 | 50 | 106 |
| 2021 Junio | 88 | 39 | 127 |
| 2021 Mayo | 167 | 79 | 246 |
| 2021 Abril | 328 | 84 | 412 |
| 2021 Marzo | 311 | 49 | 360 |
| 2021 Febrero | 151 | 51 | 202 |
| 2021 Enero | 164 | 39 | 203 |
| 2020 Diciembre | 183 | 34 | 217 |
| 2020 Noviembre | 334 | 49 | 383 |
| 2020 Octubre | 226 | 20 | 246 |
| 2020 Septiembre | 161 | 27 | 188 |
| 2020 Agosto | 95 | 30 | 125 |
| 2020 Julio | 142 | 14 | 156 |
| 2020 Junio | 214 | 36 | 250 |
| 2020 Mayo | 215 | 28 | 243 |
| 2020 Abril | 241 | 28 | 269 |
| 2020 Marzo | 124 | 36 | 160 |
| 2020 Febrero | 319 | 67 | 386 |
| 2020 Enero | 182 | 47 | 229 |
| 2019 Diciembre | 226 | 97 | 323 |
| 2019 Noviembre | 441 | 147 | 588 |
| 2019 Octubre | 253 | 70 | 323 |
| 2019 Septiembre | 201 | 56 | 257 |
| 2019 Agosto | 132 | 54 | 186 |
| 2019 Julio | 113 | 47 | 160 |
| 2019 Junio | 130 | 46 | 176 |
| 2019 Mayo | 222 | 126 | 348 |
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| 2019 Marzo | 82 | 81 | 163 |
| 2019 Febrero | 49 | 105 | 154 |
| 2019 Enero | 37 | 107 | 144 |
| 2018 Diciembre | 84 | 144 | 228 |
| 2018 Noviembre | 111 | 148 | 259 |
| 2018 Octubre | 34 | 42 | 76 |
| 2018 Septiembre | 31 | 28 | 59 |
| 2018 Agosto | 37 | 23 | 60 |
| 2018 Julio | 23 | 29 | 52 |
| 2018 Junio | 19 | 33 | 52 |
| 2018 Mayo | 17 | 37 | 54 |
| 2018 Abril | 22 | 32 | 54 |
| 2018 Marzo | 19 | 26 | 45 |
| 2018 Febrero | 13 | 9 | 22 |
| 2018 Enero | 13 | 25 | 38 |
| 2017 Diciembre | 13 | 22 | 35 |
| 2017 Noviembre | 27 | 26 | 53 |
| 2017 Octubre | 10 | 36 | 46 |
| 2017 Septiembre | 14 | 23 | 37 |
| 2017 Agosto | 12 | 20 | 32 |
| 2017 Julio | 16 | 30 | 46 |
| 2017 Junio | 29 | 23 | 52 |
| 2017 Mayo | 27 | 19 | 46 |
| 2017 Abril | 22 | 11 | 33 |
| 2017 Marzo | 11 | 7 | 18 |
| 2017 Febrero | 31 | 8 | 39 |
| 2017 Enero | 11 | 8 | 19 |
| 2016 Diciembre | 21 | 14 | 35 |
| 2016 Noviembre | 45 | 8 | 53 |
| 2016 Octubre | 42 | 28 | 70 |
| 2016 Septiembre | 42 | 16 | 58 |
| 2016 Agosto | 29 | 7 | 36 |
| 2016 Julio | 15 | 8 | 23 |
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