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Revista americana de medicina respiratoria

versión On-line ISSN 1852-236X


ALVAREZ, Sabrina; ABDALA, Javier; BARIMBOIM, Enrique  y  GONZALEZ FABREGA, Julio. El desafío diagnóstico y terapéutico de la tuberculosis en terapia intensiva. Rev. am. med. respir. [online]. 2016, vol.16, n.4, pp.324-331. ISSN 1852-236X.

Introduction: TBC requiring Critical Care is rare and recognized as a poor prognosis. We describe a cohort of patients with this pathology interned in critical area determining: demographic characteristics, mortality and risk factors associated with it. Material and Methods: A descriptive study was conducted in the NOA Region. It was determined as the reference population the three sectors involved in the provision of OCD: pulmonologists of the region, local representatives of the main suppliers of medical oxygen and representatives of the three health subsystems. surveys and interviews especially designed applied. Results: In this period 151 attended Patients with TB. (Required ICU: 19%), 30 patients (17 males). Average Age: 40.3 (17-78), mortality was 24 (80%), all in the ICU; The median survival of the dead was 6.8 days (1-24); Pathologies associated were: HIV: 8 (26%), malnutrition: 6 (20%), nothing: 5 (16 %), alcohol abuse: 4 (13 %), lung pathology prior: 4 (13%) (bronchiectasis: 2, emphysema:1, smoking: 1) Chronic kidney disease: 3 (10%), renal transplant: 1 ( 3%) (receiving corticosteroids at immunosuppressive doses), muscular dystrophy: 1 (3%), rheumatoid arthritis: 3 (10%)( Of which 1 received low-dose corticosteroids and the other 2 treatment with biological), diabetes mellitus: 2: (6%) Von Recklinghausen: 1 (3%) ; Were found radiological patterns: alveolar opacity: 16 ( 53% ), miliary: 4 (13%), cavern: 2 (6%), rx standard: 4 (13%), pleural effusion: 1 (3%); cardiomegaly: 3: (10%).TB Presentation Forms were: pulmonary: 17 (56%), extrapulmonary: 7 (23%): pericardial: 4, peritoneal nodes: 1, bone: 1, disseminated forms: 6 (20%); ARM average 6.84 days (1-24); Causes of death: septic shock lung focus 8 (26%), NAVT: 6 (18%), ARDS: 5 (16%) , septic shock abdominal focus: 2 (6%), hemoptysis: 1 (3%) . Conclusion: Mortality of Patients with TBC requiring Critical Care is very high and occurs within the first week of UCI in our Hospital, as the different found series. Patients had severe associated pathologies. Most were pulmonary forms and the most common cause of death was septic shock.

Palabras clave : Tuberculosis; ICU; Critical care.

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