Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introduction: Perioperative mortality rate represents a global indicator for safe access to surgical and anesthesiological care.Objective: To characterize patients who deceased during the perioperative period in surgical interventions.Methods: A cross-sectional and descriptive study was carried out in the anesthesiology service of Arnaldo Milián Castro Clinical-Surgical Hospital, in Villa Clara Province, in the period from January 2015 to December 2018. The study population consisted of patients who received surgery within that hospital (N: 133 724). The sample consisted of patients who died during the intraoperative period and within the first 24 hours after surgery (n: 77).Results: The general perioperative mortality rate was 5.76/10 000. There was incidence of higher mortality among men (59.7%), elderlies (75.3%), patients with several associated comorbidities (51.9%), those classified as ASA-IV (41.5%), those belonging to group II for surgical risk (62.3%), cases of abdominal surgery (63.6%), emergency interventions (88.3%), patients under general anesthetic technique (84.4 %), and at 24 hours after the postoperative period (68.8%). Septic shock was the main cause of mortality (48.1%).Conclusions: There was a predominance of deaths among elderlies with associated comorbidities, high anesthetic, as well as surgical risk, who received emergency surgery under general anesthesia, being septic shock the main cause of death. The perioperative mortality rate was similar to that in nations of equivalent socioeconomic development.

Introduction: Laryngospasm is a complication feared by anesthesiologists. It is associated with bronchospasm, hypoxia, arrhythmias, aspiration of gastric contents, and cardiac arrest. It is more common among neonates and infants. It is closely related to the type of surgery and consists in an intense and prolonged closure of the glottis in response to direct or reflex glottic stimulation.Objective: To describe the management of reflex partial laryngospasm in a pediatric patient during a urological intervention.Case presentation: 18-month-old patient who received meatotomy. During surgery, he presented reflex partial laryngospasm managed with physical maneuvers, without the need to use medication or the mechanic airways ventilation.Conclusions: The maneuvers used are safe and effective for the management of reflex laryngospasm without the need to address the airway or using of medications. Satisfactory outcomes were achieved with a risk-benefit ratio in favor of the patient.

Introduction:The “air leak” test around the endotracheal tube is not invasive. It is relatively easy to perform and provides an indication of the permeability of the upper airway.Objective:To evaluate the effectiveness of the air leak” test around the endotracheal tube, qualitatively and quantitatively measured, for the safety of extubation.Method:A descriptive, prospective and cross-sectional study was carried out with patients of any gender scheduled for surgical intervention by laryngeal microsurgery, surgery for endotoxic goiter, maxillofacial surgery, and those with a history of difficult intubation that required more than three attempts at intubation and/or the usage of drivers or guides. The sample consisted of 52 patients who met the selection criteria. Statistical analysis was performed by calculating measures for qualitative variables, while for quantitative variables, Pearson's chi-square (x2) was used.Results:The group with more frequency was represented by those under 40 years. The male sex prevailed. The 7.5 tube was the most used (50%). The results of the concordance between the qualitative and quantitative test according to the presence or absence of air leak around the tube was 90.4%, respectively. Complications based on the tests were scarce.Conclusions:Both tests are useful tools for the diagnosis of airway obstruction during extubation. The qualitative modality proved to be as effective as the quantitative and easier to reproduce for the operators in the study.Keywords: test of leak around the tube; cuff-leak test; extubation.

Introduction:Bradyarrhythmias are serious heart diseases that cause severe hemodynamic disorders. Bringing the patient to normal cardiac output may imply that a pacemaker be implanted.Objective:To describe some clinical and epidemiological aspects of patients who received the technique of implanting a pacemaker.Methods:A descriptive and cross-sectional study was carried out with 36 patients who needed a temporary pacemaker, admitted to the intensive care unit of Orlando Pantoja Tamayo General Teaching Hospital in Contramaestrem, in the period from October 2015 to May 2019. The variables used were age group and sex, causes of arrhythmias, and personal pathological history, most used medications prior to admission, time of usage of the temporary pacemaker, and the need for permanent implantation.Results:The male sex and ages 80 and older predominated, the most frequent atrioventricular conduction disorder was the third-degree atrioventricular block. The average time of temporary pacemaker usage was between two and six days.Conclusions:Early implantation in this municipal institution significantly improved patient survival.Keywords:  conduction disorders;  bradyarrhythmias; temporary pacemaker

Multifocal progressive leukoencephalopathy, caused by reactivation of a latent JC-virus infection, has been classically correlated with certain conditions such as HIV infection, hematological malignancies and profound immunosuppression. Nevertheless, more recently, rheumatic autoimmune diseases have been identified as a risk factor for the development of this condition. Amongst these diseases, Systemic Erythematous Lupus stands out as the disease with greater incidence for PM; a remarkable superior prevalence which doesn’t seem to be related with pharmacological immunosuppression, but with inherent characteristics of the disease

Between 76% and 94% of animal bites are due to dog bites. Approximately 8 cases of dog bites per month are admitted to Costa Rica in the different health centers, where half of the cases correspond to patients under 9 years old. The most commonly isolated microorganism is Pasteurella canis. There is still controversy in the need to give antibiotic prophylaxis in all cases, thus experts are agree that each case should be evaluated individually. Suturing a dog bite wound has been observed does not generate an increased risk of infection and produces better esthetic results. Prophylaxis against tetanus and rabies should be guaranteed in those patients who do not have their complete vaccination schedule or in those patients with an increased risk of contracting the infection, either due to virus endemicity, mainly canine urban rabies or the risk that the animal responsible for the incident have the infection  

The antiphospholipid syndrome is a systemic autoimmune disease, orchestrated by multiple autoantibodies directed against phospholipid binding proteins. The disease has diverse clinical manifestations, in which thrombotic events and obstetric complications stand out. Current pharmacological treatment of obstetric antiphospholipid syndrome is oriented towards preventive methods, nonetheless, a considerable number of patients develop clinical manifestations despite optimal pharmacological measures. The current case report deals about a 24-year-old patient with a recent diagnosis of antiphospholipid syndrome who, despite treatment with low dose aspirin, heparin at full therapeutic dose and hydroxychloroquine, eventually develops severe preeclampsia and pregnancy interruption through an emergency c-section.