[Pulmonary Hypertension Centers].

Pulmonary hypertension is a group of entities whose most severe form is represented by pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. Patient survival is reduced without treatment, so early diagnosis and treatment should be the primary objective. The Instituto Mexicano del Seguro Social participates in this fight to improve the care of these patients, since it has doctors with knowledge in the entity and even a department of Pulmonary Hypertension and Right Heart from where a successful, viable and versatile structure proposal has been made.

[Repeatability of spirometrys expiratory flows].

Background: The quality of the spirometry is estimated with criteria of acceptability and repeatability. The repeatability criteria accepted by consensus is < 0.150 L.

[Circulatory support with venovenous ECMO in a patient with reperfusion pulmonary edema after pulmonary artery thromboendarterectomy].

Chronic thromboembolic pulmonary hypertension (CTEPH) is a subtype of pulmonary hypertension characterized by the obstruction of pulmonary arteries secondary to chronic thromboembolism. Pulmonary thromboendarterectomy surgery (PTE) is the main treatment for patients with CTEPH, as it removes the chronic thrombi from the pulmonary arteries. Pulmonary reperfusion syndrome is a common complication of the surgery, which involves the development of pulmonary edema in the area where blood perfusion improves after the surgery.

[Treatment of cardiogenic shock due to right ventricular involvement].

The right ventricle is susceptible to changes in preload, afterload, and contractility. The answer is its dilation with dysfunction/acute failure; filling is limited to the left ventricle and cardiac output. Systemic venous congestion is retrograde to the right heart, it is involved in the genesis of cardiogenic shock due to right ventricle involvement.

[Anatomy-physiology considerations for cardiogenic shock with right ventricular involvement].

Since the discovery of right ventricular infarction, interest in the characteristics of the right ventricle has been increasing. Right ventricular function is now known to be a predictor of mortality in different settings. The right ventricle is a low-pressure, high-compliance, high-volume chamber.

[Response to comment on the article "Variability of hemoglobin and hematocrit determined in blood gas equipment"].

Hemoglobin and hematocrit are parameters widely used. They can be obtained from an automated hematology analyzer or from an arterial blood gas analyzer. Its variability is shown in the article "Variability of hemoglobin and hematocrit determined in blood gas equipment.

Echocardiographic analysis of pulmonary arterial systolic pressure in pulmonary hypertension.

Introduction: The reliability of pulmonary arterial systolic pressure by transthoracic echocardiography is limited by its variability to define pulmonary hypertension.

Objective: To know the variability of pulmonary arterial systolic pressure estimated by echocardiography in pulmonary hypertension. Their demographic variables were obtained.

[Six minute walk test in young native high altitude residents].

Background: The 6-minute walk test is widely used and evaluates the functional capacity to perform sub-maximal exercise, its behavior in healthy young native hight-altitude resident is unknown.

Objective: To describe the behavior of the 6-minute walk test in healthy young native hight-altitude resident.

Material And Methods: Analytical cross-sectional design.

Venous-arterial oxygen saturation and serum lactate in the postoperative period of cardiac surgery.

Introduction: Oxygen saturation and lactate are markers of tissue hypoxia; they are obtained from central venous and mixed venous sample of the pulmonary artery. The simultaneous behavior of these parameters in the postoperative period of cardiac surgery is unknown.

Objective: To characterize the lactate and oxygen saturation of the venous-arterial circuit of the postoperative patient from cardiac surgery.

["Follow up" strategy in the management of hospital stay].

Background: In countries with emerging economies, the adequate and efficient management of resources is a priority, through strategies to reduce prolonged stay, increase the availability of beds, maximize profitability and reduce iatrogenic complications.

Objective: The purpose of the study was to evaluate the effect of the "Follow up" strategy (FU) on the main indicators of the hospitalization process.

Material And Methods: A cross-sectional, comparative study was developed to evaluate the impact of the FU strategy on the indicators: hospital admissions and discharges, average days of hospital stay (DEH), percentage of hospital occupancy (OH), bed substitution interval (ISC), bed turnover rate (CRI) and prolonged hospital stay (EHP).

[Variability of hemoglobin and hematocrit determined in blood gas equipment].

Background: Usually hemoglobin and hematocrit are obtained from peripheral venous blood samples processed in equipment for hematic biometry. These parameters can also be determined from arterial samples processed on blood gas equipment. Its variability when using arterial samples and this equipment is unknown, in addition, if the lack of knowledge of this variability affects clinical decisions.

[Pulmonary hypertension. Defining the structure and the departmental function based on risk].

A departmental model for the comprehensive care of patients with pulmonary hypertension is presented. The current knowledge of pulmonary hypertension, its mortality, prognosis and the stratification of its severity that justify the proposal of the departmental structure and function are summarized.

[Within-subject variability of the 6-minute walk test].

Background: The 6-minute walk test assesses the ability to perform exercise and it is widely used, of low cost, and of diverse variability.

Objective: To define the usefulness of a second 6-minute walk test performed 30 minutes from the first. Material and methods.

[Characterization of gas exchange parameters in Mexico City].

Background: At high altitude the gas exchange is impaired, in the moderate altitude of Mexico City they are not yet defined.

Objective: To characterize the gas exchange in the moderate altitude of Mexico City.

Material And Methods: Through an analytical cross-sectional study, subjects born and inhabitants of Mexico City, both genders, aged 20 to 59 years without cardiopulmonary disease, were studied.

[Chronic exposure to altitude. Clinical characteristics and diagnosis].

Chronic exposure to altitude has been associated with hypobaric hypoxia in its inhabitants. Two entities have been associated with it, high altitude pulmonary hypertension and chronic mountain sickness. Its physiological and pulmonary circulation characteristics are described, as well as its clinical profile and diagnosis.

[Deterioration of gas exchange in subjects with an increase in body mass index at an altitude of 2,240 meters above sea level].

IntroducciÓn: Las alteraciones del intercambio gaseoso se han reconocido en la obesidad mórbida; sin embargo, no se conoce su comportamiento conforme se incrementa el índice de masa corporal.

Objetivo: Conocer el comportamiento del intercambio gaseoso a la altura de la Ciudad de México en el desarrollo de obesidad mórbida.

MÉtodos: Mediante un diseño transversal analítico se estudió a sujetos pareados por género y edad de cuatro grupos diferentes de índice de masa corporal (kg/m): normal (18.

[Complicaciones trombóticas en COVID-19 grave: enfoque en tromboembolia venosa, tromboprofilaxis y anticoagulación].

La enfermedad grave por coronavirus 2019 (COVID-19) está causada por el Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) y predispone a complicaciones trombóticas. En esta revisión se aborda de manera práctica la estrecha relación entre la tromboembolia venosa y la COVID-19, enfatizando aspectos epidemiológicos, factores de riesgo y tromboprofilaxis, así como potenciales opciones de anticoagulación. Actualmente la evidencia científica es muy escasa, pero día a día seguimos aprendiendo, estando atentos a cambios novedosos y dinámicos en esta enfermedad infecciosa e inmunotrombótica emergente.

Incisión de Spangaro en lesiones cardiacas penetrantes, reporte de casos.

IntroducciÓn: El trauma en México es un problema mayor de salud pública, siendo una de las principales causas de mortalidad en personas jóvenes. La incidencia reportada de trauma cardiaco varía. El sitio primario de lesión miocárdica es la pared libre del ventrículo derecho.

[Circulatory support with venoarterial ECMO in a patient with biventricular Takotsubo cardiomyopathy].

La cardiomiopatía de Takotsubo es una entidad caracterizada por disfunción ventricular aguda y transitoria, la cual está generalmente relacionada a un evento desencadenante (estrés emocional o físico) y que, por lo general, se presenta con disfunción sistólica regional del ventrículo izquierdo, aunque hasta en un 30% puede ser biventricular. Según su severidad, en algunos casos puede condicionar choque cardiogénico refractario a manejo con inotrópicos y vasopresores, por lo que para estos casos deben considerarse los dispositivos de asistencia circulatoria. Presentamos el caso de una paciente joven a quien se realizó cambio valvular pulmonar con prótesis biológica, la cual siete semanas posteriores a la cirugía acudió al servicio de urgencias con derrame pericárdico y fisiología de tamponade secundario a síndrome pospericardiotomía.

Participation of pulmonary embolism response teams during the perioperative period.

La tromboembolia pulmonar aguda representa una causa frecuente de morbimortalidad cardiovascular, sólo rebasada por los síndromes coronarios agudos y la enfermedad cerebrovascular. El inicio y la intervención de un equipo multidisciplinario de respuesta rápida en la tromboembolia pulmonar son imperantes para mejorar el pronóstico y reducir al mínimo las posibles secuelas en el subgrupo de pacientes más graves. En este artículo de revisión se describe y revisa de manera general el papel actual y potencial que tienen dichos equipos de respuesta rápida, con un enfoque particular en el perioperatorio.

Feasibility in the echocardiographic estimation of parameters of the right ventricle in prone position.

Background: Echocardiographic cardiac parameters in the prone position are usually obtained with an esophageal probe. The feasibility of obtaining them by means of a transthoracic approach is unknown.

Objective: Estimating the feasibility to obtain parameters of the right ventricle by transthoracic echocardiography in prone position on the subject.

Critical care ultrasonography during COVID-19 pandemic: The ORACLE protocol.

Background: Coronavirus disease 2019 (COVID-19) is characterized by severe lung involvement and hemodynamic alterations. Critical care ultrasonography is vital because it provides real time information for diagnosis and treatment. Suggested protocols for image acquisition and measurements have not yet been evaluated.