<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2448-8909</journal-id>
<journal-title><![CDATA[Medicina crítica (Colegio Mexicano de Medicina Crítica)]]></journal-title>
<abbrev-journal-title><![CDATA[Med. crít. (Col. Mex. Med. Crít.)]]></abbrev-journal-title>
<issn>2448-8909</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Medicina Crítica A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-89092020000400249</article-id>
<article-id pub-id-type="doi">10.35366/95881</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Síndrome de distrés respiratorio agudo en paciente con COVID-19]]></article-title>
<article-title xml:lang="en"><![CDATA[Acute respiratory distress syndrome in patient with COVID-19]]></article-title>
<article-title xml:lang="pt"><![CDATA[Síndrome do desconforto respiratório agudo em um paciente com COVID-19]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez-Campaña]]></surname>
<given-names><![CDATA[Jesús Cleofas]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Morales-Barraza]]></surname>
<given-names><![CDATA[Jesús Ariel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arrambí-Díaz]]></surname>
<given-names><![CDATA[Cibeles]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Valenzuela-Molina]]></surname>
<given-names><![CDATA[Lucia Concepción]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Hospital de Especialidades No. 2 ]]></institution>
<addr-line><![CDATA[Cd. Obregón Sonora]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Hospital Regional No. 1 ]]></institution>
<addr-line><![CDATA[Cd. Obregón Sonora]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2020</year>
</pub-date>
<volume>34</volume>
<numero>4</numero>
<fpage>249</fpage>
<lpage>253</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092020000400249&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092020000400249&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092020000400249&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  La enfermedad por coronavirus (COVID-19 coronavirus disease por sus siglas en inglés) es una emergencia sanitaria, y una de las complicaciones más temidas es el síndrome de distrés respiratorio agudo (SDRA) dada su elevada mortalidad.  Caso clínico:  Paciente masculino de 59 años con antecedente de hipertensión y tabaquismo, que inicia síntomas posteriores a contacto con portador asintomático de COVID-19 proveniente del extranjero. La sintomatología que presentó fue mialgias, artralgias, febrícula de 37.7 grados, posteriormente fiebre de 38.4 grados, disnea, fatiga y odinofagia. Acude a consulta y se hospitaliza, otorgando tratamiento con cloroquina, azitromicina y oseltamivir por cuatro días; se tomó de muestra para COVID-19. El paciente mostró aumento de trabajo respiratorio, se tomó radiografía de tórax con opacidades heterogéneas periféricas de ambos pulmones y se corroboró por tomografía de tórax imagen de vidrio despulido. Presentó disnea progresiva e hipoxemia requiriendo manejo avanzado de la vía aérea y se trasladó a la Unidad de Cuidados Intensivos Metabólicos donde se recibió con ventilación mecánica (VM), requiriendo sedación, analgesia, relajante muscular así como ventilación protectora. Se realizaron cambios de posición para evitar microatelectasias. Se obtuvo por cultivos Pseudomonas aeruginosa y Escherichia coli. El día 11 de estancia en la UCI se logró progresar ventilación mecánica hasta destete de ésta, y el paciente se egresó de dicho servicio 48 horas después.  Conclusiones:  El presente caso evidencia el progreso del daño pulmonar por COVID-19 causando falla respiratoria que requirió ventilación mecánica, el tratamiento crítico consistió en fortalecer la dinámica de calidad enfatizando monitoreo ventilatorio, hemodinámico y metabólico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  Coronavirus disease (COVID-19) is a health emergency and one of the most feared complications is acute respiratory distress syndrome (ARDS) due to its high mortality.  Clinical case:  A 59-year-old male patient with a history of hypertension and smoking, who begins to show symptoms after contact with an asymptomatic carrier of COVID-19 from abroad. The symptoms presented were myalgia, arthralgia, 37.7-degree fever, later 38.4-degree fever, dyspnea, fatigue and odynophagia. He went to the clinic and was hospitalized, being treated with chloroquine, azithromycin and oseltamivir for four days and a sample was taken for COVID-19. The patient presented increased respiratory work, chest radiography was taken with heterogeneous peripheral opacities of both lungs and was corroborated by chest tomography image of polished glass. He presented progressive dyspnea and hypoxemia requiring advanced airway management and was transferred to the metabolic intensive care unit where he was received with mechanical ventilation (MV), requiring sedation, analgesia, muscle relaxant, as well as protective ventilation. Changes of position were made to avoid micro atelectasis. It was obtained by culture of Pseudomonas aeruginosa and Escherichia coli. On the 11th day of the stay in ICU, mechanical ventilation was achieved until weaning, and the patient was discharged from ICU 48 hours later.  Conclusions:  The present case evidences the progress of lung damage by COVID-19 causing respiratory failure requiring mechanical ventilation, where the critical treatment consisted in strengthening the quality dynamics emphasizing ventilatory, hemodynamic and metabolic monitoring.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução:  A doença por coronavírus (COVID-19 coronavirus disease, por sus siglas en inglés) é uma emergência de saúde, e uma das complicações mais temidas é a síndrome do desconforto respiratório agudo (SDRA), dada sua alta mortalidade.  Caso clínico:  Paciente do sexo masculino, 59 anos, com história de hipertensão e tabagismo, que iniciou os sintomas após contato com portador de COVID-19 assintomático do exterior. Os sintomas que apresentou foram mialgias, artralgias, febrícula de 37.7 graus, posterioriormente febre de 38.4 graus, dispnéia, cansaço e odinofagia, assiste a consulta médica e é hospitalizado, iniciando tratamento com cloroquina, azitromicina e oseltamivir durante 4 dias e foi uma colhida amostra por COVID-19. O paciente apresentava aumento do esforço respiratório, radiografia de tórax com opacidades periféricas heterogêneas de ambos pulmões e imagem em vidro fosco corroborada pela tomografia de tórax. Apresentou dispnéia progressiva e hipoxemia com necessidade de manejo avançado das vias aéreas e foi encaminhado para unidade de terapia intensiva metabólica onde recebeu ventilação mecânica (VM), necessitando de sedação, analgesia, relaxante muscular, além de ventilação protetora. Mudanças de posição foram feitas para evitar micro atelectasia. No cultivo obtivemos Pseudomonas aeruginosa e Escherichia coli. No 11 dia de internação na UTI, a ventilação mecânica foi progredida até o desmame, sendo dispensado do referido serviço 48 horas depois.  Conclusões:  O presente caso mostra a evolução do dano pulmonar por COVID-19 causando insuficiência respiratória que requer ventilação mecânica, onde o tratamento crítico consistiu no fortalecimento da dinâmica de qualidade com ênfase na monitoração ventilatória, hemodinâmica e metabólica.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[COVID-19]]></kwd>
<kwd lng="es"><![CDATA[síndrome de distrés respiratorio agudo (SDRA)]]></kwd>
<kwd lng="es"><![CDATA[ventilación mecánica (VM)]]></kwd>
<kwd lng="en"><![CDATA[COVID-19]]></kwd>
<kwd lng="en"><![CDATA[acute respiratory distress syndrome (ARDS)]]></kwd>
<kwd lng="en"><![CDATA[mechanical ventilation (MV)]]></kwd>
<kwd lng="pt"><![CDATA[COVID-19]]></kwd>
<kwd lng="pt"><![CDATA[síndrome do desconforto respiratório agudo (SDRA)]]></kwd>
<kwd lng="pt"><![CDATA[ventilação mecânica (VM)]]></kwd>
</kwd-group>
</article-meta>
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