Purpose: Central venous oxygen saturation (ScvO₂) has been reported as a prognostic marker of in-hospital mortality when it is below 60% in certain situations. Nevertheless, it has not been widely reported in patients undergoing coronary artery bypass graft (CABG). The study determined the association between ScvO₂ and in-hospital mortality in patients undergoing CABG in a high-complexity health institution in Santiago de Cali, Colombia. Patients and Methods: A retrospective cohort study was conducted with patients undergoing isolated CABG. The subject sample included 515 subjects aged 18 years or older. Exposure was defined as ScvO₂ < 60% upon admission to the intensive care unit (ICU) following surgery. The major outcome was mortality rates after 30 days. Furthermore, exposure variables were measured at preoperative, intra-operative, and postoperative time points. Results: A total of 103 exposed and 412 unexposed subjects were included. The final model revealed a higher mortality risk in individuals with ScvO₂ < 60% upon ICU admission compared with those with higher saturation levels (relative risk 4.2, 95% confidence interval: 2.4– 7.2; p = 0.001). Values were adjusted using variables such as age (> 75 years), low socioeconomic stratum, chronic kidney failure before surgery, unstable angina before surgery, ischemia time (> 60 min), and intra-operative inotrope use. The primary cause of death was cardiogenic shock (54.7%), followed by sepsis (25.0%) and postoperative bleeding (17.2%). Conclusion: The study identified an association between ScvO₂ < 60% and in-hospital mortality in patients undergoing CABG.

Background: Therapeutic exercise and early mobilization are strategies that have demonstrated benefits in patients in intensive care units, however postsurgical patients of cardiovascular surgery present differential risks and therefore specialized interventions. Objectives: To identify the effects of therapeutic exercise in intensive care unit patients who underwent cardiac surgery as reported in the scientific literature. Methods: A scoping review was conducted using the following databases: Scopus, ScienceDirect, Physiotherapy Evidence Database, and PubMed®. There were no language restrictions, and articles published between January 1, 2018, and October 30, 2023, were included. The characteristics of the population were collected according to exercise prescription principles, frequency, intensity, time, type of activity/mode, and the benefits reported for early exercise. Results: From a 814 papers, 12 that met the inclusion criteria were selected for final analysis. Most patients were male, aged between 54 and 68 years; the rehabilitation protocol started between 2 and 8 hours after extubation, with different degrees of exercise intensity. Finally, improved exercise tolerance and functional capacity, decreased onset of delirium, improved oxygen consumption and decreased intensive care unit stay were reported. Discussion: Most studies use validated scales to determine aerobic capacity and other physical qualities in the population. However, the prescription of exercise intensity reflects variations. This difficulty could be attributed to the differential response associated with the particular conditions of each subject, which highlights the importance of trained professionals to address these interventions safely. Conclusion: Therapeutic exercise prescribed in intensive care unit patients after cardiac surgery positively affects their outcomes. However, our findings report a lack of precision in exercise intensity and heterogeneous intervention protocols.

Background: Thoracentesis is pivotal in managing pleural effusion (PE), particularly in invasive mechanical ventilation (IMV), with documented improvements in respiratory mechanics, oxygenation, and hemodynamic parameters. However, its efficacy may vary based on effusion type and drained volume. Methods: A retrospective longitudinal study was conducted at a high-complexity care center in Cali, Colombia (2019–2024), including 93 (IMV) patients who underwent therapeutic thoracentesis (TT). Respiratory and hemodynamic parameters were assessed before and up to 24 h post-procedure. Stratified analysis was performed by drained volume, fluid type, and left ventricular ejection fraction (LVEF). Results: TT yielded significant improvements in fraction of inspired oxygen (FiO₂) (−4%), positive end expiratory pressure (PEEP) (−0.5 cmH₂O), and Oxygen arterial Pressure Index/Inspired Oxygen Fraction (PaO₂/FiO₂-ratio) (+27.1), with greater impact for volumes ≥500 mL and transudative PE. Patients with LVEF ≤ 40% showed increased mean arterial pressure (MAP) and PaO₂. Complication rates were low (<4%). Conclusions: TT is safe and effective in critically ill IMV patients, particularly for transudative PE and drained volumes ≥500 mL, as well as in subjects with LVEF ≤ 40%. Its positive impact on oxygenation and ventilation supports its therapeutic utility in critical care.

Background: Handgrip strength has been proposed as an objective marker of post-COVID functional impairment, but its contribution relative to fatigue and sleep quality has not been formally evaluated in Latin American populations. Methods: We conducted an exploratory cross-sectional analysis of 130 adults with post-COVID condition in Palmira, Colombia. The outcome was any functional limitation on the Post-COVID Functional Status (PCFS) scale (grades 1–4 versus grade 0). Eight predictors were pre-specified on clinical grounds before examining outcome associations, and ridge-penalized logistic regression was pre-specified as the primary model. Sample size adequacy followed the criteria of Riley et al. Internal validation used bootstrap optimism correction (B = 1000), re-running the complete pipeline within each replicate. We assessed calibration, decision curves, prediction stability, SHapley Additive exPlanations (SHAP) with bootstrap rank intervals, and subgroup performance. Reporting followed TRIPOD + AI; risk of bias was self-assessed with PROBAST + AI. Results: Functional limitation affected 91/130 participants (70.0%). The minimum sample required for eight parameters was 566; the cohort met 23.0% of this requirement, so the analysis is exploratory. The optimism-corrected area under the curve was 0.748 (95% confidence interval (CI) 0.669–0.830), with calibration slope 1.15 (0.71–1.69). Fatigue ranked first in SHAP importance (54.0% of resamples), whereas grip strength ranked fifth (median rank 6). Net benefit exceeded both default strategies between thresholds 0.38 and 0.88. Thirty percent of participants changed classification in over 20% of resamples. Conclusions: Fatigue, sleep quality and acute-phase severity, rather than grip strength, emerged as the most influential correlates. These hypothesis-generating findings require confirmation in adequately powered cohorts.

En 2013, la posición decúbito prono se afirmó como una herramienta efectiva para el tratamiento del síndrome de dificultad respiratoria aguda, tras un estudio experimental que demostró que su aplicación temprana y prolongada mejora significativamente la supervivencia de los pacientes con este diagnóstico. Diferentes asociaciones incluyen este tratamiento como un elemento fundamental y fue necesaria su aplicación de forma continua a causa de la pandemia por COVID-19, demostrando su efectividad en esta población. Dentro de sus beneficios fisiológicos se enumera una mejor distribución del estrés y la tensión pulmonar total, controlando la sobre distensión, además de limitar la apertura y cierre en las áreas pulmonares dependientes de manera cíclica, atenuando así la injuria pulmonar inducida por ventilación mecánica y el control de la poscarga del ventrículo.

La cirugía de revascularización miocárdica es una de las opciones te-rapéuticas para la enfermedad cardíaca isquémica en conjunto con la intervención farmacológica y el abordaje de los estilos de vida. Al constituir una intervención invasiva trae consigo una serie de riesgos de complicación, especialmente a nivel cardiopulmonar, neurológi-co, renal e infeccioso, condiciones que comprometen la recuperación funcional del paciente y el grado de discapacidad, los tiempos de es-tancia, costos hospitalarios y la mortalidad. Las complicaciones pul-monares evidencian una incidencia importante, donde se destacan la atelectasia, el derrame pleural, neumotórax, neumonía, la disfun-ción muscular diafragmática, la ventilación mecánica prolongada, entre otras. Además, se ha observado deficiencias funcionales como la disminución de volúmenes y capacidades pulmonares, de la movi-lidad torácica y del nivel de oxigenación; resultados enmarcados en la disfunción pulmonar restrictiva, que a la luz del modelo de transpor-te de oxígeno llegan a influenciar los factores del sistema cardiovas-cular y pulmonar que facilitan o limitan la producción de movimien-to corporal, objetivo de estudio de la fisioterapia. En este sentido, la fisioterapia cuenta con estrategias de prevención e intervención para este tipo de deficiencias, dentro de las cuales se encuentran las téc-nicas de ejercicios respiratorios de inspiración profunda, ejercicios con incentivo respiratorio, el ciclo activo de la respiración, ejercicios con presión positiva, el entrenamiento muscular respiratorio, entre otros modos terapéuticos. Dichas estrategias orientadas al manejo de variables fisiológicas descritas por Postiaux y referentes al modelo mecánico de fisioterapia respiratoria que se basa en la modificación de la presión motriz del sistema respiratorio, la presión pleural.