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Autor Juan Camilo Jaramillo Bustamante
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Comentario :
Médico Pediatra Subespecialista en Cuidado Intensivo, Hospital Pablo Tobón Uribe
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Documentos disponibles escritos por este autor (5)
Clasificado(s) por (Año de edición descendente) Refinar búsquedaAdrenaline for the early resuscitation of children with sepsis - a randomizedcontrolled pilot study (ANDES CHILD): study protocol and analysis plan / Juan Camilo Jaramillo Bustamante ; Lopera Múnera, Natalia ; Ortiz, Jorge ; Casson, Nils ; Iramain, Ricardo ; Pavlicich, Viviana ; Flauzino de Oliveira, Claudio ; Mozun, Rebeca ; Schlapbach, Luregn J ; Jabornisky, Roberto
Título : Adrenaline for the early resuscitation of children with sepsis - a randomizedcontrolled pilot study (ANDES CHILD): study protocol and analysis plan Tipo de documento : documento electrónico Autores : Juan Camilo Jaramillo Bustamante, Autor ; Lopera Múnera, Natalia, Autor ; Ortiz, Jorge, Autor ; Casson, Nils, Autor ; Iramain, Ricardo, Autor ; Pavlicich, Viviana, Autor ; Flauzino de Oliveira, Claudio, Autor ; Mozun, Rebeca, Autor ; Schlapbach, Luregn J, Autor ; Jabornisky, Roberto, Autor Fecha de publicación : 2025 Títulos uniformes : Intensive Care Medicine – Paediatric and Neonatal Idioma : Inglés (eng) Palabras clave : Adrenaline Child Inotrope Resuscitation Sepsis Septic shock Resumen : Purpose Sepsis is a leading cause of pediatric morbidity and mortality worldwide. Current guidelines recommend fluid bolus administration of 40–60 mL/kg as part of initial resuscitation, despite limited evidence and concerns about potential harm from high fluid volumes. The ANDES-CHILD pilot study hypothesizes that early initiation of inotropes is feasible and reduces fluid use compared to standard resuscitation. Methods Multicenter open label randomized controlled pilot trial conducted in three Pediatric Emergency Departments in Latin America. Children aged 28 days to 18 years with presumed septic shock will be randomized in a 1:1 ratio to receive either early adrenaline infusion after 20 mL/kg fluid bolus versus standard resuscitation with 40–60 mL/kg fluid bolus prior to initiating inotropes. The primary outcome is feasibility, with survival free of organ support censored at 28 days as the exploratory primary clinical outcome. The study will enroll 40 patients, representing approximately 10% of a full trial, with follow-up at 28 days. Baseline characteristics, adverse events and protocol violations will be summarized descriptively. Outcomes will be analyzed using difference estimates with 95% confidence intervals. An intention-to-treat approach will be used for statistical analysis. Discussion This pragmatic pilot study will generate essential data to evaluate the feasibility and guide the design of a full trial aimed to assessing the benefits of early inotrope use in pediatric septic shock. The study was registered on ClinicalTrials.gov prior to the start of recruitment (NCT06478797). Recruitment started on July 18, 2024. Mención de responsabilidad : Natalia Lopera-Múnera1, Jorge Ortiz2, Nils Casson3, Ricardo Iramain2, Viviana Pavlicich1, Juan Camilo Jaramillo-Bustamante, Claudio Flauzino de Oliveira, Rebeca Mozun, Luregn J Schlapbach6, and Roberto Jabornisky† Referencia : Intensive Care Medicine – Paediatric and Neonatal DOI (Digital Object Identifier) : 10.1007/s44253-025-000 Derechos de uso : CC BY-NC-ND En línea : file:///C:/Users/1128458306/Downloads/Adrenaline_for_the_early_resuscitation_of_ [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Adrenaline for the early resuscitation of children with sepsis - a randomizedcontrolled pilot study (ANDES CHILD): study protocol and analysis plan [documento electrónico] / Juan Camilo Jaramillo Bustamante, Autor ; Lopera Múnera, Natalia, Autor ; Ortiz, Jorge, Autor ; Casson, Nils, Autor ; Iramain, Ricardo, Autor ; Pavlicich, Viviana, Autor ; Flauzino de Oliveira, Claudio, Autor ; Mozun, Rebeca, Autor ; Schlapbach, Luregn J, Autor ; Jabornisky, Roberto, Autor . - 2025.
Obra : Intensive Care Medicine – Paediatric and Neonatal
Idioma : Inglés (eng)
Palabras clave : Adrenaline Child Inotrope Resuscitation Sepsis Septic shock Resumen : Purpose Sepsis is a leading cause of pediatric morbidity and mortality worldwide. Current guidelines recommend fluid bolus administration of 40–60 mL/kg as part of initial resuscitation, despite limited evidence and concerns about potential harm from high fluid volumes. The ANDES-CHILD pilot study hypothesizes that early initiation of inotropes is feasible and reduces fluid use compared to standard resuscitation. Methods Multicenter open label randomized controlled pilot trial conducted in three Pediatric Emergency Departments in Latin America. Children aged 28 days to 18 years with presumed septic shock will be randomized in a 1:1 ratio to receive either early adrenaline infusion after 20 mL/kg fluid bolus versus standard resuscitation with 40–60 mL/kg fluid bolus prior to initiating inotropes. The primary outcome is feasibility, with survival free of organ support censored at 28 days as the exploratory primary clinical outcome. The study will enroll 40 patients, representing approximately 10% of a full trial, with follow-up at 28 days. Baseline characteristics, adverse events and protocol violations will be summarized descriptively. Outcomes will be analyzed using difference estimates with 95% confidence intervals. An intention-to-treat approach will be used for statistical analysis. Discussion This pragmatic pilot study will generate essential data to evaluate the feasibility and guide the design of a full trial aimed to assessing the benefits of early inotrope use in pediatric septic shock. The study was registered on ClinicalTrials.gov prior to the start of recruitment (NCT06478797). Recruitment started on July 18, 2024. Mención de responsabilidad : Natalia Lopera-Múnera1, Jorge Ortiz2, Nils Casson3, Ricardo Iramain2, Viviana Pavlicich1, Juan Camilo Jaramillo-Bustamante, Claudio Flauzino de Oliveira, Rebeca Mozun, Luregn J Schlapbach6, and Roberto Jabornisky† Referencia : Intensive Care Medicine – Paediatric and Neonatal DOI (Digital Object Identifier) : 10.1007/s44253-025-000 Derechos de uso : CC BY-NC-ND En línea : file:///C:/Users/1128458306/Downloads/Adrenaline_for_the_early_resuscitation_of_ [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Título : Clinical Outcomes of Hypertonic Saline vs Mannitol Treatment Among Children With Traumatic Brain Injury Tipo de documento : documento electrónico Autores : Juan Camilo Jaramillo Bustamante, Autor ; Chong, Shu Ling, Autor ; Zhu, Yanan, Autor ; Wang, Quan, Autor ; Caporal, Paula, Autor ; Roa, Juan D, Autor ; Pantoja Chamorro, Freddy Israel, Autor ; Teran Miranda, Thelma Elvira, Autor ; Dang, Hongxing, Autor ; Seng Gan, Chin, Autor ; Abbas, Qalab, Autor ; Ardila, Ivan J, Autor ; Antar, Mohannad Ahmad, Autor ; Domínguez Rojas, Jesús A, Autor ; Miñambres Rodríguez, María, Autor ; Zita Watzlawik, Natalia, Autor ; Gómez Arriola, Natalia Elizabeth, Autor ; Yock Corrales, Adriana, Autor ; Lasso Palomino, Rubén Eduardo, Autor ; Mei Xiu, Ming, Autor ; S M Ong, Jacqueline, Autor ; Kurosawa, Hiroshi, Autor ; Aparicio, Gabriela, Autor ; Chunfeng Liu, Autor ; Rujipat, Samransamruajkit, Autor ; Nattachai, Anantasit, Autor ; Yek Kee Chor, Autor ; Turina, Deborah M, Autor ; Pei Chuen Lee, Autor ; Fonseca Flores, Marisol, Autor ; Pilar Orive, Francisco Javier, Autor ; Pei Wen, Jane Ng, Autor ; González Dambrauskas, Sebastián, Autor ; Lee, Jan Hau, Autor Fecha de publicación : 2025 Títulos uniformes : JAMA Network Open Idioma : Inglés (eng) Resumen : Importance: The use of hypertonic saline (HTS) vs mannitol in the control of elevated intracranial pressure (ICP) secondary to neurotrauma is debated. Objective: To compare mortality and functional outcomes of treatment with 3% HTS vs 20% mannitol among children with moderate to severe traumatic brain injury (TBI) at risk of elevated ICP. Design, setting, and participants: This prospective, multicenter cohort study was conducted between June 1, 2018, and December 31, 2022, at 28 participating pediatric intensive care units in the Pediatric Acute and Critical Care Medicine in Asia Network (PACCMAN) and the Red Colaborativa Pediátrica de Latinoamérica (LARed) in Asia, Latin America, and Europe. The study included children (aged Mención de responsabilidad : Shu-Ling Chong, MD, MPH; Yanan Zhu, PhD; Quan Wang, MD; Paula Caporal, MPH; Juan D. Roa, MD; Freddy Israel Pantoja Chamorro, MD;Thelma Elvira Teran Miranda, MD; Hongxing Dang, MD; Chin Seng Gan, MD; Qalab Abbas, MD; Ivan J. Ardila, MD; Mohannad Ahmad Antar, MD;Jesús A. Domínguez-Rojas, MD; María Miñambres Rodríguez, PhD; Natalia Zita Watzlawik, MD; Natalia Elizabeth Gómez Arriola, MD; Adriana Yock-Corrales, MD;Rubén Eduardo Lasso-Palomino, MD; Ming Mei Xiu, MD; Jacqueline S. M. Ong, MD; Hiroshi Kurosawa, MD; Gabriela Aparicio, MD; Chunfeng Liu, MD;Rujipat Samransamruajkit, MD; Juan C. Jaramillo-Bustamante, MD; Nattachai Anantasit, MD; Yek Kee Chor, MD; Deborah M. Turina, MD; Pei Chuen Lee, MD;Marisol Fonseca Flores, MD; Francisco Javier Pilar Orive, PhD; Jane Ng Pei Wen, BSc; Sebastián González-Dambrauskas, MD; Jan Hau Lee, MCI;for the Pediatric Acute and Critical Care Medicine in Asia Network (PACCMAN) and the Red Colaborativa Pediátrica de Latinoamérica (LARed) Referencia : JAMA Netw Open . 2025 Mar 3;8(3):e250438. DOI (Digital Object Identifier) : 10.1001/jamanetworkopen.2025.0438. PMID : 40067302 Derechos de uso : CC BY-NC-ND En línea : https://pubmed.ncbi.nlm.nih.gov/40067302/ Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Clinical Outcomes of Hypertonic Saline vs Mannitol Treatment Among Children With Traumatic Brain Injury [documento electrónico] / Juan Camilo Jaramillo Bustamante, Autor ; Chong, Shu Ling, Autor ; Zhu, Yanan, Autor ; Wang, Quan, Autor ; Caporal, Paula, Autor ; Roa, Juan D, Autor ; Pantoja Chamorro, Freddy Israel, Autor ; Teran Miranda, Thelma Elvira, Autor ; Dang, Hongxing, Autor ; Seng Gan, Chin, Autor ; Abbas, Qalab, Autor ; Ardila, Ivan J, Autor ; Antar, Mohannad Ahmad, Autor ; Domínguez Rojas, Jesús A, Autor ; Miñambres Rodríguez, María, Autor ; Zita Watzlawik, Natalia, Autor ; Gómez Arriola, Natalia Elizabeth, Autor ; Yock Corrales, Adriana, Autor ; Lasso Palomino, Rubén Eduardo, Autor ; Mei Xiu, Ming, Autor ; S M Ong, Jacqueline, Autor ; Kurosawa, Hiroshi, Autor ; Aparicio, Gabriela, Autor ; Chunfeng Liu, Autor ; Rujipat, Samransamruajkit, Autor ; Nattachai, Anantasit, Autor ; Yek Kee Chor, Autor ; Turina, Deborah M, Autor ; Pei Chuen Lee, Autor ; Fonseca Flores, Marisol, Autor ; Pilar Orive, Francisco Javier, Autor ; Pei Wen, Jane Ng, Autor ; González Dambrauskas, Sebastián, Autor ; Lee, Jan Hau, Autor . - 2025.
Obra : JAMA Network Open
Idioma : Inglés (eng)
Resumen : Importance: The use of hypertonic saline (HTS) vs mannitol in the control of elevated intracranial pressure (ICP) secondary to neurotrauma is debated. Objective: To compare mortality and functional outcomes of treatment with 3% HTS vs 20% mannitol among children with moderate to severe traumatic brain injury (TBI) at risk of elevated ICP. Design, setting, and participants: This prospective, multicenter cohort study was conducted between June 1, 2018, and December 31, 2022, at 28 participating pediatric intensive care units in the Pediatric Acute and Critical Care Medicine in Asia Network (PACCMAN) and the Red Colaborativa Pediátrica de Latinoamérica (LARed) in Asia, Latin America, and Europe. The study included children (aged Mención de responsabilidad : Shu-Ling Chong, MD, MPH; Yanan Zhu, PhD; Quan Wang, MD; Paula Caporal, MPH; Juan D. Roa, MD; Freddy Israel Pantoja Chamorro, MD;Thelma Elvira Teran Miranda, MD; Hongxing Dang, MD; Chin Seng Gan, MD; Qalab Abbas, MD; Ivan J. Ardila, MD; Mohannad Ahmad Antar, MD;Jesús A. Domínguez-Rojas, MD; María Miñambres Rodríguez, PhD; Natalia Zita Watzlawik, MD; Natalia Elizabeth Gómez Arriola, MD; Adriana Yock-Corrales, MD;Rubén Eduardo Lasso-Palomino, MD; Ming Mei Xiu, MD; Jacqueline S. M. Ong, MD; Hiroshi Kurosawa, MD; Gabriela Aparicio, MD; Chunfeng Liu, MD;Rujipat Samransamruajkit, MD; Juan C. Jaramillo-Bustamante, MD; Nattachai Anantasit, MD; Yek Kee Chor, MD; Deborah M. Turina, MD; Pei Chuen Lee, MD;Marisol Fonseca Flores, MD; Francisco Javier Pilar Orive, PhD; Jane Ng Pei Wen, BSc; Sebastián González-Dambrauskas, MD; Jan Hau Lee, MCI;for the Pediatric Acute and Critical Care Medicine in Asia Network (PACCMAN) and the Red Colaborativa Pediátrica de Latinoamérica (LARed) Referencia : JAMA Netw Open . 2025 Mar 3;8(3):e250438. DOI (Digital Object Identifier) : 10.1001/jamanetworkopen.2025.0438. PMID : 40067302 Derechos de uso : CC BY-NC-ND En línea : https://pubmed.ncbi.nlm.nih.gov/40067302/ Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Título : Risk factors and outcomes of pediatric non-invasive respiratory support failure in Latin America Tipo de documento : documento electrónico Autores : Juan Camilo Jaramillo Bustamante, Autor ; Hernán Darío Herrera Salazar, Autor ; Escobar Serna, Diana Paola, Autor ; Barajas Romero, Juan Sebastian, Autor ; Peralta Palmezano, Juan Javier, Autor ; Monteverde Fernandez, Nicolas, Autor ; Serra, Jesus Alberto, Autor ; Caporal, Paula, Autor ; Menta, Soledad, Autor ; Lasso Palomino, Ruben, Autor ; Zemanate, Eliana, Autor ; Martínez, Javier, Autor ; Martínez, Luis, Autor ; Castro Zamorano, Francisca, Autor ; Carvajal, Cristobal, Autor ; Decía, Monica, Autor ; Jabornisky, Roberto, Autor ; Diaz, Franco, Autor ; Gonzalez Dambrauskas, Sebastian, Autor ; Vasquez Hoyos, Pablo, Autor Fecha de publicación : 2025 Títulos uniformes : Journal of Intensive Medicine Idioma : Español (spa) Palabras clave : Continuous positive airway pressure; Noninvasive ventilation; Oxygen therapy; Pediatric intensive care unit; Pediatrics Resumen : Background: Noninvasive respiratory support (NRS) is standard in pediatric intensive care units (PICUs) for respiratory diseases, but its failure can lead to complications requiring invasive mechanical ventilation (IMV). This study aimed to identify risk factors for NRS failure in children with acute respiratory failure (ARF) in PICUs, and compare complications and outcomes between IMV-only and NRS failure patients. Methods: We conducted a cohort study using data from the LARed Network prospective registry (April 2017–November 2022), in children under 18 years admitted to PICUs for ARF. Cases were divided into subgroups: those managed with IMV only, those who experienced NRS failure requiring IMV, those who received NRS successfully, and those who did not require NRS or IMV. Exclusions included patients with home respiratory support prior to admission, patients without PICU discharge at the cutoff date of the analysis and those with incomplete data. Multivariate mixed models analyzed NRS failure risk factors, and complications between the IMV-only and NRS failure groups, using centers as a random effect. Results: A total of 7374 children met the inclusion criteria, with 6208 in the NRS group and 1166 in the IMV-only group. The NRS success rate was 85.3 %. Risk factors for NRS failure included age (median of 4.6 months, interquartile range of 2.1–14.2 months), history of prematurity (adjusted odds ratio [aOR]=1.53, 95 % confidence interval [CI]: 1.20 to 1.95) or malnutrition (aOR=1.85, 95 % CI: 1.18 to 2.91), suspected bacterial infection (aOR=5.12, 95 % CI: 4.05to 6.49), FiO2 >30 % (aOR=1.52, 95 % CI: 1.18 to 1.97), severe hypoxemia with SpO2/FiO2 ?150 (aOR=1.85, 95 % CI: 1.48 to 2.30), tachypnea (aOR=1.42, 95 % CI: 1.18 to 1.72), tachycardia (aOR=1.77, 95 % CI: 1.47 to 2.12), and lung consolidations (aOR=1.45, 95 % CI: 1.14 to 1.85) or interstitial infiltrates (aOR=1.29, 95 % CI: 1.05 to 1.58) on chest X-ray. There were no significant differences in morbidity, mortality, duration of IMV, or PICU length of stay between patients who received IMV only and those who experienced NRS failure. However, patients who experienced NRS failure were more likely to develop withdrawal symptoms related to sedative or opioid discontinuation and/or delirium (aOR=2.57, 95 % CI: 1.85 to 2.57). Conclusion: This study identified key risk factors for predicting NRS failure in children with acute ARF in PICUs, including younger age, prematurity, malnutrition, suspected bacterial infection, FiO2 >30 %, severe hypoxemia (SpO2/FiO2 ?150), tachypnea, tachycardia, and radiological findings such as lung consolidation and interstitial infiltrates. Compared to patients managed with IMV from the start, those who experienced NRS failure were more likely to develop withdrawal symptoms and/or delirium, although clinical outcomes such as mortality, IMV duration, and PICU length of stay were similar in both groups. © 2024 The Author(s) Mención de responsabilidad : Escobar-Serna, Diana Paola; Barajas-Romero, Juan Sebastian; Peralta-Palmezano, Juan Javier; Jaramillo-Bustamante, Juan Camilo; Monteverde-Fernandez, Nicolas; Serra, Jesus Alberto; Caporal, Paula; Menta, Soledad; Lasso-Palomino, Ruben; Zemanate, Eliana; Martínez, Javier; Herrera, Hernan; Martínez, Luis; Zamorano, Francisca Castro; Carvajal, Cristobal; Decía, Monica; Jabornisky, Roberto; Diaz, Franco; Gonzalez-Dambrauskas, Sebastian; Vasquez-Hoyos, Pablo. Referencia : Journal of Intensive Medicine Volume 5, Issue 2, April 2025, Pages 176-184 DOI (Digital Object Identifier) : 10.1016/j.jointm.2024.09.001 Derechos de uso : CC BY-NC-ND En línea : https://pdf.sciencedirectassets.com/778774/1-s2.0-S2667100X25X00025/1-s2.0-S2667 [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Risk factors and outcomes of pediatric non-invasive respiratory support failure in Latin America [documento electrónico] / Juan Camilo Jaramillo Bustamante, Autor ; Hernán Darío Herrera Salazar, Autor ; Escobar Serna, Diana Paola, Autor ; Barajas Romero, Juan Sebastian, Autor ; Peralta Palmezano, Juan Javier, Autor ; Monteverde Fernandez, Nicolas, Autor ; Serra, Jesus Alberto, Autor ; Caporal, Paula, Autor ; Menta, Soledad, Autor ; Lasso Palomino, Ruben, Autor ; Zemanate, Eliana, Autor ; Martínez, Javier, Autor ; Martínez, Luis, Autor ; Castro Zamorano, Francisca, Autor ; Carvajal, Cristobal, Autor ; Decía, Monica, Autor ; Jabornisky, Roberto, Autor ; Diaz, Franco, Autor ; Gonzalez Dambrauskas, Sebastian, Autor ; Vasquez Hoyos, Pablo, Autor . - 2025.
Obra : Journal of Intensive Medicine
Idioma : Español (spa)
Palabras clave : Continuous positive airway pressure; Noninvasive ventilation; Oxygen therapy; Pediatric intensive care unit; Pediatrics Resumen : Background: Noninvasive respiratory support (NRS) is standard in pediatric intensive care units (PICUs) for respiratory diseases, but its failure can lead to complications requiring invasive mechanical ventilation (IMV). This study aimed to identify risk factors for NRS failure in children with acute respiratory failure (ARF) in PICUs, and compare complications and outcomes between IMV-only and NRS failure patients. Methods: We conducted a cohort study using data from the LARed Network prospective registry (April 2017–November 2022), in children under 18 years admitted to PICUs for ARF. Cases were divided into subgroups: those managed with IMV only, those who experienced NRS failure requiring IMV, those who received NRS successfully, and those who did not require NRS or IMV. Exclusions included patients with home respiratory support prior to admission, patients without PICU discharge at the cutoff date of the analysis and those with incomplete data. Multivariate mixed models analyzed NRS failure risk factors, and complications between the IMV-only and NRS failure groups, using centers as a random effect. Results: A total of 7374 children met the inclusion criteria, with 6208 in the NRS group and 1166 in the IMV-only group. The NRS success rate was 85.3 %. Risk factors for NRS failure included age (median of 4.6 months, interquartile range of 2.1–14.2 months), history of prematurity (adjusted odds ratio [aOR]=1.53, 95 % confidence interval [CI]: 1.20 to 1.95) or malnutrition (aOR=1.85, 95 % CI: 1.18 to 2.91), suspected bacterial infection (aOR=5.12, 95 % CI: 4.05to 6.49), FiO2 >30 % (aOR=1.52, 95 % CI: 1.18 to 1.97), severe hypoxemia with SpO2/FiO2 ?150 (aOR=1.85, 95 % CI: 1.48 to 2.30), tachypnea (aOR=1.42, 95 % CI: 1.18 to 1.72), tachycardia (aOR=1.77, 95 % CI: 1.47 to 2.12), and lung consolidations (aOR=1.45, 95 % CI: 1.14 to 1.85) or interstitial infiltrates (aOR=1.29, 95 % CI: 1.05 to 1.58) on chest X-ray. There were no significant differences in morbidity, mortality, duration of IMV, or PICU length of stay between patients who received IMV only and those who experienced NRS failure. However, patients who experienced NRS failure were more likely to develop withdrawal symptoms related to sedative or opioid discontinuation and/or delirium (aOR=2.57, 95 % CI: 1.85 to 2.57). Conclusion: This study identified key risk factors for predicting NRS failure in children with acute ARF in PICUs, including younger age, prematurity, malnutrition, suspected bacterial infection, FiO2 >30 %, severe hypoxemia (SpO2/FiO2 ?150), tachypnea, tachycardia, and radiological findings such as lung consolidation and interstitial infiltrates. Compared to patients managed with IMV from the start, those who experienced NRS failure were more likely to develop withdrawal symptoms and/or delirium, although clinical outcomes such as mortality, IMV duration, and PICU length of stay were similar in both groups. © 2024 The Author(s) Mención de responsabilidad : Escobar-Serna, Diana Paola; Barajas-Romero, Juan Sebastian; Peralta-Palmezano, Juan Javier; Jaramillo-Bustamante, Juan Camilo; Monteverde-Fernandez, Nicolas; Serra, Jesus Alberto; Caporal, Paula; Menta, Soledad; Lasso-Palomino, Ruben; Zemanate, Eliana; Martínez, Javier; Herrera, Hernan; Martínez, Luis; Zamorano, Francisca Castro; Carvajal, Cristobal; Decía, Monica; Jabornisky, Roberto; Diaz, Franco; Gonzalez-Dambrauskas, Sebastian; Vasquez-Hoyos, Pablo. Referencia : Journal of Intensive Medicine Volume 5, Issue 2, April 2025, Pages 176-184 DOI (Digital Object Identifier) : 10.1016/j.jointm.2024.09.001 Derechos de uso : CC BY-NC-ND En línea : https://pdf.sciencedirectassets.com/778774/1-s2.0-S2667100X25X00025/1-s2.0-S2667 [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Título : Transporte terrestre pedia?trico: revisio?n de la literatura y propuesta mnemote?cnica. ¿Co?mo optimizar los recursos? Otros títulos : Pediatric ground transport: A review of the evidence and a mnemonic proposal. How to optimize resources? Tipo de documento : documento electrónico Autores : Juan Camilo Jaramillo Bustamante, Autor ; Vallejo, Sara, Autor ; Builes Arbeláez, Nicole, Autor ; Lopera Sánchez, Natalia, Autor ; Osorio Cadavid, Natalia, Autor Fecha de publicación : 2025 Títulos uniformes : Acta Colombiana de Cuidado Intensivo Idioma : Español (spa) Palabras clave : Pediatría Transporte pediátrico Cuidado crítico Emergencias Resumen : El transporte terrestre de los pacientes pediátricos es un componente vital del sistema de atención de emergencias médicas. Requiere de una integración de los servicios pre-hospitalarios, hospital receptor y centro coordinador, para así maximizar los recursos humanos y materiales, pudiendo incluso brindar desde el ámbito extrahospitalario una atención similar a la de un servicio de urgencias o unidad de cuidados intensivos. En los países de bajos y medianos ingresos, como algunos latinoamericanos, el transporte constituye un reto mayor por múltiples razones como la falta de un sistema de coordinación nacional, la ausencia de prácticas proto-colizadas y las difíciles condiciones topográficas. La identificación y resolución de los desafíos específicos asociados con este tipo de transporte, junto con la implementación de estrategias efectivas, pueden mejorar los resultados y garantizar una atención de calidad. En este artículo se revisarán los desafíos específicos que en Colombia están asociados con el transporte terrestre pediátrico, desde la remisión de un nivel hospitalario de menor a mayor complejidad, incluyendo una evaluación inicial completa, la estabilización del paciente y un transporte seguro hasta el ingreso al servicio objetivo. Por último, se hace una propuesta mnemotécnica para mejorar la calidad a la hora de realizarlo. Mención de responsabilidad : Sara Vallejo a, Nicole Builes Arbélaez, Natalia Osorio Cadavid, Natalia Lopera Sánchez y Juan Camilo Jaramillo Bustamante DOI (Digital Object Identifier) : 10.1016/j.acci.2024.11.006 Derechos de uso : CC BY-NC-ND En línea : https://www.sciencedirect.com/science/article/abs/pii/S0122726224001162?via%3Dih [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Transporte terrestre pedia?trico: revisio?n de la literatura y propuesta mnemote?cnica. ¿Co?mo optimizar los recursos? = Pediatric ground transport: A review of the evidence and a mnemonic proposal. How to optimize resources? [documento electrónico] / Juan Camilo Jaramillo Bustamante, Autor ; Vallejo, Sara, Autor ; Builes Arbeláez, Nicole, Autor ; Lopera Sánchez, Natalia, Autor ; Osorio Cadavid, Natalia, Autor . - 2025.
Obra : Acta Colombiana de Cuidado Intensivo
Idioma : Español (spa)
Palabras clave : Pediatría Transporte pediátrico Cuidado crítico Emergencias Resumen : El transporte terrestre de los pacientes pediátricos es un componente vital del sistema de atención de emergencias médicas. Requiere de una integración de los servicios pre-hospitalarios, hospital receptor y centro coordinador, para así maximizar los recursos humanos y materiales, pudiendo incluso brindar desde el ámbito extrahospitalario una atención similar a la de un servicio de urgencias o unidad de cuidados intensivos. En los países de bajos y medianos ingresos, como algunos latinoamericanos, el transporte constituye un reto mayor por múltiples razones como la falta de un sistema de coordinación nacional, la ausencia de prácticas proto-colizadas y las difíciles condiciones topográficas. La identificación y resolución de los desafíos específicos asociados con este tipo de transporte, junto con la implementación de estrategias efectivas, pueden mejorar los resultados y garantizar una atención de calidad. En este artículo se revisarán los desafíos específicos que en Colombia están asociados con el transporte terrestre pediátrico, desde la remisión de un nivel hospitalario de menor a mayor complejidad, incluyendo una evaluación inicial completa, la estabilización del paciente y un transporte seguro hasta el ingreso al servicio objetivo. Por último, se hace una propuesta mnemotécnica para mejorar la calidad a la hora de realizarlo. Mención de responsabilidad : Sara Vallejo a, Nicole Builes Arbélaez, Natalia Osorio Cadavid, Natalia Lopera Sánchez y Juan Camilo Jaramillo Bustamante DOI (Digital Object Identifier) : 10.1016/j.acci.2024.11.006 Derechos de uso : CC BY-NC-ND En línea : https://www.sciencedirect.com/science/article/abs/pii/S0122726224001162?via%3Dih [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Título : Evaluation of the Utility of the Renal Angina Index for the Early Diagnosis of Severe Acute Kidney Injury in Critically Ill Pediatric Patients in Three Institutions in Low-Resource Country Tipo de documento : documento electrónico Autores : Morantes Florez, Jennifer, Autor ; Juan Camilo Jaramillo Bustamante, Autor ; Fuentes Bernal, Kasey, Autor ; Byron Enrique Piñeres Olave, Autor ; Peña, Oscar, Autor ; Fernández, Mauricio, Autor ; Montoya, Francisco, Autor ; Álvarez, Eliana Maria, Autor Fecha de publicación : 2024 Títulos uniformes : Research Square Idioma : Inglés (eng) Palabras clave : Acute kidney injury creatinine critical care child Resumen : Background: Acute kidney injury (AKI) occurring in up to 30% of children admitted to the intensive care unit. Creatinine is the primary functional marker for AKI; however, its utility in early diagnosis is limited. The renal angina index (RAI) has proven to be an effective predictive model for early injury, with limited evidence in Colombia regarding its performance. Methods: Prospective, analytical, multicenter diagnostic test study in critically ill children in three pediatric intensive care units (PICUs) in Medellín, Colombia. We assess the diagnostic utility of the positive RAI as an early predictor of severe AKI. Results: Between August 2022 and February 2023, 191 patients were analyzed. The incidence of AKI was 12.5/100 patients, 26% exhibited a positive RAI, 12.6% developed severe AKI at 72 hours. Among RAI-positive patients when comparing with negative, 75% experienced severe AKI (RR 3.23; 95% CI 1.61-6.49), 14% required renal support therapy (RR 2.09; 95% CI 0.95-4.59), and 8% died within 28 days (p=0.964). The sensitivity of RAI for early diagnosis of severe AKI was 85.71%, specificity 78.3%, PPV 24%, NPV 98.5%, AUC 0.812 (95% CI 0.72-0.92). To the patients with a doubled baseline creatinine, 33% developed AKI at 72 hours (RR 1.45; 95% CI 1.09-1.92). Conclusions: The RAI proved to be a marker for early prediction of severe AKI in critically ill children, potentially serving as a useful tool to improve outcomes related to the presence of AKI compared to the isolated use of creatinine. Mención de responsabilidad : Jennifer Morantes Flórez, Kasey Fuentes Bernal, Byron Piñeres-Olave, Oscar Peña, Mauricio Fernandez, Francisco Montoya, Eliana Maria Alvarez, Juan Camilo Jaramillo-Bustamante DOI (Digital Object Identifier) : 10.21203/rs.3.rs-3930475/v1 Derechos de uso : CC BY En línea : https://www.researchsquare.com/article/rs-3930475/v1 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Evaluation of the Utility of the Renal Angina Index for the Early Diagnosis of Severe Acute Kidney Injury in Critically Ill Pediatric Patients in Three Institutions in Low-Resource Country [documento electrónico] / Morantes Florez, Jennifer, Autor ; Juan Camilo Jaramillo Bustamante, Autor ; Fuentes Bernal, Kasey, Autor ; Byron Enrique Piñeres Olave, Autor ; Peña, Oscar, Autor ; Fernández, Mauricio, Autor ; Montoya, Francisco, Autor ; Álvarez, Eliana Maria, Autor . - 2024.
Obra : Research Square
Idioma : Inglés (eng)
Palabras clave : Acute kidney injury creatinine critical care child Resumen : Background: Acute kidney injury (AKI) occurring in up to 30% of children admitted to the intensive care unit. Creatinine is the primary functional marker for AKI; however, its utility in early diagnosis is limited. The renal angina index (RAI) has proven to be an effective predictive model for early injury, with limited evidence in Colombia regarding its performance. Methods: Prospective, analytical, multicenter diagnostic test study in critically ill children in three pediatric intensive care units (PICUs) in Medellín, Colombia. We assess the diagnostic utility of the positive RAI as an early predictor of severe AKI. Results: Between August 2022 and February 2023, 191 patients were analyzed. The incidence of AKI was 12.5/100 patients, 26% exhibited a positive RAI, 12.6% developed severe AKI at 72 hours. Among RAI-positive patients when comparing with negative, 75% experienced severe AKI (RR 3.23; 95% CI 1.61-6.49), 14% required renal support therapy (RR 2.09; 95% CI 0.95-4.59), and 8% died within 28 days (p=0.964). The sensitivity of RAI for early diagnosis of severe AKI was 85.71%, specificity 78.3%, PPV 24%, NPV 98.5%, AUC 0.812 (95% CI 0.72-0.92). To the patients with a doubled baseline creatinine, 33% developed AKI at 72 hours (RR 1.45; 95% CI 1.09-1.92). Conclusions: The RAI proved to be a marker for early prediction of severe AKI in critically ill children, potentially serving as a useful tool to improve outcomes related to the presence of AKI compared to the isolated use of creatinine. Mención de responsabilidad : Jennifer Morantes Flórez, Kasey Fuentes Bernal, Byron Piñeres-Olave, Oscar Peña, Mauricio Fernandez, Francisco Montoya, Eliana Maria Alvarez, Juan Camilo Jaramillo-Bustamante DOI (Digital Object Identifier) : 10.21203/rs.3.rs-3930475/v1 Derechos de uso : CC BY En línea : https://www.researchsquare.com/article/rs-3930475/v1 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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