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The Respiratory Rate-Oxygenation Index predicts failure of post-extubation high-flow nasal cannula therapy in intensive care unit patients: a retrospective cohort study / Santiago Cardona Marín
Título : The Respiratory Rate-Oxygenation Index predicts failure of post-extubation high-flow nasal cannula therapy in intensive care unit patients: a retrospective cohort study Tipo de documento : documento electrónico Autores : Santiago Cardona Marín, Autor asociado al HPTU Fecha de publicación : 2022 Títulos uniformes : Revista Brasileira de Terapia Intensiva Idioma : Inglés (eng) Palabras clave : Cannula Oxygenation Respiratory rate Airway extubation Pneumonia Critical care Intensive care units Resumen : Objective: To investigate the applicability of the Respiratory Rate-Oxygenation Index to identify the risk of high-flow nasal cannula failure in post-extubation pneumonia patients. Methods: This was a 2-year retrospective observational study conducted in a reference hospital in Bogotá, Colombia. All patients in whom post-extubation high-flow nasal cannula therapy was used as a bridge to extubation were included in the study. The Respiratory Rate-Oxygenation Index was calculated to assess the risk of post-extubation high-flow nasal cannula failure. Results: A total of 162 patients were included in the study. Of these, 23.5% developed high-flow nasal cannula failure. The Respiratory Rate-Oxygenation Index was significantly lower in patients who had high-flow nasal cannula failure [median (IQR): 10.0 (7.7 - 14.4) versus 12.6 (10.1 - 15.6); p = 0.006]. Respiratory Rate-Oxygenation Index > 4.88 showed a crude OR of 0.23 (95%CI 0.17 - 0.30) and an adjusted OR of 0.89 (95%CI 0.81 - 0.98) stratified by severity and comorbidity. After logistic regression analysis, the Respiratory Rate-Oxygenation Index had an adjusted OR of 0.90 (95%CI 0.82 - 0.98; p = 0.026). The area under the Receiver Operating Characteristic curve for extubation failure was 0.64 (95%CI 0.53 - 0.75; p = 0.06). The Respiratory Rate-Oxygenation Index did not show differences between patients who survived and those who died during the intensive care unit stay. Conclusion: The Respiratory Rate-Oxygenation Index is an accessible tool to identify patients at risk of failing high-flow nasal cannula post-extubation treatment. Prospective studies are needed to broaden the utility in this scenario. Mención de responsabilidad : Yuli V. Fuentes, Katherine Carvajal, Santiago Cardona, Gina Sofia Montaño, Elsa D. Ibáñez-Prada, Alirio Bastidas, Eder Caceres, Ricardo Buitrago, Marcela Poveda, Luis Felipe Reyes Referencia : Rev Bras Ter Intensiva. 2022 Sep 19;34(3):360-366. DOI (Digital Object Identifier) : 10.5935/0103-507X.20220477-en PMID : 36134847 Derechos de uso : CC BY En línea : http://rbti.org.br/artigo/detalhes/0103507X-34-3-8 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis The Respiratory Rate-Oxygenation Index predicts failure of post-extubation high-flow nasal cannula therapy in intensive care unit patients: a retrospective cohort study [documento electrónico] / Santiago Cardona Marín, Autor asociado al HPTU . - 2022.
Obra : Revista Brasileira de Terapia Intensiva
Idioma : Inglés (eng)
Palabras clave : Cannula Oxygenation Respiratory rate Airway extubation Pneumonia Critical care Intensive care units Resumen : Objective: To investigate the applicability of the Respiratory Rate-Oxygenation Index to identify the risk of high-flow nasal cannula failure in post-extubation pneumonia patients. Methods: This was a 2-year retrospective observational study conducted in a reference hospital in Bogotá, Colombia. All patients in whom post-extubation high-flow nasal cannula therapy was used as a bridge to extubation were included in the study. The Respiratory Rate-Oxygenation Index was calculated to assess the risk of post-extubation high-flow nasal cannula failure. Results: A total of 162 patients were included in the study. Of these, 23.5% developed high-flow nasal cannula failure. The Respiratory Rate-Oxygenation Index was significantly lower in patients who had high-flow nasal cannula failure [median (IQR): 10.0 (7.7 - 14.4) versus 12.6 (10.1 - 15.6); p = 0.006]. Respiratory Rate-Oxygenation Index > 4.88 showed a crude OR of 0.23 (95%CI 0.17 - 0.30) and an adjusted OR of 0.89 (95%CI 0.81 - 0.98) stratified by severity and comorbidity. After logistic regression analysis, the Respiratory Rate-Oxygenation Index had an adjusted OR of 0.90 (95%CI 0.82 - 0.98; p = 0.026). The area under the Receiver Operating Characteristic curve for extubation failure was 0.64 (95%CI 0.53 - 0.75; p = 0.06). The Respiratory Rate-Oxygenation Index did not show differences between patients who survived and those who died during the intensive care unit stay. Conclusion: The Respiratory Rate-Oxygenation Index is an accessible tool to identify patients at risk of failing high-flow nasal cannula post-extubation treatment. Prospective studies are needed to broaden the utility in this scenario. Mención de responsabilidad : Yuli V. Fuentes, Katherine Carvajal, Santiago Cardona, Gina Sofia Montaño, Elsa D. Ibáñez-Prada, Alirio Bastidas, Eder Caceres, Ricardo Buitrago, Marcela Poveda, Luis Felipe Reyes Referencia : Rev Bras Ter Intensiva. 2022 Sep 19;34(3):360-366. DOI (Digital Object Identifier) : 10.5935/0103-507X.20220477-en PMID : 36134847 Derechos de uso : CC BY En línea : http://rbti.org.br/artigo/detalhes/0103507X-34-3-8 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001952 AC-2022-113 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
AC-2022-113Adobe Acrobat PDF Damage control approach to refractory neurogenic shock: a new proposal to a well-established algorithm / David Alejandro Mejía Toro
Título : Damage control approach to refractory neurogenic shock: a new proposal to a well-established algorithm Otros títulos : El control de daños en el choque neurogénico refractario: propuesta de un nuevo algoritmo de manejo Tipo de documento : documento electrónico Autores : David Alejandro Mejía Toro, Autor asociado al HPTU Fecha de publicación : 2021 Títulos uniformes : Colombia Médica Idioma : Inglés (eng) Palabras clave : Hemorrhagic Shock Hypovolemia Spinal Cord Injuries Balloon Occlusion Spinal Cord Ischemia Intensive Care Units REBOA Damage control surgery Resumen : Resuscitative endovascular balloon occlusion of the aorta (REBOA) is commonly used as an adjunct to resuscitation and bridge to definitive control of non-compressible torso hemorrhage in patients with hemorrhagic shock. It has also been performed for patients with neurogenic shock to support the central aortic pressure necessary for cerebral, coronary and spinal cord perfusion. Although volume replacement and vasopressors are the cornerstones of the management of neurogenic shock, we believe that a REBOA can be used as an adjunct in carefully selected cases to prevent prolonged hypotension and the risk of further anoxic spinal cord injury. This manuscript aims to propose a new damage control algorithmic approach to refractory neurogenic shock that includes the use of a REBOA in Zone 3. There are still unanswered questions on spinal cord perfusion and functional outcomes using a REBOA in Zone 3 in trauma patients with refractory neurogenic shock. However, we believe that its use in these case scenarios can be beneficial to the overall outcome of these patients. Mención de responsabilidad : Michael W. Parra, Carlos A. Ordoñez, David Mejia, Yaset Caicedo, Javier Mauricio Lobato, Oscar Javier Castro, Jose Alfonso Uribe, Fernando Velásquez Referencia : Colomb Med (Cali). 2021 Jun 30;52(2):e4164800. DOI (Digital Object Identifier) : 10.25100/cm.v52i2.4800 PMID : 34908624 Derechos de uso : CC BY-NC-ND En línea : https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/4800 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Damage control approach to refractory neurogenic shock: a new proposal to a well-established algorithm = El control de daños en el choque neurogénico refractario: propuesta de un nuevo algoritmo de manejo [documento electrónico] / David Alejandro Mejía Toro, Autor asociado al HPTU . - 2021.
Obra : Colombia Médica
Idioma : Inglés (eng)
Palabras clave : Hemorrhagic Shock Hypovolemia Spinal Cord Injuries Balloon Occlusion Spinal Cord Ischemia Intensive Care Units REBOA Damage control surgery Resumen : Resuscitative endovascular balloon occlusion of the aorta (REBOA) is commonly used as an adjunct to resuscitation and bridge to definitive control of non-compressible torso hemorrhage in patients with hemorrhagic shock. It has also been performed for patients with neurogenic shock to support the central aortic pressure necessary for cerebral, coronary and spinal cord perfusion. Although volume replacement and vasopressors are the cornerstones of the management of neurogenic shock, we believe that a REBOA can be used as an adjunct in carefully selected cases to prevent prolonged hypotension and the risk of further anoxic spinal cord injury. This manuscript aims to propose a new damage control algorithmic approach to refractory neurogenic shock that includes the use of a REBOA in Zone 3. There are still unanswered questions on spinal cord perfusion and functional outcomes using a REBOA in Zone 3 in trauma patients with refractory neurogenic shock. However, we believe that its use in these case scenarios can be beneficial to the overall outcome of these patients. Mención de responsabilidad : Michael W. Parra, Carlos A. Ordoñez, David Mejia, Yaset Caicedo, Javier Mauricio Lobato, Oscar Javier Castro, Jose Alfonso Uribe, Fernando Velásquez Referencia : Colomb Med (Cali). 2021 Jun 30;52(2):e4164800. DOI (Digital Object Identifier) : 10.25100/cm.v52i2.4800 PMID : 34908624 Derechos de uso : CC BY-NC-ND En línea : https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/4800 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001763 AC-2021-079 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
2021-079Adobe Acrobat PDF
Título : Reinterventions after damage control surgery Otros títulos : Reintervención en cirugía de control de daños Tipo de documento : documento electrónico Autores : David Alejandro Mejía Toro, Autor asociado al HPTU ; Salín Pereira Warr, Autor asociado al HPTU Fecha de publicación : 2021 Títulos uniformes : Colombia Médica Idioma : Inglés (eng) Palabras clave : Laparotomy Ostomy Thoracic Cavity Anastomosis Surgical Postoperative Period Cardiac Surgical Procedures Intensive Care Units Surgical Wound Infection Colostomy Abdominal Wall Reoperation Intra-Abdominal Hypertension Resumen : Damage control has well-defined steps. However, there are still controversies regarding whom, when, and how re-interventions should be performed. This article summarizes the Trauma and Emergency Surgery Group (CTE) Cali-Colombia recommendations about the specific situations concerning second interventions of patients undergoing damage control surgery. We suggest packing as the preferred bleeding control strategy, followed by unpacking within the next 48-72 hours. In addition, a deferred anastomosis is recommended for correction of intestinal lesions, and patients treated with vascular shunts should be re-intervened within 24 hours for definitive management. Furthermore, abdominal or thoracic wall closure should be attempted within eight days. These strategies aim to decrease complications, morbidity, and mortality. Mención de responsabilidad : Mejia, D., Pereira-Warr, S., Delgado-Lopez, C., Salcedo, A., Rodriguez-Holguín, F., Serna, J. J., Caicedo, Y., Pino, L. F., Gonzalez Hadad, A., Herrera, M. A., Parra, M., García, A., & Ordoñez, C. A. Referencia : Colomb Med (Cali). 2021 Jun 30;52(2):e4154805. DOI (Digital Object Identifier) : 10.25100/cm.v52i2.4805 PMID : 34908623 Derechos de uso : CC BY-NC En línea : https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/4805 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reinterventions after damage control surgery = Reintervención en cirugía de control de daños [documento electrónico] / David Alejandro Mejía Toro, Autor asociado al HPTU ; Salín Pereira Warr, Autor asociado al HPTU . - 2021.
Obra : Colombia Médica
Idioma : Inglés (eng)
Palabras clave : Laparotomy Ostomy Thoracic Cavity Anastomosis Surgical Postoperative Period Cardiac Surgical Procedures Intensive Care Units Surgical Wound Infection Colostomy Abdominal Wall Reoperation Intra-Abdominal Hypertension Resumen : Damage control has well-defined steps. However, there are still controversies regarding whom, when, and how re-interventions should be performed. This article summarizes the Trauma and Emergency Surgery Group (CTE) Cali-Colombia recommendations about the specific situations concerning second interventions of patients undergoing damage control surgery. We suggest packing as the preferred bleeding control strategy, followed by unpacking within the next 48-72 hours. In addition, a deferred anastomosis is recommended for correction of intestinal lesions, and patients treated with vascular shunts should be re-intervened within 24 hours for definitive management. Furthermore, abdominal or thoracic wall closure should be attempted within eight days. These strategies aim to decrease complications, morbidity, and mortality. Mención de responsabilidad : Mejia, D., Pereira-Warr, S., Delgado-Lopez, C., Salcedo, A., Rodriguez-Holguín, F., Serna, J. J., Caicedo, Y., Pino, L. F., Gonzalez Hadad, A., Herrera, M. A., Parra, M., García, A., & Ordoñez, C. A. Referencia : Colomb Med (Cali). 2021 Jun 30;52(2):e4154805. DOI (Digital Object Identifier) : 10.25100/cm.v52i2.4805 PMID : 34908623 Derechos de uso : CC BY-NC En línea : https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/4805 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001755 AC-2021-071 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
2021-071Adobe Acrobat PDF Prediction of prolonged mechanical ventilation for intensive care unit patients: A cohort study / Álvaro Enrique Sanabria Quiroga
Título : Prediction of prolonged mechanical ventilation for intensive care unit patients: A cohort study Otros títulos : Predicción de la ventilación mecánica prolongada en pacientes de la unidad de cuidado intensivo: Estudio de cohorte Tipo de documento : documento electrónico Autores : Álvaro Enrique Sanabria Quiroga, Autor asociado al HPTU Fecha de publicación : 2013 Títulos uniformes : Colombia Médica Idioma : Inglés (eng) Palabras clave : tracheostomy artificial respiration intensive care units ventilator weaning intratracheal intubation risk factors Resumen : Introduction: There are no established guidelines for selecting patients for early tracheostomy. The aim was to determine the factors that could predict the possibility of intubation longer than 7 days in critically ill adult patients. Methods: This is cohort study made at a general intensive care unit. Patients who required at least 48 hours of mechanical ventilation were included. Data on the clinical and physiologic features were collected for every intubated patient on the third day. Uni- and multivariate statistical analyses were conducted to determine the variables associated with extubation. Results: 163 (62%) were male, and the median age was 59±17 years. Almost one-third (36%) of patients required mechanical ventilation longer than 7 days. The variables strongly associated with prolonged mechanical ventilation were: age (HR 0.97 (95% CI 0.96-0.99); diagnosis of surgical emergency in a patient with a medical condition (HR 3.68 (95% CI 1.62-8.35), diagnosis of surgical condition-non emergency (HR 8.17 (95% CI 2.12-31.3); diagnosis of non-surgical-medical condition (HR 5.26 (95% CI 1.85-14.9); APACHE II (HR 0.91 (95% CI 0.85-0.97) and SAPS II score (HR 1.04 (95% CI 1.00-1.09) The area under ROC curve used for prediction was 0.52. 16% of patients were extubated after day 8 of intubation. Conclusions: It was not possible to predict early extubation in critically ill adult patients with invasive mechanical ventilation with common clinical scales used at the ICU. However, the probability of successfully weaning patients from mechanical ventilation without a tracheostomy is low after the eighth day of intubation. Mención de responsabilidad : Alvaro Sanabria, Ximena Gomez, Valentin Vega, Luis Carlos Dominguez, Camilo Osorio DOI (Digital Object Identifier) : 10.25100/cm.v44i3.1285 Derechos de uso : CC BY-NC-ND En línea : https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/1285 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Prediction of prolonged mechanical ventilation for intensive care unit patients: A cohort study = Predicción de la ventilación mecánica prolongada en pacientes de la unidad de cuidado intensivo: Estudio de cohorte [documento electrónico] / Álvaro Enrique Sanabria Quiroga, Autor asociado al HPTU . - 2013.
Obra : Colombia Médica
Idioma : Inglés (eng)
Palabras clave : tracheostomy artificial respiration intensive care units ventilator weaning intratracheal intubation risk factors Resumen : Introduction: There are no established guidelines for selecting patients for early tracheostomy. The aim was to determine the factors that could predict the possibility of intubation longer than 7 days in critically ill adult patients. Methods: This is cohort study made at a general intensive care unit. Patients who required at least 48 hours of mechanical ventilation were included. Data on the clinical and physiologic features were collected for every intubated patient on the third day. Uni- and multivariate statistical analyses were conducted to determine the variables associated with extubation. Results: 163 (62%) were male, and the median age was 59±17 years. Almost one-third (36%) of patients required mechanical ventilation longer than 7 days. The variables strongly associated with prolonged mechanical ventilation were: age (HR 0.97 (95% CI 0.96-0.99); diagnosis of surgical emergency in a patient with a medical condition (HR 3.68 (95% CI 1.62-8.35), diagnosis of surgical condition-non emergency (HR 8.17 (95% CI 2.12-31.3); diagnosis of non-surgical-medical condition (HR 5.26 (95% CI 1.85-14.9); APACHE II (HR 0.91 (95% CI 0.85-0.97) and SAPS II score (HR 1.04 (95% CI 1.00-1.09) The area under ROC curve used for prediction was 0.52. 16% of patients were extubated after day 8 of intubation. Conclusions: It was not possible to predict early extubation in critically ill adult patients with invasive mechanical ventilation with common clinical scales used at the ICU. However, the probability of successfully weaning patients from mechanical ventilation without a tracheostomy is low after the eighth day of intubation. Mención de responsabilidad : Alvaro Sanabria, Ximena Gomez, Valentin Vega, Luis Carlos Dominguez, Camilo Osorio DOI (Digital Object Identifier) : 10.25100/cm.v44i3.1285 Derechos de uso : CC BY-NC-ND En línea : https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/1285 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001026 AC-2013-113 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
2013-113.pdfAdobe Acrobat PDF