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Post-COVID-19 necrotizing pneumonia in patients on invasive mechanical ventilation / Alicia Inés Hidrón Botero
Título : Post-COVID-19 necrotizing pneumonia in patients on invasive mechanical ventilation Tipo de documento : documento electrónico Autores : Alicia Inés Hidrón Botero, Fecha de publicación : 2021 Títulos uniformes : Infectious Disease Reports Idioma : Inglés (eng) Palabras clave : necrotizing pneumonia critically ill COVID-19 mechanical ventilation pulmonary embolism Resumen : (1) Background: Few reports of necrotizing pneumonia in patients with COVID-19 have been published. We have observed an elevated incidence at two hospitals in our city, suggesting this complication is not uncommon, and may have been overlooked. (2) Methods: This article presents a retrospective, descriptive cohort study that was undertaken from 22 March 2020 to 15 June 2021 in two tertiary care hospitals in Medellín, Colombia. All adult patients admitted to the intensive care unit (ICU) for respiratory failure related to confirmed COVID-19, on invasive mechanical ventilation (IMV), with imaging or surgical findings documenting necrotizing pneumonia (NP) were included. (3) Results: Of 936 patients with COVID-19 that required IMV, 42 (4.5%) developed NP. Overall mortality was 57% and in-hospital mortality was 71%, occurring 15–79 days after COVID-19 diagnosis. NP was diagnosed at a median of 27 days after COVID-19 symptom onset and 15.5 days after initiation of IMV. Infections were polymicrobial in 52.4% of patients. Klebsiella pneumoniae (57%) and Pseudomonas aeruginosa (33%) were the most common etiologic agents. Pulmonary embolism (PE) was documented in 13 patients overall (31%), and in 50% of patients who underwent an angioCT. Drainage and/or surgical procedures were performed on 19 patients (45.2%) with a 75% mortality rate. (4) Conclusions: In our experience, NP is a relatively common, albeit neglected, complication in mechanically ventilated COVID-19 patients, possibly originating in poorly vascularized areas of lung parenchyma. Associated mortality is high. Although drainage procedures did not seem to favorably impact patient outcomes, diagnosis and treatment were late events in the overall disease course, suggesting that early recognition and timely treatment could have a positive impact on prognosis. Mención de responsabilidad : Alicia Hidron,William Quiceno, John J. Cardeño, Gustavo Roncancio and Cristian García Referencia : Infect Dis Rep. 2021 Sep 8;13(3):835-842. DOI (Digital Object Identifier) : 10.3390/idr13030075 PMID : 34563000 Derechos de uso : CC BY En línea : https://www.mdpi.com/2036-7449/13/3/75 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5854 Post-COVID-19 necrotizing pneumonia in patients on invasive mechanical ventilation [documento electrónico] / Alicia Inés Hidrón Botero, . - 2021.
Obra : Infectious Disease Reports
Idioma : Inglés (eng)
Palabras clave : necrotizing pneumonia critically ill COVID-19 mechanical ventilation pulmonary embolism Resumen : (1) Background: Few reports of necrotizing pneumonia in patients with COVID-19 have been published. We have observed an elevated incidence at two hospitals in our city, suggesting this complication is not uncommon, and may have been overlooked. (2) Methods: This article presents a retrospective, descriptive cohort study that was undertaken from 22 March 2020 to 15 June 2021 in two tertiary care hospitals in Medellín, Colombia. All adult patients admitted to the intensive care unit (ICU) for respiratory failure related to confirmed COVID-19, on invasive mechanical ventilation (IMV), with imaging or surgical findings documenting necrotizing pneumonia (NP) were included. (3) Results: Of 936 patients with COVID-19 that required IMV, 42 (4.5%) developed NP. Overall mortality was 57% and in-hospital mortality was 71%, occurring 15–79 days after COVID-19 diagnosis. NP was diagnosed at a median of 27 days after COVID-19 symptom onset and 15.5 days after initiation of IMV. Infections were polymicrobial in 52.4% of patients. Klebsiella pneumoniae (57%) and Pseudomonas aeruginosa (33%) were the most common etiologic agents. Pulmonary embolism (PE) was documented in 13 patients overall (31%), and in 50% of patients who underwent an angioCT. Drainage and/or surgical procedures were performed on 19 patients (45.2%) with a 75% mortality rate. (4) Conclusions: In our experience, NP is a relatively common, albeit neglected, complication in mechanically ventilated COVID-19 patients, possibly originating in poorly vascularized areas of lung parenchyma. Associated mortality is high. Although drainage procedures did not seem to favorably impact patient outcomes, diagnosis and treatment were late events in the overall disease course, suggesting that early recognition and timely treatment could have a positive impact on prognosis. Mención de responsabilidad : Alicia Hidron,William Quiceno, John J. Cardeño, Gustavo Roncancio and Cristian García Referencia : Infect Dis Rep. 2021 Sep 8;13(3):835-842. DOI (Digital Object Identifier) : 10.3390/idr13030075 PMID : 34563000 Derechos de uso : CC BY En línea : https://www.mdpi.com/2036-7449/13/3/75 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5854 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001792 AC-2021-104 Archivo digital Producción Científica Artículos científicos Disponible Development of a predictive model for Extubation Failure in weaning from mechanical ventilation: A retrospective cohort study / Fabián Alberto Jaimes Barragán
Título : Development of a predictive model for Extubation Failure in weaning from mechanical ventilation: A retrospective cohort study Tipo de documento : documento electrónico Autores : Fabián Alberto Jaimes Barragán, Fecha de publicación : 2017 Títulos uniformes : Trends in Anaesthesia and Critical Care Idioma : Inglés (eng) Palabras clave : Respiratory insufficiency Weaning Endotracheal intubation Extubation failure Mechanical ventilation Intensive care unit Resumen : Introduction: Extubation failure (EF) occurs in 2–25% of ICU patients. Our objective was to develop an EF predictive model. Methods: We performed a retrospective cohort study in a medical-surgical ICU with 40 beds at a University Hospital. Were analyzed 1017 patients, from January 2010 to December 2014, all over 16 years old, undergoing invasive ventilation for more than 24 h, and successful spontaneous breathing test (SBT). Seventeen variables were evaluated; we utilized logistic regression analysis with an evaluation of discrimination and calibration based on the area under the ROC curve (AUC-ROC) and the Hosmer-Lemeshow's goodness-of-fit test (Chi2 H-L), respectively. Results: Extubation failure was present in 157 patients (15.4%); we developed a predictive model that included PaO2/FIO2 ratio ≤ 237.5, hemoglobin ≤9.5 g, accumulated fluid balance > 6022 ml, APACHE II > 16, blood urea nitrogen > 22.5 mg/dl and the presence of cardiopulmonary diagnostics. This model exhibited an AUC-ROC = 0.689 and a Chi2 H-L, p = 0.579. Conclusion: This study presents a risk score with an estimated probability of EF based on a multivariate predictive model. Due to the strong limitation of our retrospective study, however, it is necessary for an independent prospective cohort to improve discrimination and to prove the model applicability. Mención de responsabilidad : Jorge Eliécer Sará-Ochoa, Olga Helena Hernández Ortíz y Fabián Alberto Jaimes DOI (Digital Object Identifier) : 10.1016/j.tacc.2017.10.060 En línea : https://linkinghub.elsevier.com/retrieve/pii/S2210844017301144 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4673 Development of a predictive model for Extubation Failure in weaning from mechanical ventilation: A retrospective cohort study [documento electrónico] / Fabián Alberto Jaimes Barragán, . - 2017.
Obra : Trends in Anaesthesia and Critical Care
Idioma : Inglés (eng)
Palabras clave : Respiratory insufficiency Weaning Endotracheal intubation Extubation failure Mechanical ventilation Intensive care unit Resumen : Introduction: Extubation failure (EF) occurs in 2–25% of ICU patients. Our objective was to develop an EF predictive model. Methods: We performed a retrospective cohort study in a medical-surgical ICU with 40 beds at a University Hospital. Were analyzed 1017 patients, from January 2010 to December 2014, all over 16 years old, undergoing invasive ventilation for more than 24 h, and successful spontaneous breathing test (SBT). Seventeen variables were evaluated; we utilized logistic regression analysis with an evaluation of discrimination and calibration based on the area under the ROC curve (AUC-ROC) and the Hosmer-Lemeshow's goodness-of-fit test (Chi2 H-L), respectively. Results: Extubation failure was present in 157 patients (15.4%); we developed a predictive model that included PaO2/FIO2 ratio ≤ 237.5, hemoglobin ≤9.5 g, accumulated fluid balance > 6022 ml, APACHE II > 16, blood urea nitrogen > 22.5 mg/dl and the presence of cardiopulmonary diagnostics. This model exhibited an AUC-ROC = 0.689 and a Chi2 H-L, p = 0.579. Conclusion: This study presents a risk score with an estimated probability of EF based on a multivariate predictive model. Due to the strong limitation of our retrospective study, however, it is necessary for an independent prospective cohort to improve discrimination and to prove the model applicability. Mención de responsabilidad : Jorge Eliécer Sará-Ochoa, Olga Helena Hernández Ortíz y Fabián Alberto Jaimes DOI (Digital Object Identifier) : 10.1016/j.tacc.2017.10.060 En línea : https://linkinghub.elsevier.com/retrieve/pii/S2210844017301144 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4673 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001153 AC-2017-107 Archivo digital Producción Científica Artículos científicos Disponible